Patchy Hair Loss: Causes & Treatment Options

The technical name for hair loss is alopecia and there are several different forms. 

Perhaps the most common form of alopecia is androgenetic alopecia, also known as male pattern baldness. This condition affects an estimated 50 million men in the United States alone and is caused by a genetic sensitivity to a hormone called dihydrotestosterone or DHT. 

While androgenetic alopecia causes gradual but significant hair loss over the entire head, some forms of alopecia are a little more localized. Take alopecia areata, for example. 

Alopecia areata is an autoimmune disease that causes your hair to fall out in patches. Patchy hair loss can be just as frustrating as diffuse hair loss, perhaps even more so given the fact it is difficult to treat. 

Though there is no known cure for patchy hair loss, some treatments may slow hair loss and help you regrow hair in areas affected by the condition. 

Below, we’ve explained what patchy hair loss is and what causes it. We’ve also discussed the topic of treatment for alopecia areata along with tips for regrowing hair affected by the disease.

What Is Patchy Hair Loss? 

Alopecia areata is a condition that causes your hair to fall out in patches. These patches are generally fairly small, but the more patches you develop the more likely they are to connect and form larger patches. This condition can even lead to total hair loss or alopecia universalis. 

In most cases, alopecia areata affects the skin on the scalp, but it can also affect the eyelashes, eyebrows, and hair on the face as well as other parts of the body. 

In many cases, alopecia areata develops slowly but sudden cases have been reported. Fortunately, hair loss related to alopecia areata is often temporary — the hair typically grows back within 12 months

It is common, however, for the condition to occur and sometimes new patches of hair loss develop at the same time old patches are regrowing. 

What Causes Patchy Hair Loss? 

Alopecia areata is classified as a skin disorder and, while the exact cause of the condition is unknown, it is often labeled an autoimmune disease. 

An autoimmune disease occurs when the immune system mistakes healthy cells for foreign invaders. 

Your immune system is designed to defend the body against foreign substances like bacteria and viruses, but in the case of autoimmune disease may end up attacking healthy cells instead. In the case of alopecia areata, the immune system attacks the hair follicles. 

White blood cells attack the hair follicles, damaging them and causing them to shrink. Over time, the hair follicles become smaller and may stop producing hair which results in patchy hair loss.

Again, the underlying cause of alopecia areata is unknown, but autoimmune diseases most often occur in people who have concurrent autoimmune diseases or a family history of them. For this reason, some scientists suspect alopecia areata may have a genetic component. 

What Are the Treatment Options For Patchy Hair Loss? 

Unfortunately, autoimmune hair loss is difficult to treat and scientists have yet to discover a permanent cure. 

That being said, the hair often regrows within 6 to 12 months, especially with treatment. The key to treating alopecia areata is to limit scalp inflammation and support regrowth in areas of hair affected by the autoimmune reaction. 

Here are the top three treatment options for patchy hair loss: 

Steroid Treatments 

The most common treatment for alopecia areata is corticosteroid injections. Corticosteroids have strong anti-inflammatory properties and can be injected directly into bald patches to suppress the body’s immune reaction. 

In one study involving 219 patients, 82 percent of patients with limited alopecia areata experienced improvements in hair regrowth following intralesional corticosteroid treatment. 

According to the National Alopecia Areata Foundation (AAF), corticosteroid injections are most effective for patients with mild hair loss (less than 50 percent). If the treatment results in new hair growth, it is usually visible within four weeks. Even better, there are few side effects associated with this treatment aside from temporary depressions in the skin called dells. 

Topical steroids may also be an option in patients who may not tolerate intralesional injections. Use of occlusive dressings may yield a higher response, leading to improvement of at least 25 percent in patients. 

Topical Treatments

In cases where corticosteroid injections fail to yield the desired result, topical treatments like minoxidil and anthralin might be beneficial.

Minoxidil is a common hair loss treatment known by the brand name RogaineⓇ. This medication is approved by the FDA and supported by scientific evidence as a treatment for several forms of hair loss. 

It won’t cure baldness, but it can improve hair growth by stimulating circulation to the scalp and encouraging hair follicles to enter the growth phase. 

The key to success with minoxidil is continued treatment — you need to use it daily to see and maintain results. 

Another topical treatment for alopecia areata is anthralin. Anthralin cream is a tar-like topical medication commonly used to treat psoriasis - it can be applied directly to the patches and washed off after 15 to 20 minutes. 

Limited research supports the use of anthralin for alopecia areata, but it may take longer to see results and there is some risk for scalp discoloration and irritation.

Oral Medications 

In some cases, short-term oral corticosteroid treatment may support hair regrowth in cases of alopecia areata. 

Prednisone is typically the drug of choice and it has been shown to be effective in the early stages of alopecia areata. 

In one small study, over half of patients experienced “cosmetically acceptable hair growth” in less than 2.5 months after starting prednisone treatment. 

Alopecia areata is a tricky condition due to the involvement of the immune system. It’s impossible to predict exactly how the condition will affect you. 

If your hair loss is fairly limited, it may grow back on its own within a few months with or without treatment. In cases of widespread hair loss, however, the effects can sometimes be permanent. 

Tips for Boosting Hair Growth 

Because alopecia areata is an autoimmune disease, it cannot be prevented. Neither can it be permanently cured. You may, however, be able to reduce the body’s autoimmune reaction to slow hair loss while taking steps to stimulate hair regrowth. 

Here are some tips for boosting hair growth

  • Be mindful of the hair products you choose. Avoid products made with harsh chemical ingredients and consider switching to shampoo that contains growth-supporting ingredients like saw palmetto

  • Follow a healthy diet to give your hair the nutrients it needs to grow. Certain nutrients like vitamin A, vitamin B12, vitamin C, vitamin D, and vitamin E may be beneficial. 

  • Consider taking biotin supplements. Though more research is needed to determine whether biotin can help treat hair loss, biotin supplementation may support hair growth. 

  • Avoid smoking and tobacco use. It’s no secret that smoking is bad for your health, but tobacco use can also be bad for your hair

  • Take steps to reduce and manage your stress. Though it’s unclear whether stress plays a role in alopecia areata, it can contribute to other forms of hair loss like telogen effluvium. 

As you wait for your hair loss treatments to take effect, there are simple things you can do to disguise your patchy hair loss. Changing your hairstyle, for example, is a simple solution to hide bald spots. 

Topical concealers like hair building fibers can help disguise patches of hair loss as well and tinted  lotion can be applied to the scalp to give the impression of thicker hair.

In Conclusion 

The cycle of hair growth is a complex process and it can be affected or interrupted by any number of factors, some of which may be beyond your control. 

An autoimmune disease like alopecia areata causes patchy hair loss that may occur suddenly or develop slowly over a period of years. Unfortunately, there is no known cure for this condition and no way to predict how it will affect you. 

Though alopecia areata isn’t currently curable, some hair loss treatments may help you regrow some of their hair you’ve lost. Check out our in-depth guide to alopecia types and how to treat it, or talk to one of our licensed telehealth consultants to discuss hair loss treatment options. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.