What is alopecia areata?
Alopecia areata is autoimmune hair loss — the immune system attacks hair follicles, causing sudden patchy hair loss. Affects about 2% of people at some point. Can range from small patches to total scalp (alopecia totalis) or body (alopecia universalis) hair loss.
Hair often regrows spontaneously but can recur. Recent oral JAK inhibitors (baricitinib, ritlecitinib) have transformed treatment of severe cases.
Do I have alopecia areata? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Autoimmune — immune system attacks hair follicles. Genetic predisposition. Often associated with other autoimmune conditions (thyroid, vitiligo). Stress, illness sometimes trigger.
Is it contagious?
No.
The new JAK inhibitors are a real breakthrough for severe alopecia areata — but they're not first-line for limited patches.
Can it be treated online?
Routine alopecia areata is well-suited to telehealth. Severe or rapidly progressive cases, those needing JAK inhibitors (lab monitoring required), or atypical presentations benefit from dermatology referral.
How alopecia areata is treated
Limited disease: topical or injected corticosteroids, minoxidil. More extensive: topical contact immunotherapy, oral steroids short-term. Severe (>50% scalp): JAK inhibitors like baricitinib (Olumiant), ritlecitinib (Litfulo) — significantly effective but require lab monitoring.
Self-care while you wait
- Sun protection on bald patches
- Gentle hair care
- Wigs or hair systems for cosmetic management
- Address coexisting autoimmune conditions (thyroid)
- Stress management
- Support groups for psychosocial impact
- Patience — hair cycles take months
How long does it last?
Variable. Some patches resolve spontaneously in months. Some progress. JAK inhibitors can substantially improve hair growth in many.
Frequently asked questions
Will my hair grow back?
Often yes — many cases resolve spontaneously. May recur. Severe cases more likely to need treatment.
Is it stress-induced?
Stress can trigger flares but isn't the underlying cause. Genetics and immune system matter most.
Are the new oral medications safe?
JAK inhibitors require monitoring — labs, infection risk, blood clot risk. Most patients tolerate them well; benefits often outweigh risks in severe cases.
Will steroid shots work for me?
Often effective for limited patches. Multiple sessions needed.
Can my kids get it?
Increased risk with family history. Not directly inherited.
