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Hair problem
Alopecia areata causes round, well-defined patches in the hair, sometimes in the beard or eyebrows as well. It has an immune origin and is not contagious. Its course is unpredictable: the hair may grow back on its own or the patches may reappear. Here we explain how to recognise it and what a medical assessment can clarify.
Reviewed by Dr Michelle Campagnoli, clinical director
How to recognise it
Alopecia areata usually has a characteristic look: rounded patches of smooth skin that appear without pain. These signs can help you tell whether this is your case.
Tick what you recognise
Tick the signs you recognise in your case. This is not a diagnosis, it is only meant to give you an idea.
You recognise some of these signs. It may be alopecia areata or it may have another cause. Only a medical assessment can confirm it.
Several signs are consistent with alopecia areata. A medical assessment confirms the diagnosis and rules out other causes. Only the doctor can confirm it.
Book an assessment consultationSudden, diffuse hair loss across the whole scalp, pain, sores, pus or heavy scaling should be seen without delay, because they usually have another cause.
Round patches. They appear with well-defined edges, smooth skin and no pain; there may be just one or several.
Skin and hairs at the edge. The doctor examines the skin in the patch and the hairs near the edge, which help confirm the diagnosis.
Back of the head and sides. These are common sites, and the patches can go unnoticed until someone sees them.
Why it happens
No single cause is known. Choose a factor to see what may contribute and what helps.
In alopecia areata, the body's defences mistakenly attack the hair follicles, which go into a resting state. It is not contagious and it is nobody's fault. The follicle is not destroyed, so the hair may grow back.
Thinking it is contagious or that something you did caused it.
Understanding that it is a reaction of the body, with a medical assessment to confirm it.
You are more likely to have it when there are cases in the family, of alopecia areata or of other immune conditions. But it can appear with no known case.
Looking for someone to blame in the family or in your diet.
Telling the doctor your family's health history.
Alopecia areata may appear together with thyroid changes and other immune conditions. The doctor may request blood tests when they find them useful.
Ignoring other symptoms, such as tiredness or changes in weight.
Blood tests, when useful, and a look at your overall health.
Some people notice the patches after a period of great stress, but stress is not a proven cause. Losing hair, in turn, takes an emotional toll, and support matters.
Hiding how you feel and isolating yourself.
Talking about it, asking for support and keeping up sleep routines and breaks.
Patches in the hair can also come from ringworm (tinea), traction, other alopecias or scalp problems. That is why assessment is important before any decision.
Treating it on your own without confirming the cause.
A consultation to examine the patch and rule out other causes.
Alopecia areata or another cause
Not every patch in the hair is alopecia areata. These signs help tell them apart, but only the doctor can confirm it.
What it looks like. A round or oval patch of smooth, normal skin, with no pain or sores, with well-defined edges.
How it progresses. It is unpredictable: it may grow back on its own, stabilise or appear somewhere else.
What the clinic does. The doctor examines the patches, confirms the diagnosis and assesses whether any treatment can support the plan.
Follow-up. The progression is monitored, with reviews over time.
What it looks like. Patches with scaling, redness, pus, intense itching or hair broken close to the root.
Warning. Pain, crusts or marked inflammation call for a prompt assessment, for example to rule out ringworm (tinea).
What the clinic does. The doctor looks for other causes, such as traction, deficiencies, thyroid problems or other alopecias.
Tell us at the consultation. When the patch appeared, whether it is growing, whether there are cases in the family and what has changed recently.
Has a round patch appeared in your hair? Book an assessment consultation, so the doctor can work out what it is and what can be done.
Book an assessment consultationWhat the clinic can do
Alopecia areata has an unpredictable course and no treatment guarantees a result. The doctor assesses your case and sees whether any of these options can support the plan, without promising a cure.
Regeneration
Vitamins, amino acids, minerals and hyaluronic acid, to nourish the scalp and support the follicle environment.
Suitable when
the doctor considers that scalp nourishment may support the plan.
Find out more→
Regeneration
Platelet-rich plasma, obtained from your own blood, to stimulate the follicle. The doctor first assesses whether it is appropriate.
Suitable when
the doctor considers that stimulating the follicle may support the plan.
Find out more→
Advanced regeneration
A regenerating solution to support the scalp and the follicle environment.
Suitable when
the doctor considers it useful to reinforce the plan with a regenerating active ingredient.
Find out more→What about oral therapy and other medical options? The doctor explains the options and chooses them after the assessment and, if useful, blood tests. When the case warrants it, the doctor may also refer you to dermatology. Results vary from person to person.
What the journey looks like
No treatment starts without an assessment consultation with the doctor. This is how it works.
The doctor asks when the patch appeared, whether it is growing or whether there are new ones, whether there are immune conditions in the family, and examines the scalp and the skin in the patch.
If useful, the doctor requests blood tests and looks for other causes, such as ringworm (tinea) or traction. The doctor explains what to expect, without promising results.
The doctor assesses whether any of the clinic's options can support the plan and, where appropriate, refers you to dermatology.
We look at the hair again after some time and adjust the plan, because the course is unpredictable.
Day to day
Nothing causes alopecia areata and there is no way to prevent it on your own. But some habits help you live better with it, alongside the doctor's plan.
The golden rule
The course is unpredictable and this can weigh on you. A medical assessment brings clarity, and talking about how you feel is also part of care.
The skin in the patch is normal and deserves care.
In practice: wash with a mild shampoo and use a soft brush.
Exposed skin burns easily.
In practice: use sunscreen, a hat or a scarf over the patches.
Losing hair affects self-esteem.
In practice: talk to someone you trust and tell the doctor how you feel.
It helps the doctor see where it is heading.
In practice: photograph the patch now and then, in the same light.
Irritating the skin does not help.
In practice: avoid rubbing, scratching or pulling out hairs.
There is no proof that they work.
In practice: talk to the doctor before applying products to the scalp.
They may not solve it and they may do harm.
In practice: only take supplements if the doctor advises it.
The internet mixes very different cases.
In practice: bring your questions to the consultation.
Who will look after you
At Luxmed, the first step is always an assessment consultation with Dra. Michelle Campagnoli. She examines the patches, rules out other causes and designs the plan with you.
Hair medicine
The first signs and when to ask for an assessment.
Read the article →
Hair medicine
What may be behind it and why it is important to rule out other causes.
Read the article →
Hair medicine
Talking about it and asking for help is part of care.
Read the article →Other hair problems
Book a consultation
Choose how you prefer to get in touch. We will arrange the assessment consultation with Dr Michelle Campagnoli.
New Life Miraflores, Algés · Office Center, R. Santa Teresa do Menino Jesus n.º 6, 9.º C, 1495-048
Your details are used only for this contact. Any treatment depends on a prior medical assessment.
No. It is a condition of immune origin and it is not passed on through contact, sharing a brush or living together.
It may be alopecia areata, but it could also be ringworm (tinea), traction or other causes. Only a medical examination can tell which, so it is worth getting assessed.
There is no cure that can be promised. The course is unpredictable: in many people the hair grows back, in others the patches return. The doctor explains what is realistic in your case.
It can happen, even without treatment, especially when there are only a few patches. It cannot be guaranteed, so it is useful to be assessed and followed up.
It can. Alopecia areata tends to come in phases and the hair may fall out again at another time. Follow-up helps you react early.
Depending on the case: NCTF hair treatment, hair PRP, hair exosomes and oral therapy or other options chosen by the doctor. None is decided before the consultation, and none guarantees a result.
We do not promise a cure. The doctor assesses whether any treatment can support the plan in your case and explains what to expect.
Not always. After the assessment, the doctor decides whether follow-up at the clinic makes sense or whether you should be referred to dermatology.
Sometimes. The doctor may request blood tests, for example for the thyroid, when they find them useful for your case.
As soon as you notice a round patch or hair falling out in well-defined areas. Pain, sores or hair loss across the whole scalp should be seen without delay.
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The assistant does not give diagnoses or replace a consultation. The plan and cost of any treatment are set at the medical assessment.