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St. Louis Alopecia Areata Treatment

Close-up image of male scalp with patches of hair loss characteristic of alopecia areata.

Alopecia areata is an autoimmune disorder that causes hair loss. This occurs when the immune system mistakenly attacks the hair follicles, leading to patchy or complete hair loss in affected areas. This condition can occur at any age and can have a significant impact on one’s self-esteem and confidence. It's important to understand that there are different types of alopecia areata, including alopecia universalis where all body hair is lost.

At Mid-County Dermatology in St. Louis, MO, we take care of many patients with alopecia areata. In this article, we aim to provide you with information regarding the causes, symptoms, and treatment options for this condition. If you or someone you know has hair loss suggestive of alopecia areata, please call or text us at 314-994-0200 or book online to schedule your visit with our St. Louis dermatology team.

Causes and Risk Factors of Alopecia Areata

Alopecia areata is a condition characterized by hair loss, typically in patches on the scalp. While the exact cause of this autoimmune disease remains unknown, several factors contribute to its development. Understanding these causes and risk factors can explain why some individuals are more susceptible to alopecia areata than others.

Genetic Predisposition of Alopecia Areata

One of the primary factors that influence the development of alopecia areata is genetic predisposition. Research suggests that individuals with a family history of autoimmune diseases, such as rheumatoid arthritis, thyroid illness, or type 1 diabetes, have higher odds of developing alopecia areata. This indicates that certain genes may make someone more susceptible to this condition.

Triggers of Alopecia Areata

While genetics play a significant role, triggers also contribute to the onset of alopecia areata. Stress is known to be a common trigger for many autoimmune diseases, including alopecia areata. When an individual experiences high levels of stress, it can disrupt the normal functioning of their immune system, leading to hair loss.

Illnesses and infections can also act as triggers for alopecia areata. In some cases, an infection or illness can cause an overactive immune response that mistakenly targets hair follicles. Hormonal changes during pregnancy or menopause may increase the risk of developing this condition.

Can I prevent alopecia areata?

Unfortunately, there is currently no known way to prevent or predict who will develop alopecia areata. The complex interplay between genetics and environmental factors makes it challenging to identify specific individuals at risk. As research continues in this field, scientists hope to uncover more information about prevention strategies and predictive markers.

Is alopecia areata contagious? 

It's important to note that alopecia areata is neither contagious nor caused by poor hygiene. This condition is an autoimmune disease, meaning it occurs when the immune system mistakenly attacks healthy cells in the body. Hair loss associated with alopecia areata is a result of this immune response and not due to external factors such as uncleanliness or contagious agents.

Recognizing Common Alopecia Areata Symptoms

Alopecia areata is a condition characterized by patchy hair loss on the scalp or body. This article explores the common symptoms associated with this condition, including smooth, round bald patches, unpredictable regrowth, and the possibility of hair loss progressing to total baldness.

One of the primary symptoms of alopecia areata is patchy hair loss. People with this condition may notice small areas on their scalp or body where hair has completely fallen out. These patches are typically smooth and round in shape, without any scaling or redness. The sudden appearance of these bald spots can be alarming and may cause individuals to seek medical attention.

Regrowth is another characteristic feature of alopecia areata. While some individuals may experience spontaneous hair regrowth within a few months, others may find their regrowth unpredictable. In some cases, the regrown hair may have a different texture or color than the original.

Unfortunately, for some people with alopecia areata, the condition can progress beyond patchy hair loss. It can lead to complete loss of scalp and body hair, known as alopecia universalis. This more severe form of alopecia can significantly impact an individual's self-esteem and quality of life.

Telogen effluvium is often mistaken for alopecia areata due to its similarity in symptomatology; however, they differ in key aspects. Unlike telogen effluvium where there is diffuse shedding throughout the scalp resulting in overall thinning rather than specific patches or bald spots seen in alopecia areata.

It's important to note that while physical symptoms such as rash or redness aren't typically associated with alopecia areata itself, they may occur secondary to scratching or irritation caused by anxiety and stress related to the condition.

How Alopecia Areata is Diagnosed in St. Louis

Several tests and examinations can be conducted to determine the presence of this autoimmune condition. Let's explore the various methods used by dermatologists to diagnose alopecia areata.

Visual Examination of Affected Areas

The first step in diagnosing alopecia areata is a visual examination of the affected areas by one of our St. Louis dermatologists. This involves carefully inspecting the scalp for any signs of hair loss or bald patches. The dermatologist will closely examine the size, shape, and distribution of these patches to make an initial assessment.

During this examination, the dermatologist may also check for any other associated symptoms such as redness, scaling, or inflammation. Our dermatologists also use a dermatoscope to identify signs (exclamation point hairs and yellow dots) that are suggestive of alopecia areata. These observations help in distinguishing alopecia areata from other types of hair loss conditions.

Pull Test

To further assess hair shedding and confirm the diagnosis, a pull test may be performed. In this test, the dermatologist gently tugs on a small cluster of hairs from different areas of the scalp. If more than six hairs come out easily with gentle pulling, it indicates an increased likelihood of alopecia areata.

The pull test helps evaluate the stage and severity of hair loss in individuals suspected of alopecia areata. However, it is important to note that this test alone cannot provide a definitive diagnosis since a positive hair pull test can be seen in telogen effluvium, but serves as a supplementary tool in conjunction with other diagnostic methods.

Scalp Biopsy

In some cases where there is uncertainty regarding the diagnosis or when additional confirmation is required, a scalp biopsy may be recommended. During this procedure, a small sample of skin tissue is taken from the affected area on the scalp and examined under a microscope.

Scalp biopsies can help identify specific characteristics associated with alopecia areata such as miniaturized hair follicles or an increased number of immune cells around them. This microscopic analysis provides valuable insights to support the diagnosis and rule out other possible causes of hair loss.

Blood Tests

While there is no specific blood test available to diagnose alopecia areata, certain laboratory tests may be conducted to rule out underlying conditions that could contribute to hair loss. These tests help identify any hormonal imbalances, nutritional deficiencies, or autoimmune disorders that might be causing or exacerbating the condition.

Blood tests commonly performed in individuals suspected of alopecia areata include:

  • Complete blood count (CBC) to check for anemia or infection

  • Thyroid function tests to evaluate thyroid hormone levels

  • Antinuclear antibody (ANA) test to detect autoimmune disorders

  • Vitamin D and iron levels assessment

These blood tests assist in eliminating other potential causes of hair loss and provide a comprehensive evaluation of the individual's overall health.

Alopecia Areata Management in St. Louis 

Alopecia areata is a challenging condition that affects many individuals worldwide. While there is currently no cure available, several management and treatment options can help those living with this condition regain their confidence and promote hair regrowth.

Topical Steroids for Hair Regrowth

Topical corticosteroid medications such as Clobetasol 0.05% solution can be applied directly to the affected area to stimulate hair growth and reduce inflammation. These medications are typically most effective when used early in the course of the disease.

Steroid Injections for Hair Regrowth

One of the main types of treatment for alopecia areata involves steroid injections into the scalp. These injections work by reducing inflammation in the affected areas, which can stimulate hair regrowth. The steroids help to suppress the immune response that causes hair loss in alopecia areata patients. By targeting specific areas of baldness, these injections have shown promising results in promoting new hair growth.

Minoxidil Topical Solution

Another treatment option for alopecia areata is the use of a minoxidil topical solution. While primarily known for its effectiveness in treating male pattern baldness, minoxidil has also shown positive outcomes in some cases of alopecia areata. When applied directly to the scalp, minoxidil may promote hair regrowth by increasing blood flow to the hair follicles and extending their growth phase.


Immunotherapy involves the use of agents that stimulate the immune system to attack the cells that cause hair loss. This treatment is typically administered by a dermatologist in a clinical setting. Immunotherapy can be administered using a variety of different agents, including contact immunotherapy, diphencyprone (DPCP), and squaric acid dibutylester (SADBE).

Baricitinib (Olumbiant): A Breakthrough Medication

  • Baricitinib is an oral Janus kinase (JAK) inhibitor that has demonstrated efficacy in treating alopecia areata.

  • Clinical trials have shown that baricitinib can stimulate hair regrowth in individuals with moderate to severe cases of alopecia areata.

  • This medication works by targeting the immune system's response responsible for attacking hair follicles.

Alternative Oral Medications for Alopecia Areata

Oral medications such as isotretinoin, mycophenolate mofetil, minoxidil, methotrexate, and cyclosporine, can help to slow the progression of hair loss and stimulate new hair growth. These medications are typically reserved for more severe cases of alopecia areata or for cases that do not respond to topical treatments. These are medications that are used to suppress the immune system and are often used to treat alopecia areata.

Practical Tools for Coping with Alopecia Areata

Dealing with hair loss can be emotionally challenging for individuals with alopecia areata. Beyond medical treatments, managing the emotional impact becomes crucial in improving overall well-being. Here are some strategies:

  • Wigs: Many people find comfort in wearing wigs as they provide a natural-looking solution to cover bald patches.

  • Scarves: Scarves offer an alternative option for those who prefer a more casual or fashionable approach to covering up.

  • Counseling: Seeking professional counseling or joining support groups can provide valuable emotional support and guidance throughout the journey.

It's important to remember that each person's experience with alopecia areata is unique, so finding what works best on an individual basis is key.

Although there is no cure yet for alopecia areata, various management and treatment options exist to help individuals cope with the condition. Steroid injections and minoxidil topical solutions have shown promising results in stimulating hair regrowth. Addressing the emotional impact through the use of wigs, scarves, and counseling can greatly assist individuals in managing the challenges associated with hair loss.

By exploring these treatment options and finding suitable coping mechanisms, those living with alopecia areata can regain their confidence and improve their overall quality of life. While a cure may still be on the horizon, it's essential to remember that there is hope and support available for individuals facing this condition.

Advancements in Research on Alopecia Areata

Growing understanding of immune system involvement

Scientists have made significant progress in unraveling the mysteries of alopecia areata, a condition characterized by bald patches on the scalp or body. Recent research has shed light on the role of the immune system in this perplexing disorder. Studies have shown that alopecia areata is an autoimmune disease, wherein the body's immune system mistakenly attacks its own hair follicles, leading to hair loss.

This newfound understanding has opened up avenues for innovative treatments targeting the immune system. Researchers are exploring various immunomodulatory therapies to suppress the abnormal immune response and promote hair regrowth. These advancements bring hope to individuals struggling with pattern baldness caused by alopecia areata.

Stem cell research shows promise for future treatments

The field of dermatology has witnessed exciting developments in stem cell research, offering potential solutions for those affected by alopecia areata. Scientists have discovered that certain cells within hair follicles possess regenerative properties, capable of stimulating new hair growth. Harnessing this knowledge, researchers are exploring ways to activate these dormant cells and induce hair regrowth in bare patches.

Stem cell-based therapies hold immense promise as they offer a targeted approach to treating alopecia areata at its root cause. By rejuvenating damaged or dormant hair follicles, these cutting-edge treatments aim to restore not only scalp hair but also other types of body hair lost due to the condition.

Increasing focus on improving the quality of life for patients

Beyond finding a cure, there is a growing emphasis on enhancing the overall well-being and quality of life for individuals affected by alopecia areata. Researchers and healthcare professionals recognize the psychological impact of hair loss and are actively working to address it.

Psychosocial interventions, such as support groups and counseling services, have proven beneficial in helping patients cope with the emotional challenges associated with alopecia areata. Advancements in cosmetic dermatology offer solutions like scalp micropigmentation and realistic wigs that help individuals regain confidence and feel comfortable in their skin.

Living with Alopecia Areata 

Living with alopecia areata can be challenging, but there are various coping strategies and support systems available to help individuals navigate this condition. By educating oneself about the condition, finding support from others, seeking counseling or therapy, and exploring cosmetic options, people with alopecia areata can enhance their emotional well-being and boost their confidence.

Educating oneself about the condition is empowering

Understanding alopecia areata is crucial for effectively managing its impact on one's life. Learning about the causes, symptoms, and treatment options empowers individuals to make informed decisions regarding their health. By researching reputable sources such as medical websites or consulting healthcare professionals, people can gain valuable insights into how to cope with alopecia areata.

Finding support from others with alopecia areata through support groups or online communities

Connecting with others who share similar experiences can provide a sense of belonging and understanding. Support groups specifically designed for individuals with alopecia areata offer a safe space to discuss challenges, exchange advice, and find encouragement. Online communities also provide an avenue for connecting with people globally who face similar struggles. These platforms allow individuals to share their stories, seek guidance, and build relationships within the comfort of their homes.

Counseling or therapy can help manage emotional challenges

Coping with hair loss due to alopecia areata can take a toll on a person's emotional well-being. Seeking professional counseling or therapy can be immensely beneficial in managing these challenges. A trained therapist can guide how to navigate feelings of insecurity or anxiety associated with hair loss. They may also help develop coping mechanisms that promote self-acceptance and resilience.

Cosmetic options like wigs or makeup can boost confidence

For some individuals living with alopecia areata, cosmetic solutions play a significant role in boosting self-confidence. Wigs offer a way to restore the appearance of natural hair while providing flexibility in experimenting with different styles. Makeup techniques, such as eyebrow pencils or eyelash extensions, can help create a more defined and balanced facial appearance. Exploring these cosmetic options allows individuals to regain control over their physical appearance and enhance their self-esteem.

Living with alopecia areata can be challenging, but by educating oneself about the condition, seeking support from others, considering counseling or therapy, and exploring cosmetic options, individuals can navigate this journey with greater confidence and emotional well-being. Remember that you are not alone—many others have faced similar challenges and have found ways to embrace their uniqueness while living fulfilling lives.

Alopecia Areata: A Recap and Resources for You

We've covered all the essential aspects of alopecia areata, from its causes and symptoms to diagnosis, management, and living with this condition. Now that you're armed with this knowledge, you can take control of your journey and make informed decisions about your hair health.

If you or someone you know is dealing with alopecia areata, remember that you're not alone. Seek support from friends, family, or online communities who understand what you're going through. Remember to consult one of our dermatologists at Mid-County Dermatology at Missouri Baptist Medical Center for an accurate diagnosis and personalized treatment plan. Together, we can navigate the challenges of alopecia areata and find ways to embrace our uniqueness.


Can alopecia areata be cured completely?

While there is currently no known cure for alopecia areata, spontaneous hair regrowth is possible in some cases. Treatment options such as medications, injections, and topical therapies can help stimulate hair growth and manage the condition effectively.

Is stress a major factor in developing alopecia areata?

Stress can be a triggering factor for some individuals with a genetic predisposition to alopecia areata. However, it's important to note that not everyone who experiences stress will develop this condition. Managing stress levels through relaxation techniques or seeking professional help can potentially reduce the risk.

Can I prevent my hair loss from worsening?

Although preventing further hair loss entirely may not be possible in all cases of alopecia areata, certain measures can be taken to minimize its impact. Protecting your scalp from harsh weather conditions (like excessive sun exposure) and avoiding hairstyles that pull on the hair roots may help maintain healthier hair.

Will my hair grow back after an episode of alopecia areata?

Hair regrowth varies from person to person. Some individuals may experience spontaneous regrowth within months or years without any treatment intervention. Others might require medical interventions to stimulate hair regrowth. It's essential to consult a healthcare professional for personalized advice and guidance.

Can alopecia areata affect other parts of the body?

Yes, alopecia areata can affect hair growth on other areas of the body besides the scalp. It may cause hair loss in eyebrows, eyelashes, beard, or even body hair. The extent and pattern of hair loss can vary from person to person.

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