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How does a Dermatologist treat Alopecia Areata

Dermatologist Dr Martin Wade explains what is Alopecia areata, what causes Alopecia areata, what are the signs and symptoms of Alopecia areata and how a Dermatologist treats Alopecia areata.

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Alopecia areata is an autoimmune condition and usually presents as patchy hair loss. It can affect any hair on the body so it may affect the scalp hair, which is the most common presentation, but can also affect the beard, body hair, eyebrows or eyelashes.

Alopecia areata can also present as dramatic diffuse hair thinning or hair loss from the scalp or body. Alopecia areata can occur in men and women or children of any age and can be a chronic relapsing condition. Alopecia areata is caused by the body’s own white blood cells attacking the hair follicle. This is therefore an autoimmune condition.

The inflammatory process does not cause permanent damage to the hair follicles and so they are able to regenerate and regrow hair.

Alopecia areata is usually painless and presents as patches of hair loss on the scalp. Occasionally however people may say that their scalp feels sore or itchy or may be able to predict where their next patch may occur.

When the dermatologist examines the scalp of a patient with alopecia areata, hair follicles can be visible however the scalp sometimes has a mild salmon pink colour where the patches of hair loss are.

We think that there is a genetic predisposition for people with alopecia areata but we also know that occasionally environmental factors can play a role as well. The most common precipitant that we see is stress.

Sometimes treatment is not required for alopecia areata when the patches are very small as spontaneous regrowth can occur.

When dermatologists treat alopecia areata the degree of hair loss needs to be taken into consideration, as well as the age of the patient.

When treating children we may use a topical steroid lotion on the scalp to reduce inflammation and allow the hair follicle to regenerate and regrow hair. When treating adults we often use intralesional triamcinolone which is a steroid injection directly into the patches of hair loss.

Once again this has an anti-inflammatory effect and allows hair follicle to recover. When hair loss from alopecia areata is more extensive a specialist type of treatment can be the use of topical immunotherapy or DCP (Diphencyprone) applied directly to the scalp.

Another form of treatment for extensive alopecia areata is the use of immunosuppressing systemic medication. This medication does need to be prescribed by a specialist and does need to be under close supervision.

PRP or platelet-rich plasma is another experimental form of treatment which has shown some early promise.

Two exciting breakthroughs have occurred with the JAK (janus kinase) inhibitors, a new class of medication which has shown some early promise for the treatment of severe alopecia areata.

These treatments are not yet commercially available but further research is on-going.

This video on how a Dermatologist treats Alopecia areata is part of the series of Dermatology video’s on dermatology conditions, produced to help patients and their families, general practitioners and other specialists, and for those who are interested in Dermatology. You can watch all the videos on The London Skin and Hair Clinic YouTube channel.

Looking for further information? You can find out more about Alopecia areata here.


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