If you just received your diagnosis and have had alopecia areata for less than a year, your dermatologist may recommend a wait-and-see approach. Your hair may regrow on its own, making treatment unnecessary.

When treatment becomes necessary, your dermatologist will consider many factors, including:

• Your age

• The amount of hair loss you have

• Where you have hair loss

It’s important to know that no one treatment works for everyone. To find one that helps, you may need to try a few types of treatment or different medications. Here’s what your dermatologist may recommend.

If you are older than 10 years of age and have a few patches of alopecia areata, your dermatologist may recommend one or more of the following treatments:

• Injections of corticosteroids: To help your hair regrow, your dermatologist will inject this medication into the bald areas. These injections are usually given every 4 to 8 weeks as needed, so you will need to return to your dermatologist’s office for treatment.
  
  This is considered the most effective treatment for people who have a few patches of hair loss. In one study of 127 patients with patchy hair loss, more than 80% who were treated with these injections had at least half of their hair regrow within 12 weeks.

• Minoxidil: Also known by the brand name Rogaine®, minoxidil can help you keep the hair growth stimulated by another treatment. You will need to apply it 2 to 3 times a day. It’s helpful for the scalp, beard area, and eyebrows.

• Corticosteroids you apply: You apply this medication to the bald spots once or twice a day as instructed by your dermatologist. This medication tends to be less effective in adults than in children for hair regrowth.

• Anthralin: You apply this medication to the bald spots, let it sit on the skin for as long as your dermatologist says, and then wash it off. It will cause some skin irritation. To get the best results, you’ll also use minoxidil.

When alopecia areata causes widespread hair loss, complete loss of hair on the scalp (alopecia totalis), or loss of all hair (alopecia universalis), few people regrow their hair without help.

If you have this type of hair loss, your dermatologist may recommend:

• Contact immunotherapy: Also called topical immunotherapy, the goal of this treatment is to change your immune system so that it stops attacking your hair follicles. Dermatologists have:

  • Used this treatment for more than 30 years to treat widespread alopecia areata

  • Found that about 60% to 70% of patients have some hair regrowth

  
  If this is an option, you will need to return to your dermatologist’s office weekly for treatment. It’s important that you keep every appointment. Missed appointments can cause this treatment to stop working, causing the regrown hair to fall out.
  
  The treatment itself involves your dermatologist (or nurse) applying a chemical to your bald skin. The first time you receive this treatment, a small amount will be applied so that your body can start to develop a reaction to the chemical.
  
  Once you develop a reaction, the chemical will be applied weekly to your bald areas and left on for 48 hours. During this time, you must keep the treated skin covered and should develop a rash, complete with redness, swelling, and itch. This rash lasts about 36 hours.
  
  Contact immunotherapy is given weekly until you completely regrow your hair or the treatment fails to regrow any hair within 6 months.
  
  To increase the effectiveness of this treatment, your dermatologist may prescribe another treatment that you use at home.

If alopecia areata causes you to lose your eyebrows, your dermatologist may recommend one of the following:

• Stick-on eyebrows

• Semi-permanent tattoo

• Intralesional corticosteroids: A dermatologist can inject this medication to help the eyebrows start growing again. If the injections work, applying minoxidil (also known as Rogaine®) as directed may help you keep the regrowth.

Alopecia areata often begins during childhood. If your child has difficulty coping with the hair loss, treatment can often help regrow hair.

Treatment options for children 10 years of age and younger are:

• Corticosteroid you apply to the bald spots: Prescription-strength corticosteroids can help regrow hair. You apply this medication once or twice a day. For children, this alone can be an effective treatment.

• Minoxidil: Also known by the brand name Rogaine®, minoxidil can help maintain the regrowth after you stop applying the corticosteroid. It has few side effects, so it’s considered a good option for children.

Our eyelashes protect our eyes. If you lose some (or all) your eyelashes, your dermatologist may include one or more of the following in your treatment plan to help protect your eyes:

• False eyelashes

• Glasses: Wearing glasses helps to protect your eyes and make the hair loss less noticeable.

• Bimatoprost (or a similar medication): This is a prescription medication that’s approved to treat a type of glaucoma and high eye pressure. The U.S. Food and Drug Administration (FDA) has also approved it to help eyelashes grow longer.