Understanding Alopecia Areata—Signs, Types, and Treatments

Hair is more than its definition, it defines who we are. Whether we're heading out on the town with bedhead or spending more time than usual to perfect the perfect looking hair-do, everyone's hair is different—whether it's curly, straight, wavy, frizzy, graying, dyed gray, dyed to reflect the rainbow—and we use it as an expression of our personality. So imagine one day when your hair simply betrays you, falling from your scalp without warning. Too frightening a thought to bear? Unfortunately for some, this is a reality people living with Alopecia Areata deal with regularly.

Through Thick and Thin

When you think about hair loss, the image of a balding, elderly person may come to mind, which is as a result of male or female pattern baldness. The American Academy of Dermatology uses this blanket term to define Alopecia Areata as when your body’s immune system attacks your hair follicles, resulting in patchy hair loss.

People with Alopecia Areata often start noticing that their hair is thinning irregularly during childhood, and the majority of cases are usually diagnosed before the person turns 30. While men more often experience hair loss in general, this autoimmune disorder is more likely to impact women. On top of that, there is no one-size-fits-all when it comes to Alopecia Areata.

The different types of Alopecia Areata:

  1. Alopecia Areata Totalis
  2. Alopecia Areata Universalis
  3. Diffuse Alopecia Areata 
  4. Ophiasis Alopecia Areata
  5. Cicatricial Alopecia

The symptoms of Alopecia Areata are all characterized by ring-sized patches of hair missing from the scalp. If the condition expands or becomes any worse, it can develop into Alopecia Totalis or Universalis, so if you see one or more bare spots on your body where hair typically grows, contact your dermatologist for an official diagnosis.

Alopecia Areata Totalis

Doctors are weary to diagnose someone with Alopecia Areata Totalis because it's characterized as the complete loss of hair on the scalp. Currently, there's no known cure for this condition, but hair is known to regrow in patients even after several years. One-fifth of all people with this kind of hair loss have a family history with Alopecia as well, and is still different from a condition known as Telogen Effluvium, which is temporary and typically onset by stress.

Alopecia Areata Universalis

This condition is similar to Alopecia Areata Totalis, but instead results in total hair loss on the scalp and body. That includes: eyebrows, eyelashes, arms, legs, private area, inside of your nose, and anywhere else hair grows. This subtype of Alopecia is said to be the result of an autoimmune disease.

Diffuse Alopecia Areata 

Characteristically seen in younger women, Diffuse Alopecia Areata (also known as Alopecia Areata Incognito, or DAA)  does not appear as missing, coin-sized patches of hair. It presents as abrupt hair loss that affects the scalp. As with Totalis  and Universalis, this condition can reappear or be a one-off experience. A third of all women with DAA experience spontaneous hair regrowth and completely recover without treatment.

Physical or emotional stress, medication, radiation, a lack of biotin, and some diseases can cause hair loss like this to appear suddenly, which makes  keeping track of your health and mental well-being critical to your hair health.

Ophiasis Alopecia Areata

Ophiasis is a Greek term that translates to snake, coining this variation of Alopecia by hair loss in a serpent-like pattern. The uniqueness here stems from a T cell-mediated (an immune response that doesn't require any antibodies) autoimmune disease that presents as a hairband-like width of bald patches on the scalp. Hair loss is seen missing from the temporal lobe, occipital lobe, and parietal region of the head, and hair regrowth with Ophiasis can be more cyclical than the other conditions. 

Cicatricial Alopecia

With Cicatricial Alopecia, your growing hair follicles trigger an immune system response. Radically different from the other forms, hair follicles are replaced with scar tissue, making it difficult for new hair to push through your scalp. As a result, the scalp may have redness, depigmentation, scaly skin, or baldness. Reducing your body's inflammation, including eating more antiinflammatory food, can help with this type of Alopecia.

Treatment Options

If you're feeling frustrated at your diagnosis or you're weary about taking prescription medication, there are some remedies for Alopecia Areata:


Corticosteroids are effective in suppressing the immune system and reducing the immune response to hair loss can be effective, but may also have unwitting side effects. Always make sure to talk to your doctor before taking corticosteroids.


Minoxidil is a non-surgical treatment option that is used to trigger an allergic reaction to help stimulate hair growth, typically within 3 months of first and regular application. When it works effectively, a rash may appear and you should notice hair growth.

Other Options for Handling Alopecia Areata

People who develop Alopecia Areata and the resulting bald spots are usually completely blindsided, as it is an unpredictable disorder with minimal research compiled onto it. The National Alopecia Areata Foundation, Wigs for Kids, Locks of Love, Pantene Beautiful Lengths, and many other organizations can help assist you in finding wigs or hair-related substitutions you might be searching for. Otherwise, surgical hair replacement may be the only option left to consider.