Alopecia areata (patchy hair loss)

What is alopecia areata?

Also known as patchy or areata hair loss, it is a condition where hair falls out, resulting in clearly defined bald patches on the skin of the scalp or body. That’s where the name “areata” (patchy) comes from. There are many possible causes, but the main ones are:

• autoimmune disease
• genetic predisposition

This condition can affect men, women, and even children.

Alopecia areata is not just about hair loss — it’s a signal from your body that something has gone wrong.

The first thing a person usually notices is the sudden appearance of one or more hairless patches (lesions). These areas are typically well-defined, round or oval in shape, and can appear anywhere — most often on the scalp, but sometimes on the beard, eyebrows, or body.

At the initial stage, the skin in the bald area appears smooth, with no signs of inflammation, flaking, or pain. However, exceptions may occur, and the following symptoms can be present:

• itching, tingling, or burning sensation in the affected area
• redness of the skin (rare)
• brittleness and deformation of the nails (pitting, ridges, rough surface)
• gradual enlargement of the patch or appearance of new ones

Alopecia areata can progress differently in each person:

• in some, it remains limited to a single spot and resolves on its own
• in others, it spreads and affects more and more areas

In any case, you shouldn’t hope it will go away by itself. As soon as you notice any signs, consult a dermatologist or trichologist without delay.

Why does hair stop growing in certain areas of the body? In reality, alopecia areata is not a single specific disease, but the result of a range of possible disorders.

Here are the most common causes:

• Autoimmune reactions. The immune system mistakenly attacks hair follicles, perceiving them as a threat.
• Genetic predisposition. In some patients, a hereditary factor is involved — that is, someone in the family has had similar symptoms.
• Psycho-emotional stress. Emotional trauma, prolonged tension, or burnout can all act as triggers.
• Hormonal imbalances. Especially dysfunctions of the thyroid gland or adrenal glands.
• Infections. Some viral or bacterial illnesses may provoke hair loss.
• Deficiencies. A lack of iron, vitamin D, zinc, biotin, and other nutrients affects hair health.
• Mechanical or chemical damage to the scalp.

Only a qualified specialist can determine the exact cause and make an accurate diagnosis after a consultation, physical examination, and medical history review. Do not self-medicate — make an appointment with a doctor right away.

Alopecia areata (patchy hair loss) appears the same in both men and women — clearly defined bald patches on the scalp or face. However, despite the similar symptoms, there are some differences in how the condition presents and progresses.

In women, alopecia areata often develops against the background of hormonal or autoimmune disorders, most commonly due to thyroid dysfunction. This condition is frequently accompanied by changes in the nails, such as ridges or pitting.

Hair thinning patches in women may appear:

• along the part line,
• on the temples,
• or at the back of the head.

Although these signs may be difficult to detect at first, their presence can significantly affect a woman’s emotional well-being. On the bright side, many women respond better to treatment and achieve remission more quickly.

In men, alopecia areata can appear at an earlier age. The patches most commonly form:

• on the crown,
• at the back of the head,
• or in the beard area.

In some male patients, the condition can take a more aggressive form, with multiple patches merging together.

Men are less likely to see a doctor right away, often mistaking alopecia areata for normal hair thinning. As a result, treatment may begin later — and in such cases, timing is crucial.

Regardless of gender, the most important thing is to seek help from a qualified specialist, determine the underlying cause, and start treatment early. This is key to successful recovery.

In childhood, hair loss is not always a sign of illness.

In infants, hair may fall out due to friction against a pillow, and in school-age children — due to tight hairstyles or the habit of pulling out their own hair. These conditions are often mistaken for alopecia areata, although the causes are entirely different.

However, true patchy alopecia can also occur in children.

It usually presents the same way as in adults:

• clearly defined patches of hair loss appear,
• the skin is smooth, without itching or flaking,
• sometimes nail changes also occur.

Triggers can include stress, immune system dysfunction, micronutrient deficiencies, or hormonal imbalances during growth periods.

It’s important not to guess — show your child to a specialist.

Only a doctor can distinguish between temporary hair loss and a condition that requires treatment.

Patchy (alopecia areata) hair loss can be caused by various factors. That’s why self-diagnosis isn’t advisable — it’s essential to undergo an examination by a specialist. Proper diagnostics help identify the underlying cause of hair loss and determine how to treat it effectively.

What does the doctor do?

Scalp examination

A trichologist evaluates the shape, size, and location of the bald patches, as well as the condition of the scalp and hair along the edges of the affected area. This helps rule out fungal, inflammatory, or mechanical causes of hair loss.

Trichoscopy

Using a special device (a trichoscope), the doctor closely examines the affected area. This helps detect specific signs characteristic of alopecia areata.

Laboratory tests

Typically, the following tests are ordered:

• complete blood count;
• iron and ferritin levels;
• vitamin D;
• thyroid hormones (TSH, T3, T4);
• sex hormones (if indicated).

Additional consultations

Depending on the test results, you may need to consult an endocrinologist, dermatologist, neurologist, or immunologist. Sometimes alopecia areata is linked to systemic disorders, and it’s important not to miss that.

Diagnosis isn’t just about “looking at the hair.” It’s a comprehensive process that reveals the real cause — not just the external symptom. Only then can the right treatment be chosen for lasting results.

Treatment of Alopecia Areata always starts with identifying the cause.

A diagnosis alone does not imply a single, specific treatment method. It’s not the name of a medication or a ready-made plan — it’s a signal that something in the body has gone wrong, and the first step is to understand what exactly.

In some people, hair loss is caused by a hormonal imbalance.
In others — by stress or vitamin deficiencies.
And in some cases — by a malfunction of the immune system.

Only once the root cause is clear can a doctor select the right treatment.

This may include:

• hormonal regulation
• correction of nutrient deficiencies
• topical treatments
• injections
• device-based therapies or psychotherapy

It’s important to understand that only a comprehensive approach can be effective.

First, the cause must be identified and addressed — while simultaneously working to treat the effects.

Only this sequence can ensure a stable and positive result.

Yes, in most cases, patchy hair loss (alopecia areata) is treatable.

If the cause is accurately identified and the therapy is properly selected, hair regrowth can begin within a few weeks or months.

However, it’s important to understand that hair loss may recur — especially if the underlying cause is chronic, such as an autoimmune condition or ongoing stress.

That’s why the main goal is not just to restore hair, but to maintain the results. To achieve this, it’s essential to consistently support your physical, hormonal, and emotional health.

And to stay in regular contact with your healthcare provider and attend follow-up check-ups.

1. What triggers the development of alopecia areata?

Patchy alopecia can be triggered by:

• autoimmune disorders,
• hormonal changes,
• severe stress,
• deficiencies or heredity.

2. Can alopecia areata go away on its own?

Yes, there are cases when hair regrows without treatment. However, you shouldn’t rely on chance — it’s better to consult a specialist.

3. Is this condition dangerous for overall health?

Alopecia itself is not life-threatening, but it is often a symptom of internal disorders. If those are left unaddressed, they can indeed pose a risk to your health.

4. Which treatment methods are most effective?

The most effective method is the one that suits you personally. Everything is highly individual — there is no universal treatment that works for everyone.

5. Can relapses of alopecia areata be prevented?

Yes, if the underlying cause is addressed, regular check-ups are done, emotional well-being is supported, deficiencies are corrected, and you stay in contact with your doctor — all of this reduces the risk of recurrence.