Alopecia Areata: Causes, Symptoms, Types And Treatment
Last reviewed on 2 August 2026. We review our treatment guides every six months to keep them accurate.
What is alopecia areata?
Alopecia areata is an autoimmune condition in which the immune system mistakenly attacks the hair follicles, causing sudden, well defined round or oval patches of smooth hair loss. It is a different problem from the gradual thinning of male and female pattern baldness, and it can begin at any age. The lifetime risk of developing it is estimated at around 2 per cent, and it affects men, women and children of all backgrounds fairly equally.
There is an important piece of reassurance built into the condition: alopecia areata does not scar the scalp. The follicles are not destroyed, only switched off by the inflammation, which means the hair can grow back, and in milder cases it often does so on its own within months. The course is unpredictable, though, and the patches can recur or, less often, spread.
This guide explains what alopecia areata is, how it differs from other kinds of hair loss, where it appears on the body, what causes it, how likely it is to regrow, and how it is treated, including the newer tablet treatments now available on the NHS. For the current UK clinical position, the British Association of Dermatologists patient leaflet on alopecia areata is the authoritative source and is kept up to date by dermatologists.
How alopecia areata differs from other hair loss
Telling alopecia areata apart from other causes of hair loss matters, because the outlook and the treatment are different. In male and female pattern hair loss the follicles gradually shrink under the influence of hormones and genetics, thinning slowly over years rather than falling out in distinct patches. In telogen effluvium, a temporary, diffuse shedding is triggered by something such as illness, stress, childbirth or a nutritional deficiency, and the hair usually recovers once the trigger passes. Alopecia areata is different again: the loss is sudden, patchy and driven by the immune system, and although the follicles survive, the pattern of regrowth is far less predictable. Only a clinician can tell these conditions apart with confidence.
One more distinction matters more than most: whether the condition scars. Alopecia areata is a non-scarring alopecia, so the follicles are not destroyed and regrowth stays possible. Some other conditions are scarring (cicatricial) alopecias, in which inflammation permanently destroys the follicle, so the hair that is lost cannot grow back and the aim of treatment is to halt further loss as early as possible. Two that we cover separately are frontal fibrosing alopecia, which slowly pushes back the frontal hairline and often thins the eyebrows, most commonly in women around and after the menopause, and central centrifugal cicatricial alopecia, which spreads outward from the crown and is the most common scarring alopecia in women of African descent. Unlike alopecia areata, both cause permanent loss, which is why an early diagnosis by a dermatologist matters so much.
Where it appears, and the named types
Although the scalp is the most common site, alopecia areata can affect any hair bearing area, including the beard, eyebrows, eyelashes and body. Dermatologists use the term as an umbrella for several patterns:
Patchy alopecia areata, the most common form, with one or more coin sized round or oval bald patches.
Alopecia totalis, the loss of all, or nearly all, of the scalp hair.
Alopecia universalis, the loss of hair across the whole body, including the face, an uncommon and more severe form.
Ophiasis, a band of hair loss around the sides and lower back of the scalp.
Alopecia barbae, alopecia areata that appears in the beard; our guide on alopecia barbae covers it in more detail.
What causes alopecia areata?
Alopecia areata is an autoimmune condition, which means the body's own immune system, which normally defends against infection, mistakenly attacks the hair follicles and stops them producing hair. Exactly why this happens is not fully understood. There is a clear genetic element: the British Association of Dermatologists notes that around 2 in 10 people affected have a family history of the condition, and it is more common in people who have other autoimmune conditions such as thyroid disease, vitiligo or type 1 diabetes, and in those with eczema, asthma or hay fever.
Stress and illness are often blamed, and they are sometimes reported before an episode, but the evidence that they directly cause alopecia areata is weak, and the link may be coincidental. It is not caused by anything you have eaten, and it cannot be caught from someone else. Our guide on stress and hair loss looks at that relationship in more detail.
What does alopecia areata look and feel like?
Alopecia areata usually begins with one or more smooth, bald patches that appear over a short time. The skin within the patch looks normal, not red, scaly or scarred. At the edge of an active patch you may see short, tapered hairs that are broader at the tip and narrow where they meet the scalp, known as exclamation mark hairs, which are a useful sign for clinicians. Some people notice itching, tingling or a burning feeling in the area shortly before or as the hair falls. When hair regrows it is often fine and white or grey at first, regaining its colour over time. The condition can also affect the nails, causing fine pitting or ridging, and this tends to go with more extensive hair loss.
Will it grow back? The likely outlook
Because the follicles are not destroyed, regrowth is genuinely possible, and for many people it happens without any treatment. According to the British Association of Dermatologists, where the hair loss is limited, about 4 in 5 people see complete regrowth within a year, although new patches can appear later. The outlook is less favourable when more than half the hair is lost at the outset, or when there is complete scalp or body loss, where the chance of full natural recovery is nearer 1 in 10. Regrowth also tends to be slower in young children, where there is a strong family history or other autoimmune disease, and where the loss affects the hairline at the back of the scalp or the nails are involved. Overall the course is unpredictable, and periods of loss and regrowth can alternate.
How is alopecia areata diagnosed?
Alopecia areata is usually diagnosed by a doctor examining the scalp, and most people do not need any tests. A dermatologist may use a handheld magnifier, called a dermatoscope, to look for the characteristic features, and occasionally a small scalp biopsy or blood tests are done if the diagnosis is uncertain or another condition needs to be ruled out. In the UK the usual route, as NHS advice on hair loss sets out, is to start with your GP, who can refer you to a dermatology department if needed.
Treatment options for alopecia areata
There is no cure for alopecia areata, and no treatment changes the long term course of the condition, but several options can encourage regrowth, and the right choice depends on how much hair is affected. Because mild patches often recover on their own, a period of watchful waiting is a reasonable first step. Any treatment is a matter for your doctor or a dermatologist, and what follows is a general description rather than advice for any individual.
For limited patches, the British Association of Dermatologists describes corticosteroids, used either as a cream or solution on the scalp or as injections into the bald patch, as a mainstay, with steroid injections being the most effective approach for small areas. Topical minoxidil is sometimes used to support regrowth, though the evidence for it on its own is limited. For more extensive loss, topical immunotherapy, in which a chemical is used to provoke a mild, deliberate allergic reaction on the scalp, can be tried in specialist centres.
The most significant recent change is the arrival of oral JAK inhibitors, a class of tablet that dampens the immune signals driving the condition. Ritlecitinib (brand name Litfulo) was recommended by the National Institute for Health and Care Excellence in its 2024 guidance and is available on the NHS for people aged 12 and over with severe alopecia areata. A second JAK inhibitor, baricitinib (Olumiant), is licensed for severe alopecia areata in adults but is not currently funded on the NHS for this condition on cost grounds, so it is only available privately. These are powerful medicines that carry a risk of infection and other side effects, and they are started and monitored by a specialist. Topical JAK inhibitors, by contrast, have not been shown to regrow scalp hair.
Can a hair transplant treat alopecia areata?
No, and this is an important and honest point, because it is a common misunderstanding. A hair transplant moves healthy follicles from one part of the scalp to another, but alopecia areata is an autoimmune condition, so the immune system would attack transplanted follicles in an active patch just as it attacks the original ones, and the moved hair would be lost. A transplant also does nothing to calm the underlying immune process. For these reasons a responsible clinic would not offer transplant surgery for active alopecia areata, and it is not a treatment for the condition. Surgery is suited to permanent, scarring or pattern hair loss, not to a condition in which the follicles are still alive and the hair may return on its own.
Living with alopecia areata and where to get support
The physical effects of alopecia areata are minor, but the effect on confidence and mood can be considerable, and UK research has found higher rates of anxiety and depression among people with the condition. Support is a legitimate part of managing it. Wigs and hairpieces can be bought privately or, in many cases, obtained through the NHS on a consultant's prescription, and cosmetic options such as hair fibres, eyebrow microblading and false eyelashes can help. It is also worth protecting any bald areas from the sun with a hat or sun block. For information and peer support, Alopecia UK is a well established charity covering all forms of hair loss. If your mood or wellbeing is affected, it is worth telling your GP, who can point you towards further help.
Frequently asked questions
Can alopecia areata be cured?
There is currently no cure, but this does not mean the hair is gone for good. Many people, especially those with small patches, see the hair regrow on its own, and several treatments can encourage regrowth. What no treatment can yet do is change the underlying tendency for the condition to come and go.
Will my hair grow back?
Often, yes. Because alopecia areata does not scar or destroy the follicles, regrowth is possible, and where the loss is limited about 4 in 5 people regrow fully within a year according to the British Association of Dermatologists. Recovery is less certain when more than half the hair, or all of it, is lost, and new patches can appear in the future even after a good recovery.
Is alopecia areata permanent?
Usually not. It is a non-scarring form of hair loss, so the follicles remain alive and the hair can return, unlike scarring alopecias where loss is permanent. The course is unpredictable, though, and in the more extensive forms, such as alopecia totalis and universalis, full natural regrowth is less likely.
Is alopecia areata hereditary?
There is a genetic predisposition. The British Association of Dermatologists notes that around 2 in 10 people affected have a family history of the condition, and it is more common alongside other autoimmune conditions. Having the predisposition does not make the condition inevitable, and most people with a family member affected never develop it.
Does stress cause alopecia areata?
Stress is not established as a direct cause. It is sometimes reported before an episode and may act as a trigger in some people, but the evidence is weak and the link may be coincidental. Managing stress is good for general wellbeing, but it is not a treatment for the condition itself.
Can a hair transplant fix alopecia areata?
No. Because the condition is autoimmune, the immune system would attack transplanted follicles in an affected area just as it attacks the original hair, so surgery is not a treatment for active alopecia areata and a responsible clinic would not offer it. Transplant surgery is intended for permanent hair loss, such as pattern baldness, not for a condition where the hair may regrow by itself.
Get back to Great Hair
in 3 Easy Steps:
01
Arrange Free Consultation
Speak to one of our specialist consultants for expert advice on our range of different hair loss treatments
02
Book Your Procedure
Place a deposit to reserve a time slot at one of the My Hair UK clinics across the UK
03
Attend Your Surgery
Arrive on the day and our specialist surgical team will look after your every need
