Alopecia areata

Alopecia areata is a type of non-scarring hair loss. In this post, you will read more about the subtypes, symptoms, cause and possible solutions.

Symptoms en subtypes

The literal translation of alopecia is hair loss. Alopecia areata literally means localized hair loss. There are three subtypes depending on how extensive the hair loss is:

  • Alopecia areata: this is the localized subtype: this type manifests itself in round/oval spots on your scalp
  • Alopecia totalis: in this case, you lose all the hair on your head, including your eyebrows and eyelashes
  • Alopecia universalis: with this type of hair loss, you lose all your body hair, so that includes your pubic and armpit hair, your leg and arm hair, your nose hair and all the other little hairs that you didn’t realize you had. It is possible to get itchy because of the hair loss, and it can sometimes cause hair pain too.


The cause of alopecia areata is a combination of genetic predisposition and an extreme trigger, such as stress or an infection. Due to a genetic abnormality, your immune system gets confused quite easily. People who have alopecia areata often have other autoimmune illnesses too (such as a thyroid disorder, vitiligo, eczema, asthma or hay fever). Worldwide, the chance of someone getting alopecia areata is around 2% per person. If you’re unlucky enough to get it, your immune system attacks your hair follicles. The inflammation that is caused by that is all the way down by the root, at the deepest point. The advantage of this is that it doesn’t affect your stem cells. Your stem cells are actually further up and they are the memory of your hair follicle - they are responsible for ensuring that new hairs can be generated. Therefore, your hair can start growing back. But if your immune system gets confused again because of an external trigger again (e.g. due to an operation, but also due to COVID-19 or its vaccine), it can fall out again.


If you only have a few bald spots, the chance of a spontaneous recovery is quite high. But the younger you are when the condition first appears, and the more extensive and long-lasting the hair loss is, the smaller the chance that you will ever be fully rid of it. If the hair loss lasts longer than a year, the prospects get worse. But it sometimes happens that alopecia areata changes from one subtype into another, so you get some of your hair back, or you lose some more. So there’s no guarantee.

As doctors find out more and more about this autoimmune disease, they can offer more targeted treatments. As a result of this, the chance of success increases and that of side effects decreases. Most treatments start with a hormone cream, foam or lotion, but they often don’t go deep enough.

Injections into the scalp do work, but they’re only for when you have few bald spots or if you want to have your eyebrows back, for example. You can’t get injections all over your scalp. If you decide to go for injections, you have to keep getting them every 4-6 weeks but after a while you can usually maintain the hair growth with a cream.

If injections don’t work (well enough), you can get immunosuppressive medication. There are many different types that you can try. But this has its disadvantages too, because it makes your defense against all kinds of diseases considerably weaker. The chance that a medication like this will work for you is around 50%, but the chance of all your hair growing back because of it is smaller. And you probably won’t be happy with half a head of hair… So you really need to weigh the advantages and disadvantages.