What is the fastest way to cure alopecia?

Losing hair (known as alopecia, in medical language) can be distressing. This article describes the different types of hair loss, explores treatment options and advises on where to seek help.

Alopecia is a condition that causes people to lose hair from a single area or from multiple areas of their head, face or body.

The most common types are:

• male pattern baldness
• female pattern baldness
• alopecia areata

Less commonly, hair loss can be caused by medicines (such as cancer treatments), medical conditions, or psychological conditions.

Male pattern baldness

Male pattern baldness occurs when the hair follicles, which are the bottom of the stalks of hair, become too sensitive to hormones. The hair then stops growing.

Two things happen: the hair recedes back from the forehead; and the hair on top of the head thins. Some men end up with a 'horseshoe' shape of hair around the back of their head, while others lose all their hair.

Male pattern baldness tends to run in families.

Female pattern baldness

The cause of female pattern baldness (also called female pattern hair loss, or FPHL) is not as clear, but it’s also likely to be caused by a sensitivity to hormones. It can also run in families. In women, thinning is the bigger problem.

Alopecia areata

Alopecia areata is a treatable but not fully curable autoimmune disease that occurs when the immune system attacks hair follicles. It can affect children as well as adults.

No one knows for sure what causes alopecia areata, but it’s probably triggered by a combination of genetics and environmental factors. Some people believe that extreme stress and anxiety can trigger it, but there is little scientific evidence to support this.

Usually, alopecia areata leads to one or more small, circular patches of hair loss, usually on the head. Bald patches can grow quickly. The hair usually grows back, but it can take several months.

Apart from the head, alopecia areata can cause hair loss on the face, beard, eyebrows and eyelashes. Even nostril hairs can fall out. It’s less likely that hair will grow back if there is more extensive hair loss. If you have alopecia areata, talk to your doctor about the options: your hair follicles aren’t dead, but they need a trigger to start working again.

How is alopecia diagnosed?

Talk to your doctor if you’re worried about hair loss. Your doctor will usually be able to find the cause, but might refer you to a dermatologist, who will inspect the area. If they are unsure about what’s causing the hair loss, they might take a sample of skin, hair or blood to examine more closely. Your doctor will want to rule out medical conditions that may lead to hair loss.

Living with alopecia

Alopecia can be temporary or permanent. Accepting hair loss is the most straightforward and cheapest way to cope, but this may not be easy.

Some people might find it easy to accept, and feel it doesn't affect their life. However, it can be confusing and embarrassing, affecting self-image, self-esteem, confidence or mental health.

There are practical actions that a person living with alopecia can take, such as wearing a wig, getting a hair transplant or getting eyebrow tattoos.

If you have male or female pattern baldness, treatments such as minoxidil and finasteride can sometimes slow the hair loss – see your doctor for advice.

If you have alopecia areata, medications such as corticosteroids might help. Again, talk to your GP or your dermatologist.

If you are finding it difficult to accept your hair loss, remember that you are not alone. There is help and advice available to you.

Where to seek help

• Beyond Blue can help you if you feel anxious or depressed. Call 1300 22 4636 anytime.

Last reviewed: April 2020

Though the hair loss that results from alopecia areata is due to a malfunctioning immune system—in this case, one that attacks hair follicles—there is no medical need to treat it. Alopecia areata is not contagious, painful, or dangerous. (However, there is an association between alopecia areata and autoimmune disease, so experts screening tests.)

No treatment can permanently change the course of this skin disorder or cure it. Still, some people with alopecia areata seek medications, therapies, and other solutions to help manage it and regrow hair.

In this article, you'll learn about the treatment options for alopecia areata, including prescription and over-the-counter medications, complementary and experimental therapies, and self-care/cosmetic approaches.

Igor Novakovic / Getty Images

The treatment plan that's right for you depends on several factors, including the severity of your condition, the unique risks and benefits of each therapy, and your personal preferences/goals.

If you'd like to pursue treatment, be sure to carefully discuss your options with a board-certified doctor who specializes in skin disorders (dermatologist).

Although there is only one treatment for alopecia areata approved by the U.S. Food and Drug Administration (FDA), various prescription medications have been scientifically shown to help regrow hair.

JAK inhibitors, which include Olumiant (baricitinib), Xeljanz (tofacitinib), and Rinvoq (upadacitinib), blunt inflammation by blocking signaling pathways during the immune response. At present, these drugs are FDA approved to treat rheumatoid arthritis.

In June 2022, the FDA approved Olumiant for the treatment of adults with severe alopecia areata. It is taken by mouth and is the first systemic treatment approved for alopecia areata.

There are serious possible side effects associated with JAK inhibitors, such as heart-related events, infection, cancer, blood clots, and even death.

Corticosteroids, also known as steroids, are commonly used to treat alopecia areata. They block the immune system's attack on hair follicles.

These drugs can be injected into the skin with a needle, applied to the skin (topical), or taken by mouth (oral).

Injected Corticosteroids

A dermatologist may inject corticosteroids directly into the areas on the skin where there is no hair or the hair is thinning.

This office-based procedure is used to treat patients with patchy, relatively stable hair loss. It is not for patients with extensive hair loss, like someone who is mostly bald.

Injected steroids have been found to be quite effective, although results are not immediate.

Injections are generally given every one to two months. To minimize any discomfort from the needle stick, your dermatologist may apply a numbing cream to the skin prior to the injection.

Topical Corticosteroids

Topical corticosteroids come in different strengths and preparations, such as solutions, creams, lotion, foams, ointments, and shampoos.

They are often applied daily to the area of hair loss and used for patients with patchy alopecia areata who cannot tolerate injected corticosteroids.

Oral Corticosteroids 

Oral corticosteroids, like prednisone, are sometimes prescribed for a short period of time for patients with extensive and/or rapid hair loss.

Prolonged corticosteroid use is not advised due to the risk of serious, sometimes irreversible, side effects.

Topical immunotherapy is sometimes used to treat extensive cases of alopecia areata. With this, a dermatologist applies a chemical—like diphencyprone (DPCP) or squaric acid dibutyl ester (SADBE)—to the scalp once a week to trigger hair regrowth.

These chemicals essentially create a mild allergic rash on the skin which is believed to alter a person's immune response to the hair follicles. Redness and itching at the site of application are common.

Hair regrowth is expected to occur within three to six months of beginning treatment, but it can take up to 12 months. Treatment is continued every week until the hair is re-grown.

Once the hair is re-grown and the treatment is stopped, patients are monitored for a recurrence of hair loss. If that occurs, patients may benefit from re-starting therapy.

For some patients, continuing topical immunotherapy may be recommended to maintain hair regrowth.

Anthralin is a tar-like substance available as a cream or ointment. It was one of the first medications used for psoriasis.

For alopecia areata, it is applied daily to hairless patches, left on for around 30 minutes, and then washed off. Hair regrowth may occur within two to three months of beginning treatment.

The downsides to anthralin are that it's not always effective, can stain fabric, and can cause your skin to itch and/or become discolored.

Other drugs that weaken the immune system are occasionally used to treat extensive and/or rapidly worsening alopecia areata.

Methotrexate or cyclosporine are two examples.

Rogaine, which is minoxidil that gets applied to the skin, works by both improving blood flow to the hair follicles and increasing their growth phase.

It is available over the counter in a solution or foam formulation, and is usually applied to the scalp twice daily.

Rogaine is only effective in people with early or patchy hair loss, and it takes up to six months to see results.

On the plus side, Rogaine has minimal side effects and may be combined with topical steroids for improved outcomes.

Various medications may be used to manage alopecia areata. Topical or injectable corticosteroids, Rogaine, or some combination are commonly used for patchy hair loss. Therapies, like oral corticosteroids or topical immunotherapy, are reserved for more severe cases.

Most studies examining the benefit of CAM therapies for alopecia areata are, unfortunately, not well-designed or reveal conflicting results.

It's still reasonable, though, to consider trying out a CAM treatment option with your healthcare provider's OK.

While not a complete list, here are some CAM remedies that have at least some scientific evidence, albeit limited, for hair regrowth in alopecia areata.

In one study, participants with alopecia areata were taught by a trained aromatherapist to perform nightly scalp massages using one of two combinations of oils:

• The treatment group received an essential oil blend of thyme, rosemary, lavender, and cedarwood in a mixture of carrier oils (jojoba and grapeseed).
• The control group only received the carrier oils (jojoba and grapeseed).

Photographs of the participants' scalps were taken at the start of the study and after three and seven months of treatment. The photographs were assessed for hair growth and scored by two dermatologists.

Results revealed that those who underwent the essential oil aromatherapy massages had a meaningful improvement in hair growth compared to the control group.

The relative lack of improvement in hair growth in the control group suggests that simply massaging the scalp is not useful for treating alopecia areata.

Garlic extract may promote hair growth by tamping down inflammation and altering how a person's immune system works.

One study found that combining a garlic-containing gel with topical steroids was more beneficial in treating alopecia areata than using topical steroids alone.

Extracts from the root of the Peony plant and the licorice plant are traditional Chinese medical therapies that have been found to improve mild and moderate alopecia areata in adults and severe alopecia areata in children.

These plant extracts—specifically compound glycyrrhizin tablets (CGT) and total glucosides of peony capsules (TGPC)—are believed to prevent hair loss by reducing inflammation and suppressing a person's immune system response.

Since hair loss in alopecia areata may be triggered by stress, undergoing hypnosis to help reduce stress is considered by some experts to be a reasonable complementary therapy.

During hypnosis, a trained mental health professional or therapist guides you into a trance-like state of consciousness. As a result, you have a heightened ability to concentrate and are more responsive to therapeutic suggestions.

While there is some scientific evidence that hypnosis may have some benefit in treating alopecia areata, it looks like this therapy is more useful for reducing anxiety and depression than regrowing hair.

That said, hypnosis is considered safe for most people, so you might consider giving it a try.

In an animal study published in Acupuncture in Medicine in 2013, tests on mice demonstrated that electroacupuncture may inhibit certain alopecia-related changes in skin cells.

Electroacupuncture is a form of acupuncture in which needles are attached to a device that produces continuous electric impulses. The needles are then placed at specific points on the patient's body.

It's unclear exactly how this therapy could help hair loss, but it may be related to improved blood flow. Studies on humans are needed to determine its true benefit.

Certain CAM treatments may help with hair regrowth. These include undergoing essential oil aromatherapy, applying garlic gel, and ingesting certain plant extracts, among others. More research is needed to prove how effective they are, however.

As researchers learn more about alopecia areata, there are a couple of treatment options being explored.

The excimer laser delivers a highly energetic beam of ultraviolet (UV) light directly onto the area of hair loss.

This procedure is generally performed twice a week for a maximum of six months. It's believed to work by destroying the immune system cells that are attacking the hair follicles.

Excimer laser therapy for patchy alopecia areata appears safe, even in children. However, more investigation is needed to better understand its long-term effects and how it compares to standard therapies.

Platelet-rich plasma (PRP) is a 30-minute procedure that is done in a doctor's office. It involves a doctor drawing a small amount of blood, and then spinning the blood in a machine that separates it into parts.

The goal of this is to pull out plasma, the part of the blood that's rich in platelets (cell fragments that help your blood clot) and growth factors (substances that increase cell growth and survival).

The doctor then takes that plasma and injects it into areas of the body with hair loss.

PRP needs to be repeated—generally once a month for three months initially, and once every three to six months thereafter.

While more investigation is needed, early research suggests it's a safe and effective treatment option for alopecia areata.

Whether or not you are undergoing active treatment for your hair loss, you should still adopt certain self-care strategies to protect your skin.

For instance, your dermatologist may recommend the following:

• Wear a hat or sunscreen on your scalp if your hair loss is extensive.
• Apply an antibiotic ointment inside each nostril if you have lost your nose hairs.
• Wear glasses to protect your eyes if you have lost your eyelashes.

You may also consider the following cosmetic approaches:

• Wearing a wig or hairpiece, including one that is custom-made.
• Wearing a spray or powder scalp concealer to hide your hair loss.
• Wearing false eyelashes.
• Tattooing on eyebrows or applying stick-on eyebrows.
• Shaving your head or beard to hide hair loss.

If your self-image or self-esteem has been impacted by alopecia areata, you may find that opting for ways to make your hair look more abundant or to hide the amount of loss you've experienced are worthwhile.

But remember that you always have the option to embrace your new look. Not only does it offer the practical benefits of being easier and less expensive, but it may just open up the opportunity for you to educate someone curious about alopecia areata.

Do what you feel is best and makes you feel most like yourself.

Alopecia areata is an autoimmune disease that causes a person's hair to fall out. While treatment is not medically necessary, many people consider it due to how the disorder can affect self-image and self-esteem.

If you decide to pursue treatment, there are a number of options available, depending on your preference and the severity of your disease.

Common therapies include injecting or applying corticosteroids to the areas of hair loss and/or using Rogaine. Complementary therapies and cosmetic approaches to cover up hair loss may also be tried.

Alopecia areata, while harmless, can be a frustrating disease. Even if you do not want treatment, seeing a dermatologist can help you feel supported and help you gain knowledge, especially since each case is unique.

It's also important to not underestimate the emotional toll hair loss can have on your life. If you are feeling anxious or depressed, be sure to reach out to a primary care physician, dermatologist, or therapist for guidance. You may also consider joining a support group through a professional organization like the National Alopecia Areata Foundation.