What Is the First Treatment for Alopecia Areata?

Alopecia areata is an immune-related condition that can cause sharply defined areas of hair loss on the scalp, beard area, eyebrows, or other hair-bearing skin. Steroid injection into the skin places medicine directly into a limited patch to calm local inflammation. Several small patches may be treated during a dermatology visit, with the schedule decided by the clinician.

The starting choice depends on the size, number, location, and duration of patches, as well as age and other health factors. Topical corticosteroids may be used when injections are unsuitable. More extensive or persistent hair loss can lead to discussion of JAK inhibitor treatment or oral corticosteroid treatment.

Have new, smooth patches assessed so the diagnosis is clear; fungal infection, traction, scarring disorders, and other causes can look different and need different care. Do not scratch or repeatedly pull at the area. Protect exposed scalp from sun and cold, and use gentle hair care while waiting for regrowth.

After steroid injection into the skin, follow the clinic’s instructions and report marked pain, skin thinning, colour change, or an unusual reaction. Hair regrowth can be uneven, and a patch may need monitoring even when treatment appears to be helping. Ask how the eyebrows, eyelashes, or beard should be managed if they are involved.

Book a prompt dermatology assessment when hair loss is sudden, spreading quickly, affecting eyelashes or eyebrows, or accompanied by scalp inflammation, pain, scaling, or scarring. Seek urgent help for facial swelling, breathing difficulty, or a severe medicine reaction. These warning signs are not typical reasons to simply wait for hair to return.

Are my patches suitable for steroid injection into the skin? Should topical corticosteroids be used instead or alongside it? How will we check for spread or regrowth? If the loss is extensive, when would JAK inhibitor treatment or oral corticosteroid treatment be considered?