Areata hair loss: signs, assessment, and next steps

It can involve scalp, beard, eyebrows, eyelashes, or other hair-bearing areas. The skin may look normal, although short broken hairs or nail surface changes can occur. Appearance alone is not enough to confirm the cause.

Alopecia areata often produces sharply defined patches. Male pattern hair loss and female pattern hair loss more often cause a gradual distribution of thinning, while telogen effluvium typically presents with diffuse shedding. Traction alopecia follows repeated pulling, and scalp ringworm may cause scale, inflammation, or broken hairs.

A clinician may examine the scalp and hair shafts closely, review medicines and recent illness or stress, and ask about autoimmune conditions in the person or family. Testing is selected according to the pattern rather than performed identically for everyone.

Photograph affected areas in consistent lighting so change is easier to track. Use gentle hair care, minimise tight styles and harsh chemical processing, and avoid rubbing or repeatedly checking the patch. Note any itching, scale, pain, nail changes, or hair loss elsewhere.

Book a dermatology assessment for new patchy loss or unexplained shedding. Treatment depends on the diagnosis, extent, location, age, and effect on daily life. Finasteride treatment is used for certain pattern hair-loss conditions, not as a routine treatment for alopecia areata.

Seek prompt care when hair loss comes with a painful, hot, swollen, crusted, or draining scalp; fever; rapidly spreading inflammation; or suspected fungal infection in a child. These features may require treatment that differs from alopecia areata.

Arrange timely review if loss is rapidly progressing, affects eyelashes or eyebrows, involves extensive body hair, or causes substantial distress. Sudden shedding with weakness, weight change, menstrual change, or other systemic symptoms also deserves medical evaluation.

Ask which pattern the examination suggests, whether scale or broken hairs change the diagnosis, whether any blood or fungal tests are appropriate, what regrowth can reasonably be expected, and how treatment side effects will be monitored.