Alopecia areata is an autoimmune condition in which the immune system incorrectly attacks hair follicles, causing patchy hair loss that can occur anywhere on the scalp or body. It affects approximately 2% of the population and has no direct relationship with androgenic alopecia — it can affect men and women of any age, including children.
The characteristic presentation is one or more smooth, round or oval patches of hair loss, typically appearing suddenly and without prior warning. The skin in the affected areas is usually normal in appearance. In some cases the condition progresses to alopecia totalis (complete scalp hair loss) or alopecia universalis (hair loss over the entire body), though these are less common.
Treatment options include topical or intralesional corticosteroids to suppress local immune activity, immunotherapy with diphenylcyclopropenone (DPCP), topical minoxidil, and — most recently — JAK inhibitors such as baricitinib, which have shown significant results in clinical trials for severe alopecia areata.
Hair transplant surgery is generally not recommended for alopecia areata in its active phase. The autoimmune process that destroyed the original follicles may also attack transplanted ones, and the unpredictable nature of the condition makes surgical planning very difficult. Surgery may be considered for patients with stable, long-standing alopecia areata — particularly those in complete remission for at least two years — but requires very careful case selection.
If you have been diagnosed with alopecia areata, a consultation with a dermatologist specialising in hair disorders is the appropriate first step, before considering any surgical intervention.
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