Alopecia Areata – The dreaded spot baldness


Do you find yourself inspecting your hairline regularly with concern and trepidation? Those pesky bald spots could be due to Alopecia Areata aka spot baldness. ‘Alopecia’ means bald and ‘Areata’ means patchy.

In this condition, there is significant hair loss in some or all areas of your scalp and body, usually in the form of round or oval coin-sized patches. This hair loss often appears during childhood, but how and when is unpredictable. The hard deal is that there are no specific reasons for Alopecia Areata.

This condition might be triggered by autoimmune diseases, genetics, psychological stress or illness, but not always. It can affect anyone, even the healthiest ones among us. Hard luck!

Types of Alopecia Areata

Though this condition manifests as coin size bald spots, there are different types when it comes to diagnosis.

Alopecia Totalis

All hair on the scalp is lost.

Alopecia Universalis

All body hair is lost including those in eyebrows and eyelids.

Diffuse Alopecia Areata

Sudden unexpected thinning of the hair all over the scalp.

Alopecia Areata Monolocularis

Significant baldness in one spot in scalp/body.

Alopecia Areata Multilocularis

Multiple hair loss in multiple areas of scalp/body.

Alopecia Areata Barbae

Bald spots limited to beard area.

Alopecia Ophiasis

Band like hair loss along the sides and back of the head.

Though Patchy Alopecia Areata is common, Alopecia Totalis and Alopecia Universalis are quite rare.

In all types, the hair loss can be permanent or temporary. In the same way, hair loss and regrowth can be unpredictable and cyclical.

Symptoms of Alopecia Areata

Every type of Alopecia Areata results in some or other form of hair loss. So, it is not always easy to predict the hair loss and regrowth patterns.

If you notice hair loss, just spend a few minutes examining your scalp and body on a daily basis.

The signs of Alopecia Areata include,

  • Small oval or round patches of hair loss on the scalp, beard, or other areas of your body with hair
  • Significant hair loss and regrowth in any area of your body or scalp
  • Drastic hair loss in a very short period
  • Colour change in skin (red, gray, or brown)
  • Visible mouth-like openings in the hair hair follicles – black dot like hair shafts could also be seen
  • Uneven hair loss on one side of the scalp, instead of both sides
  • Burning or itching feeling in the area of hair loss (not in all cases)
  • Gray/white hairs remain in the spots where most of the hair is lost
  • Straight hairs that appear as regrowth break off after just few millimeters of growth ( Also called as “Exclamation Point’ hairs)
  • As strange as it seems, significant nail changes like stippling/pitting can be a symptom of Alopecia Areata.
  • Tingling/Itching in the area pre-hair loss

Causes of Alopecia Areata in Men

The exact cause of Alopecia Areata is not fully understood or proved beyond doubt.  It is generally considered an auto-immune disorder where your immune system attacks your hair follicles mistakenly, thereby leading to hair loss. The condition affects us all differently.


Though there is no definite evidence to prove that genetics play a role in the development of Alopecia Areata, individuals with a family history of autoimmune diseases or Alopecia Areata are at a higher risk of developing it themselves.

Auto-immune diseases

For some individuals, their body’s immune system starts targeting their own tissues and hair follicles. This leads to an internal battle and heavy hair loss.

Stress & Anxiety

Stress affects your body in different ways, and might trigger hair loss. Significant levels of stress pushes a large number of hair follicles into a resting phase. With most of us encountering the proverbial ‘100 hair fall’ a day combined with no new hair growth occurring due to hair follicles being in the resting phase…Alopecia Areata is inevitable.

Viral Infections

When you fall sick, your immune system goes through a big upheaval. The infection along with medications might temporarily trigger Alopecia Areata. The hair growth will resume once you recover.

Consulting a dermatologist – Diagnosis

Though Alopecia Areata is not a life debilitating condition, bald spots have a way of affecting one’s self esteem. So getting a proper diagnosis will pave the way to manage this condition.

More often than not, your physician might not be the right person to diagnose Alopecia Areata, but a dermatologist is. Dermatologists specialise in diseases and conditions that affect the skin.

The dermatologist might ask about your and your family’s medical history, your diet, the hair and skin care products you use, and details about your lifestyle & stress levels.

He will further examine you for redness, scars, swelling, sores, patterns of hair loss, and the health of your finger nails, among other things.

Some of the tests include,

Pull Test

The specialist will pull part of your hair with a gentle force. If significant strands come out, it marks active hair loss.

Tug Test

The specialist will gently tug your hair to observe if strands break off abruptly.

Scalp Biopsy

If your specialist is not sure of the diagnosis, he might recommend a scalp biopsy from a laboratory.

Treatment Options

Spot baldness doesn’t have a sure-fire cure, nor does it go away on its own. The best solution for Alopecia Areata is finding the right treatment on time.

The hair treatment for Alopecia Areata include:


A topical drug available over the counter, Minoxidil is regularly used to treat Male Pattern Baldness and Alopecia Areata. It typically takes around 12 weeks to see visible results.


Corticosteroids are inflammatory drugs typically used to treat autoimmune diseases. It is injected into your scalp to treat Alopecia Areata. It is also available as an ointment, cream, or foam. Though this treatment is moderately effective, it will take atleast 6 months to see visible results.

Scalp Micropigmentation

This cosmetic non-invasive treatment involves adding hair follicles emulating dots on the scalp using specially formulated pigments. This treatment helps camouflage your bald spots and sport a fuller hairline.


It is proven that ultraviolet light waves can help certain skin and nail disorders, including Alopecia Areata. Phototherapy treatment involves ultraviolet light from special lamps. Your dermatologist may also use a drug called psoralen along with the ultraviolet A or B light waves.

Platelet-rich Plasma

This invasive treatment includes removing & processing the blood from your body and injecting it into the scalp to stimulate hair growth. It might have side effects, but your doctor can advise.

Total Immunotherapy

Slightly unconventional, this treatment includes your healthcare provider rubbing an allergen into your skin to create an allergic reaction (aka contact dermatitis,) thereby inducing hair growth.

Whatever the treatment option you opt for, you will start noticing new hair growth between four and 12 weeks after starting.

However, if you notice any unpleasant side effects or are not keen to undergo treatment, there is one other way to manage Alopecia Areata!

Styling Differently

Be uniquely you by styling your hair differently or choosing wigs/hair weaves.

Alopecia Areata may come and go throughout most lives. Apart from treatments, eat a well balanced diet and maintain an ideal Vitamin D level.

Living with Alopecia Areata

Living with Alopecia Areata can be challenging, but always remember that you are not alone. Accept it as an integral part of your persona. If you find yourself riddled with self-doubt and emotional pain for prolonged periods, seek therapy from a trained therapist, counselor, social worker, or psychologist.

There are few things to avoid when you have Alopecia Areata,

  • Exposure to harsh sun and wind
  • High stress levels
  • Hair products with harsh chemicals

On the whole, Alopecia Areata can easily be managed if you contact your health care provider as soon as you start noticing significant hair loss or bald spots.


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