Alopecia areata affects 2 percent of the worldwide population. And although it doesn’t cause physical pain or make you feel sick, it can be a psychologically devastating disease. This autoimmune disease involves the loss of hair around the scalp, face and parts of the body. It can come on at any time, without warning.
Alopecia areata is commonly misdiagnosed as other types of hair loss, like androgenetic alopecia (also called male pattern baldness). But with alopecia areata, your immune system is actually attacking your hair follicles. So treatment plans have to address the autoimmune response that’s occurring.
There are conventional medications and creams doctors commonly prescribe to help hair regrow. But most of them come with side effects and only result in temporary hair growth.
What Is Alopecia Areata?
Alopecia areata is an autoimmune disease that involves the immune system attacking the cells in your hair follicles, leading to hair loss. The word alopecia means “baldness” in latin. Areata means “in patches.” So this perfectly explains this disease that results in small patches of baldness across the scalp and other parts of the face and body.
The amount of hair loss experienced by people with alopecia areata varies. Some lose small, round patches of hair about the size of a quarter, which is most common. Others experience extensive or even total hair loss.
The onset of alopecia areata usually begins when a person is between 20 and 40 years old. But symptoms of the disease can occur at any age.
Studies show that in 82–88 percent of cases, patients experience their first onset of alopecia areata by the age of 40. Forty percent of patients develop symptoms by 20 years old. If the symptoms develop earlier in life, there is an increased lifetime risk of a more extensive disease.
The most common symptoms of alopecia areata include:
The most common site of hair loss is the scalp. Sometimes patients experience hair loss in other body sites, like the beard, eyebrows and eyelashes. Studies show that when patients develop symptoms of alopecia areata earlier in life, they experience more severe hair loss. This is especially true if hair loss begins within the first two decades of life.
However, the course of the disease can be unpredictable. Hair grows back spontaneously in 80 percent of patients within the first year. But sudden relapses can occur at any time.
Alopecia areata involves patchy hair loss, with one or more coin-sized patches on the scalp or other areas of the body. Alopecia areata can convert into two other types of alopecia. This occurs in about 7 percent of patients with alopecia areta.
The two types of alopecia that can develop in patients include:
- alopecia areata totalis — hair loss across the entire scalp (occurs in about 5 percent of cases)
- alopecia areata universalis — complete hair loss (occurs in about 5 percent of cases), across the entire scalp, face and body, including areas like the eyebrows, eyelashes, arms, legs and pubic hair
Research shows that nail changes occur in 10 to 38 percent of patients with alopecia areata. The severity of the changes corresponds with the extent of hair loss. Some common changes include nail pitting (depressions in your fingernails or toenails), rough, sandpapered nails, and vertical ridges or lines that run from the base of the nail to the top.
Anxiety and depression
People with alopecia areata are also at risk for anxiety and depression. Studies show that among patients with alopecia areata, 38–39 percent of them develop signs of depression and 39–62 percent of them develop generalized anxiety disorder. These psychiatric disorders can develop before or after the onset of alopecia areata symptoms. About half of the cases occur after the onset of symptoms.
Furthermore, research shows that stressful events occur before the onset of alopecia areata in about 10 percent of adults and 10–80 percent of children with the disease.
Other possible symptoms
Other symptoms inlcude thyroid disease (including Hashimoto’s disease), vitiligo, atopy (a heightened immune response to common allergens, which can lead to conditions like asthma and eczema), lupus, psoriasis, inflammatory bowel disease, rheumatoid arthritis and other autoimmune diseases.
Causes and Risk Factors
With alopecia areata, your white blood cells — which are supposed to protect your body from foreign invaders like viruses and bacteria — attack the cells of the hair follicles that normally grow rapidly. As a result of this, the hair follicles become smaller and slow down hair production.
Scientists believe that a combination of genes may predispose a person to alopecia areata. But unlike some genetic diseases, it’s unlikely that a child actually inherits all of the genes needed to predispose her to the autoimmune disease.
According to a systematic review published in Clinical, Cosmetic and Investigational Dermatology, in which researchers collected data from all studies published in English within a 51 year period that was associated with alopecia areata, zero to 8.6 percent of patients with alopecia areata reported a family history of the disease.
Studies involving identical twins suggest that environmental factors also play a role in the development of alopecia areata. A study published in the Journal of the American Academy of Dermatology evaluated 11 sets of identical twins and three sets of fraternal twins to determine the concordance rate of alopecia areata. Researchers found that there was a 55 percent concordance rate for identical twins and zero percent for fraternal twins.
This supports a genetic component as the cause of alopecia areata. But it’s not 100 percent, so environmental triggers must also play a role in the development of the disease. Some environmental factors that may play a role in the developing of alopecia areata include viral infections, psychological stress and trauma.
Scientists believe that environmental factors perpetuate an inflammatory response that interacts with your hair follicles and heightens the body’s immune response. This interaction triggers the processes that lead to hair loss.
To explain this further, scientists point to the seasonal cycle of the disease and the increase of relapses in the early spring, which is when there is an increase in viral infections. Research also shows that people who have a family member with other autoimmune diseases, like rheumatoid arthritis, type-1 diabetes, lupus, Addison’s disease or thyroid disease, have an increased risk of developing alopecia areata.
There is no cure for alopecia areata. Hair usually regrows on its own. Treatments make hair grow back more quickly and to prevent remission. Some of the most common conventional treatments for alopecia areata include:
The doctor injects topical, locally injected or systemic corticosteroids to reduce inflammation and promote hair growth. Dermatologists typically use injections of corticosteroids to treat alopecia areata. You need to have the procedure repeated every four to six weeks. This treatment method does not prevent new hair loss from occurring. It is only used to help hair to grow back in bald areas.
One side effect of corticosteroid shots is that it may leave dells, or depressions in the skin after a treatment. Some other side effects include upset stomach, lightening of the color of the skin where the injection was given, soreness at the injection sight and inflammation at the injection site.
Minoxidil (which is found in popular hair loss brands like Rogaine®) is a hair growth medicine used to help patients regrow their hair. It is applied topically on both adults and children by spreading the medicine on the area of hair loss, be it the scalp, face or body.
Minoxidil therapy is usually combined with another type of treatment. It’s not effective on its own in treating extensive hair loss.
Anthralin is used to alter the skin’s immune function. It is applied topically for 20–60 minutes and then washed off. Anthralin cream is used to help hair regrow in bald areas. But, it may irritate the skin and even cause a brow discoloration of the skin temporarily.
Diphencyprone is applied topically to the areas of hair loss in order to stimulate the immune system. It actually causes a mild allergic reaction, thereby sending white blood cells to the surface of the bald areas.
The hope is that this fights inflammation at the site of affected areas and stimulates the hair follicles to regrow hair. This type of immunotherapy is used to treat severe cases of alopecia areata, including alopecia totalis and alopecia universalis.
Immunosuppressants such as methotrexate and cyclosporine block the immune response that’s causing hair loss. In a 2014 study evaluating the efficacy of methotrexate in alopecia areata, researchers found that hair regrowth greater than 50 percent occurred in 67 percent of patients. Some side effects from taking immunosuppressants like methotrexate include nausea, diarrhea, sores, pale skin and tiredness.
It’s true that digestive tract controls your immune system. This is why probiotics can help to treat a number of autoimmune conditions, including alopecia areata. Researchers at the Massachusetts Institute of Technology found that feeding probiotic bacteria to aged mice caused beneficial changes to the integumentary system. This resulted in healthier and younger looking hair and skin.
Probiotic supplements can be used to improve your immune system so that your body doesn’t overreact to perceived threats and cause inflammation. You should also eat probiotic foods daily, such as kefir, kombucha, cultured vegetables, yogurt and apple cider vinegar.
Zinc may work as a natural treatment for alopecia areata because it helps to boost your immune system and repair your gut, which is vital for normal immune responses. Plus, zinc is a vital mineral for important functional activities of the hair follicles.
A 2016 study published in the International Journal of Dermatology found that lower serum zinc levels are common among patients with alopecia areata, with zinc levels being the lowest in patients with severe cases of the hair loss disease.
Researchers suggest that zinc supplements may provide a therapeutic benefit, especially for patients with a zinc deficiency. It can also help to eat foods high in zinc, such as pumpkin seeds, grass-fed beef, lamb, chickpeas, cashews, yogurt and spinach.
Quercetin is a type of flavonoid antioxidant that is known for its ability to reduce inflammation and fight free radical damage. It has strong effects on immunity and works to down-regulate, or suppress, inflammatory pathways. This is why it’s often used to treat symptoms related to autoimmune disorders.
A 2012 study conducted on mice found that quercetin was effective in stimulating hair regrowth when compared to placebo injections. Scientists believe that this is due to quercetin’s anti-inflammatory properties.
Quercetin supplements and creams are available at vitamin or health food stores. Make sure to purchase these products from a reputable company. Read the ingredient list to make sure that quercetin is the main ingredient. You may find that many formulas also include bromelain. This is another anti-inflammatory enzyme that’s used to fight immune responses.
Ginseng is a popular herbal medicine that contains various pharmacological compounds. It works to reduce inflammation and boost immune function. This helps the body to maintain immune homeostasis.
A 2012 study conducted at Korea University College of Medicine found that red ginseng serves as an effective and natural treatment for alopecia areata. People who are already receiving corticosteroid injections can use it as a complementary treatment.
There are many varieties of ginseng available today, including powdered, dried and tablet forms of both Asian and American ginseng.
5. Lavender Essential Oil
One of the many lavender oil benefits includes its ability to heal and protect the skin. It works as a powerful antioxidant and it reduces inflammation.
A 2016 study conducted using mice found that when researchers applied lavender oil topically to bald patches on mice, it caused a significant increase in the number of hair follicles, deepened hair follicle depth and thickened the dermal layer. Lavender oil treatment also significantly decreased the number of white blood cells compared to the placebo group.
Another study, conducted in Scotland, involved aromatherapy treatment for alopecia areata. Patients in the treatment group massaged lavender, rosemary, thyme and cedarwood essential oils, mixed with jojoba and grapeseed carrier oils, into their scalp daily. The control group used only carrier oils.
Forty-four percent of the treatment group showed improvement compared with only 15 percent of patients in the control group. The degree of improvement using photographic assessment of hair growth was significant, proving that lavender oil and other beneficial essential oils for hair serve as an effective natural treatment for alopecia areata.
6. Rosemary Essential Oil
Rosemary oil is commonly used to enhance hair thickness and growth. It works by increasing cellular metabolism that stimulates hair growth. Research shows that applying rosemary oil topically can be as effective as minoxidil, a conventional treatment for alopecia areata.
You can also use rosemary oil to treat dandruff and dry scalp. Simply apply 2–3 drops of rosemary oil directly to the area of concern twice daily.
Acupuncture is used as a natural treatment for alopecia areata because it can reduce the T1 cells that are attacking hair follicles and causing hair loss. It also works to stimulate and warm hair follicles, reduce inflammation and increase blood circulation in the affected area.
Acupuncture also works to reduce anxiety and depression. These are two conditions many patients with alopecia areata experience.
8. Eat Anti-Inflammatory Foods
One of the most important components of treating an autoimmune disease naturally is to eat healing, nutrient-dense foods that will work to reduce inflammation and allow your body to recover quickly. Avoid all processed and sugary foods.
Instead, eat anti-inflammatory foods like green leafy vegetables, beets, broccoli, blueberries, nuts, seeds, spices (especially turmeric and ginger), wild-caught salmon, bone broth and coconut oil. These foods provide antioxidants, important minerals and essential fatty acids. It is common for patients with alopecia areata to have nutrient deficiencies.
So eat a well-balanced diet full of a variety of colors in order to make sure you’re getting the vitamins and minerals that you need to get well. You can also have your levels checked by your healthcare provider. Then take specific measures to correct a deficiency.
9. Reduce Stress
To treat thinning hair and hair loss associated with alopecia areata, it’s important to reduce stress levels and allow your body to heal so that your hair will grow back quickly.
There are a number of stress relievers that can help to encourage blood circulation and promote hair growth. These include exercise (like yoga), meditation, journaling and spending more time outdoors.
Dealing with hair loss can be difficult emotionally, as you may begin to feel insecure about your appearance. Surround yourself with supportive friends and family members during this difficult time. And, connect with other people who are also dealing with this skin condition.
These natural treatments for alopecia areata are safe for topical and oral use. But if you notice any adverse side effects, stop using the herb, supplement or essential oil and ask your healthcare provider or nutritionist for guidance.
If you are struggling with the psychological aspects of alopecia areata, such as anxiety, depression or insecurity about your hair loss, find support from a community group or therapist. It’s important that you reduce stress as much as possible in order to get well.
- Alopecia areata is an autoimmune disease that involves the immune system attacking the cells in your hair follicles, leading to hair loss.
- The most common symptoms of alopecia areata include patchy hair loss and nail changes, such as depressions in your fingernails, vertical ridges along your nails and rough nail texture.
- Scientists believe that a combination of genes and environmental factors play a role in causing alopecia areata.
- Conventional treatments for alopecia areata include corticosteroids (usually injected), minoxidil, anthralin, diphencyprone and immunosuppressants.
- Natural remedies include probiotics, zinc and quercetin supplements, ginseng, essential oils like lavender and rosemary oil, stress relievers, anti-inflammatory foods and acupuncture.