What is alopecia areata? It is an autoimmune disease that causes round areas of sudden baldness on the scalp, eyebrows or beard. How is it treated in 2025? Topical or injectable corticosteroids, immunotherapy, minoxidil and, in moderate-severe cases, approved oral JAK inhibitors (baricitinib, ritlecitinib and deuruxolitinib) achieve regrowth in 6-12 months.
Introduction: When the immune system attacks the follicle
Alopecia areata can appear overnight and affect self-esteem as well as personal image. In Latin America, it is estimated that 2% of the population will suffer at least one episode in their life. Identifying it early can stop hair loss and stimulate regrowth before permanent damage occurs to the follicle.
What is alopecia areata?
It is a non-scarring autoimmune disorder in which T lymphocytes mistake the follicle for a foreign agent and attack it, stopping the anagen (growth) phase. It can manifest as:
- Single plaques: round, coin-sized.
- Alopecia totalis: complete hair loss.
- Alopecia universalis: Hair and body hair loss.
Although it usually appears on the scalp, it also affects the beard, eyebrows, and eyelashes.
Causes and risk factors
| Factor | How it contributes |
|---|---|
|
Genetics |
1 in 5 patients has a first-degree relative with the disease. |
|
Acute stress |
It elevates inflammatory cytokines that trigger the immune attack. |
|
Viral infections |
They trigger molecular mimicry and loss of “immune privilege” of the follicle. |
|
Nutritional deficiencies (iron, vitamin D) |
They weaken local immune tolerance. |
|
Other autoimmunities |
Hashimoto’s thyroiditis, vitiligo and atopic dermatitis increase the incidence. |
Symptoms of alopecia areata: how to detect it
- Smooth, flaky patches: the scalp looks “polished”.
- Exclamation mark hairs: thin at the base and thick at the tip, visible with a dermatoscope.
- Moth-eaten nails: pitting or ridges in 20% of cases.
- Mild itching or tinglingbefore the hair loss.
If you experience two or more of these signs, see a trichologist dermatologist. At D’Atri, we use HD trichoscopy and a complete blood count to rule out any deficiencies that could aggravate the condition.
Treatments: How to control alopecia areata?
1. Corticosteroids
- Topicals (clobetasol foam 0.05%) for plaques smaller than 3 cm.
- Intralesional (triamcinolone 2.5-5 mg/mL) every 4-6 weeks.
- Systemic in extensive outbreaks < 3 months.
2. 5% Minoxidil
3. Contact immunotherapy
4. JAK inhibitors (2022-2024 revolution)
| Drug | Via | Dose |
|---|---|---|
|
Baricitinib |
Oral |
4 mg/day |
|
Ritlecitinib |
Oral |
50 mg/day |
|
Deuruxolitinib (Leqselvi®) |
Oral |
8 mg c/12 h |
They block the JAK-STAT pathway responsible for follicular inflammation and achieve ≥ 50% repopulation in 6 months in patients with severe alopecia. Recommended only under medical supervision due to the risk of thrombotic events and dyslipidemia.
5. Complementary therapies
- Low-Level Laser Therapy (LLLT) 650 nm, 20 min, 3 times/week.
- Micropuncture with PRP: improves vascularization and delivers growth factors.
- Anti-inflammatory diet: rich in omega 3, zinc and vitamin D.
Prognosis: Does alopecia areata heal on its own?
- 1 in 2 patients with small plaques regains hair within 12 months without treatment.
- Chronic (> 12 months) or extensive cases rarely regress spontaneously and require systemic therapy.
- The disease may relapse; That’s why we combine maintenance with minoxidil, supplementation, and stress management.
Treatment roadmap at D'Atri Hair Medicine
- Comprehensive evaluation (clinical history + trichoscopy + laboratory).
- Personalized plan: corticosteroids or JAK + PRP + nutritional guide.
- Digital monitoring every 8 weeks with HD macro photos.
- Emotional support: coaching and support groups.
- With this 360° approach, 9 out of 10 patients achieve hair loss control and visible new hair after 6 months.
Alopecia areata is no longer an unsolvable enigma. With early diagnosis, cutting-edge medical therapies, and healthy habits, it is possible to regain your hair and your confidence.
Next step
Request your free hair consultation at D’Atri Medicina Capilar. Our team will evaluate your case and create a plan tailored to your needs. Schedule your appointment todayand take control of your hair health.