Alopecia Areata: What It Is, What Causes It, and How It’s Treated

A plain-language guide for people researching alopecia areata, whether for themselves, a child, or someone they care about.

Updated: March 2026

Types of Hair Loss

What Is Alopecia Areata?

Alopecia areata is an autoimmune condition that causes hair to fall out typically in patches on the scalp, face, or other parts of the body. It is one of the most common autoimmune disorders in the world, affecting an estimated 6.7 million people in the United States and roughly 2% of the global population at some point in their lives. It can affect anyone, at any age, of any background.

The word “alopecia” simply means hair loss. “Areata” refers to the patchy pattern that is often the first sign of the condition. Despite being so common, alopecia areata is frequently misunderstood and finding it for the first time can be alarming and disorienting. Understanding what it is, and what it isn’t, is a helpful first step.

A few important things to know from the outset:

• Alopecia areata is not contagious. You cannot catch it from or pass it to anyone.
• It does not damage the hair follicle permanently. In most forms of the condition, the follicles remain alive beneath the skin, which means hair can potentially regrow.
• It is not caused by stress alone, though stress may play a role in triggering flare-ups in some people.
• It is not a reflection of overall health in the way that some hair loss can be. The scalp itself typically looks normal, just bare.

Types of Alopecia Areata

Alopecia areata exists on a spectrum. Most people experience the mildest form, but the condition can range from a single small patch to total loss of all body hair. The main types are:

• Patchy alopecia areata: The most common form. One or more coin-sized round or oval patches of hair loss appear, usually on the scalp. This is how most people first encounter the condition.
• Alopecia totalis: Complete loss of hair across the entire scalp.
• Alopecia universalis: Complete loss of all hair on the body, including eyebrows, eyelashes, and body hair.
• Ophiasis pattern: Hair loss in a band-like pattern running along the sides and back of the scalp. This pattern can be more persistent and harder to treat than patchy alopecia areata.
• Diffuse alopecia areata: Rather than distinct patches, hair thins broadly across the scalp. This form can be harder to distinguish from other types of hair loss and usually requires a professional evaluation to diagnose correctly.

The type and extent of hair loss affects both the experience of the condition and the range of treatment options that a healthcare provider may discuss. This is one of the many reasons a proper diagnosis from a qualified healthcare provider is so valuable. Not all hair loss is the same, and what helps for one type may not be appropriate for another.

---

What Causes Alopecia Areata?

Alopecia areata is an autoimmune condition. That means the immune system which normally defends the body against infection mistakenly targets the body’s own hair follicles. Immune cells gather around the follicle and disrupt the normal hair growth cycle, causing the hair to stop growing and eventually fall out.

Importantly, this immune attack does not destroy the follicle itself. The follicles remain dormant beneath the skin, which is why hair can and often does regrow, sometimes without any treatment at all.

Why Does This Happen?

The honest answer is that researchers do not yet fully understand why some people develop alopecia areata and others don’t. What is known is that it involves a combination of:

• Genetics: Alopecia areata tends to run in families. Roughly one in five people with the condition has a family member who also has it. Multiple gene variants are associated with the condition, many related to immune function.
• Immune system activity: Something causes the immune system to lose its normal tolerance of hair follicles, though exactly what triggers this in any individual is often unclear.
• Possible triggers: For some people, a specific event seems to precede onset such as a viral illness, a period of intense stress, a hormonal change, or significant physical strain. However, triggers vary widely between individuals, and many people develop alopecia areata without an obvious precipitating event.

Alopecia areata is also associated with other autoimmune conditions, particularly thyroid disease, vitiligo, and atopic dermatitis (eczema). Having one autoimmune condition can increase the likelihood of developing another, though the relationship is complex and not fully understood. A healthcare provider can assess whether any related conditions warrant attention.

---

What Does It Look Like?

The most recognizable sign of alopecia areata is smooth, round or oval bald patches usually about the size of a coin appearing on the scalp or, less commonly, in the beard, eyebrows, eyelashes, or elsewhere on the body. The skin in affected areas typically looks and feels completely normal. There is no rash, no scaling, no inflammation visible to the naked eye, and usually no pain or itching, though some people notice a tingling or mild sensitivity before hair falls out.

Hair loss can happen very quickly, sometimes appearing overnight or over just a few days. The edges of active patches sometimes show short, stubby hairs that taper toward the scalp, a distinctive feature that dermatologists look for during examination.

Some people with alopecia areata also notice changes in their fingernails and toenails: small pits or dents, surface roughness, white spots, or unusual brittleness. Nail changes affect a minority of people with the condition and are not harmful, but they are worth mentioning to a healthcare provider as they can help confirm the diagnosis.

---

What Happens Over Time?

Alopecia areata is one of the most unpredictable conditions in dermatology. Its course varies considerably from person to person, and the same individual can experience very different episodes at different times in their life.

Some of the key things we know about how alopecia areata tends to behave:

• Spontaneous regrowth is common in mild cases. For people with limited, patchy hair loss, hair often regrows on its own — sometimes within months, sometimes over a year or more. This does not mean the condition is gone; future episodes are possible.
• The condition is typically cyclical. Many people experience periods of hair loss followed by regrowth, followed by further loss in the same or different areas. There is no reliable way to predict when episodes will occur or how long they will last.
• More extensive forms are generally more persistent. Alopecia totalis and universalis are less likely to resolve on their own and are more challenging to treat. People with these forms are encouraged to connect with a dermatologist experienced in alopecia areata.
• Regrowth hair may differ at first. Hair that regrows after alopecia areata sometimes comes in white or fine before returning to its original color and texture over time.
• Progression is not inevitable. Most people with patchy alopecia areata do not go on to develop totalis or universalis. However, certain factors including onset in childhood, the ophiasis pattern, nail involvement, and a family history are associated with a greater chance of more extensive or persistent disease. A dermatologist can help assess individual risk factors.

---

Getting a Diagnosis

If you or your child is experiencing unexplained hair loss, the most important step is to see a qualified healthcare provider, ideally a dermatologist, for a proper evaluation. Alopecia areata can sometimes resemble other conditions that cause hair loss, and getting the right diagnosis matters, because different conditions call for different approaches.

A dermatologist evaluating alopecia areata will typically review your personal and family medical history, examine the pattern and appearance of hair loss, and look closely at the affected areas, sometimes using a handheld magnifying instrument. In some cases, a small scalp sample or blood tests may be recommended to rule out other contributing factors, particularly thyroid conditions or nutritional deficiencies that can occur alongside alopecia areata.

There is no need to prepare anything specific before an appointment. Simply note when you first noticed hair loss, whether it has changed or spread since, whether anyone in your family has had alopecia areata or other autoimmune conditions, and any other symptoms you have noticed, including nail changes.

---

Treatment: What Are the Options?

There is currently no cure for alopecia areata. However, treatment options have expanded significantly in recent years, and many people, particularly those with limited or moderate hair loss, achieve meaningful hair regrowth with appropriate care. All treatment decisions for alopecia areata should be made with a qualified healthcare provider, such as a dermatologist. What follows is a general overview of the categories of treatment that exist, not a guide to self-treatment.

Some People Choose Not to Treat

Because alopecia areata is unpredictable and hair can regrow spontaneously, especially in patchy, limited cases, some people choose to monitor the condition rather than begin treatment immediately. This is a completely valid approach and one that many dermatologists support in certain circumstances, particularly when hair loss is mild and the person is not significantly distressed. The decision about whether to treat, and when, is a personal one best made in conversation with a healthcare provider.

Medical Treatments

A range of medical treatments are used for alopecia areata, and the right approach depends on the extent of hair loss, the person’s age, their overall health, and their individual priorities. Broadly, treatments work by calming or redirecting the immune system response that is attacking the hair follicles.

Options your dermatologist may discuss include anti-inflammatory treatments applied to the scalp, treatments that help modulate the immune response locally or systemically, and for more severe cases newer prescription medications that specifically target the immune pathway involved in alopecia areata. Since 2022, the FDA has approved a class of oral medications for severe alopecia areata that have shown significant results in clinical trials, representing the most meaningful treatment advance for this condition in decades. Your dermatologist can advise whether any of these options are appropriate for your situation.

It is worth knowing that treatments for alopecia areata often require patience. Response times vary, results are not guaranteed, and finding the right approach for any individual can take time. Working with a dermatologist who specializes in hair loss will give you access to the most current options and the most informed guidance.

A note on seeking medical care: The National Alopecia Areata Foundation (NAAF) at naaf.org is the leading patient advocacy organization for alopecia areata in the United States. Their website provides current, reliable information on treatments, clinical trials, and how to find a specialist. We encourage anyone newly diagnosed to visit their resources.

What About Hair Restoration Treatments?

Because alopecia areata involves autoimmune activity not hormonal miniaturization, many of the hair restoration treatments used for androgenetic alopecia (hereditary pattern hair loss) are not the primary approach for alopecia areata. Hair transplantation, for example, is generally not recommended for active alopecia areata because the underlying immune process can affect transplanted follicles in the same way it affects native ones. A dermatologist experienced in alopecia areata can advise on whether any restorative approach is appropriate given a person’s specific situation and disease status.

---

Managing Your Appearance

Regardless of what medical treatment path someone takes, or whether they choose to treat at all, managing the visible impact of alopecia areata is a completely legitimate and practical priority. Many people find that having effective appearance solutions in place significantly reduces the daily stress the condition causes, and supports their confidence and quality of life while other aspects of their care are ongoing.

This is an area where Transitions International member studios specialize. Options include:

• Custom hair systems and wigs: Modern hair replacement has come a long way from older-generation wigs and toupees. Today’s custom hair systems use premium human hair on ultra-thin, breathable bases that closely replicate the appearance of natural hair and scalp. They can be cut, colored, and styled, and are secured in ways that allow for normal daily activity including exercise and swimming. For many people with alopecia totalis or universalis, a well-made custom hair replacement system is transformative.
• Medical-grade wigs: For those whose alopecia areata is severe or ongoing, insurance may cover the cost of a cranial prosthesis (a medical wig). A Transitions member studio can advise on documentation and insurance processes.
• Hair integration systems: For those with partial hair loss, integration systems blend additional hair with existing natural hair to restore volume and coverage without a full hair replacement system.
• Eyebrow and eyelash solutions: For those whose alopecia areata has affected eyebrows or lashes, options range from professional makeup techniques and brow pencils to semi-permanent cosmetic tattooing. Some Transitions member studios can refer to trusted specialists.
• Scalp micropigmentation: A specialized cosmetic technique that creates the appearance of very short hair follicles on the scalp, a particularly popular option for those who prefer a close-shaved aesthetic.

Find a Transitions member specialist near you to explore which appearance solutions are right for your situation.

---

The Emotional Side

Alopecia areata is not just a physical experience. For many people and often particularly for women, children, and teenagers the emotional impact of losing hair can be profound. Studies consistently document elevated rates of anxiety and depression among people with alopecia areata, as well as impacts on self-esteem, social confidence, and quality of life.

If you are struggling emotionally with alopecia areata, that is a completely understandable response and you are far from alone. Some things that many people find helpful:

• Connecting with others who understand. The National Alopecia Areata Foundation maintains a network of support groups across the United States and internationally. Meeting others who have navigated the same experience can be genuinely reassuring. Visit naaf.org to find a support group.
• Professional support. A counselor or therapist, particularly one familiar with chronic conditions or appearance-related concerns, can provide practical tools for managing anxiety, grief, and self-image challenges.
• Practical solutions. Many people find that having a hair replacement solution they feel confident in significantly reduces the daily emotional toll of the condition turning what felt like an unavoidable daily reminder into something manageable.
• Staying informed. For many people, anxiety about alopecia areata is amplified by uncertainty. Understanding the condition clearly and knowing that treatment options have expanded meaningfully in recent years — can itself be reassuring.

---

Alopecia Areata in Children

Alopecia areata can develop at any age, and it is not uncommon in children. Around half of all cases begin before the age of 20, and the condition can appear as early as the toddler years. For children, the emotional and social dimensions of hair loss can be particularly acute, affecting school life, friendships, and self-confidence during formative years.

If your child has been diagnosed with alopecia areata, connecting with a pediatric dermatologist experienced in the condition is important. Treatment options for children differ from those for adults, and the approach should be guided by a specialist. The NAAF maintains resources specifically for families of children with alopecia areata, including guidance on talking to schools and supporting a child’s emotional wellbeing.

From an appearance standpoint, age-appropriate hair solutions including custom wigs designed for children and teenagers are available and can make a significant difference to a child’s daily experience and confidence. A Transitions member studio can advise on the right options for a child’s age, activity level, and preferences.

---

Finding Help

If you or someone you love is dealing with alopecia areata, here are the most useful next steps:

• See a dermatologist for a proper diagnosis and to understand what treatment options may be appropriate. If your current provider does not specialize in hair loss, ask for a referral to someone who does. This condition warrants specialist care.
• Visit the National Alopecia Areata Foundation at naaf.org for authoritative patient information, treatment updates, clinical trial listings, and support group connections.
• Connect with a Transitions member studio to explore appearance solutions, whether you are in active treatment, between episodes, or simply want to feel more like yourself while you navigate next steps. Our member studios work regularly with people with alopecia areata and understand the unique considerations involved.

You do not have to figure this out alone, and you do not have to wait until you have all the answers to start feeling better. Help is available both medically and practically.

References

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Alopecia Areata. U.S. Department of Health & Human Services. niams.nih.gov
2. National Alopecia Areata Foundation. Available Treatments. naaf.org
3. National Alopecia Areata Foundation. FDA-Approved JAK Inhibitors. naaf.org
4. Lepe K, Syed HA, Zito PM. (2024). Alopecia Areata. In: StatPearls. StatPearls Publishing. ncbi.nlm.nih.gov/books/NBK537000
5. American Academy of Dermatology Association. Hair loss: Diagnosis and treatment. aad.org
6. Villasante Fricke AC, Miteva M. (2015). Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 8:397–403. PMC4521674
7. Mostaghimi A, et al. (2023). Trends in Prevalence and Incidence of Alopecia Areata. JAMA Dermatology. jamanetwork.com
8. National Alopecia Areata Foundation. Prevalence of Alopecia Areata Across Races and Ethnicities. naaf.org