How to stop alopecia areata from spreading?

Table of Content:
Can you stop alopecia areata from spreading? | When to seek medical care? | What is alopecia areata? | Is it genetic? | Why does it spread? | Triggers | Symptoms | How to stop it?

Alopecia areata is an autoimmune condition that can be unpredictable. Some patients develop one or two patches that regrow spontaneously, while others may experience progressive or recurrent hair loss over time.

We asked Dr. Ben Williams, dermatologist and hair loss expert, whether it is possible to stop alopecia areata from spreading — and what actually makes a difference.

Can you stop alopecia areata from spreading?

According to Dr. Williams, for any type of hair loss, including alopecia areata, early intervention and appropriate treatment gives the best chance of preventing further progression and supporting regrowth. Time is hair.

Because alopecia areata is autoimmune, there is no guaranteed way to permanently stop it. However, controlling inflammation early may reduce the risk of new patches forming and may help preserve active hair follicles.

When to seek medical care for alopecia areata?

Consult a dermatologist if you notice:

• Sudden round bald patches
• Enlargement of existing spots
• Eyebrow or eyelash loss
• Rapid progression

Early evaluation allows timely intervention.

What is alopecia areata?

Alopecia areata is a common autoimmune disorder that presents as:

• Discrete, smooth, nonscarring patches of hair loss
• Most commonly on the scalp
• But also affecting beard, eyebrows, eyelashes, or body hair

The immune system mistakenly targets hair follicles, causing them to shrink and enter a dormant phase. While follicles are not destroyed (non-scarring), prolonged inflammation may make regrowth more difficult over time.

In early regrowth stages, hairs may appear:

• Thinner
• Shorter
• White (a phenomenon known as poliosis)

The lifetime risk is estimated at approximately 2%.

Is alopecia areata genetic?

To some extent. It is believed that alopecia areata may only occur in individuals who have inherited certain genes that make them more susceptible to this condition, however, the exact cause of this and other autoimmune diseases is not fully understood. Alopecia areata can be triggered by emotional stress, viral infections, or medications. These triggers affect the production of certain substances in the body that are involved in inflammation. Specifically, they reduce the levels of two anti-inflammatory substances affecting the body’s immune response, contributing to hair loss in Alopecia areata. 

Why does alopecia areata spread in some people?

Some individuals:

• Experience a few isolated patches that regrow

Others may develop:

• Recurrent patches
• Enlarging bald areas
• Alopecia totalis (entire scalp)
• Alopecia universalis (loss of all body hair)

According to Dr. Williams, the exact cause is not fully understood and current evidence suggests:

• Autoimmune dysregulation
• Genetic predisposition
• Possible environmental triggers

Potential triggers of alopecia areata

• Emotional stress
• Viral infections
• Certain medications
• Coexisting mental health conditions

However, Dr. Williams says that not all patients identify a trigger.

Alopecia areata symptoms

• Patches of hair loss (usually circular) in scalp, beard, eyebrows, eyelashes and body
• Nail pitting

In some cases:

• Itching
• Change of color on skin patches
• Visible, mouth-like openings in your hair follicles
• Regrowth of shorter, miniaturized hairs that are thicker on the top and narrow at the base in their early stages
• regrowth with white hairs or poliosis⁶

How to stop alopecia areata from progressing?

Dr. Williams says that for any type of hair loss, not only in the case of alopecia areata,  early intervention and appropriate treatment by a dermatologist is the best chance of preventing further hair loss and regrowing your hair back.

Manage your stress levels

There is likely a large connection between stress and alopecia areata since there is scientific evidence that substance P and corticotropin-releasing hormone (CRH) which are produced during emotional stress can initiate or increase the development of alopecia areata⁷. 

Research shows a clear association between mindfulness and reduced levels of depression and anxiety, both through direct and indirect pathways. Factors like suppression, reappraisal, worry, and rumination all played significant roles as mediators in the connection between mindfulness and depression. A similar pattern emerged when examining the relationship between mindfulness and anxiety⁸.

Oral minoxidil as an adjunctive therapy

Low-dose oral minoxidil does not directly treat the autoimmune pathway, but may:

• Promote transition into the anagen (growth) phase
• Increase hair thickness
• Accelerate regrowth

A study conducted where 65 patients with severe and treatment-resistant alopecia areata were given oral minoxidil at a low dose of 5 mg every 12 hours (in addition to a low sodium diet). Results showed that oral minoxidil led to faster and more extensive hair regrowth compared to its topical counterpart⁹.

Furthermore, an article published by the American Academy of Dermatology (AAD) suggests that it is advisable to prescribe a low-dose oral minoxidil for various hair loss types as it effectively enhances hair thickness and overall volume. While hypertrichosis (excessive hair growth) may occur, most patients are highly satisfied with the results, often choosing to manage the excess hair through methods like epilation or depilation while continuing the treatment¹⁰.

Topical corticosteroids (clobetasol propionate)

Used especially in:

• Mild cases
• Pediatric patients

Studies in moderate-to-severe cases have demonstrated significant regrowth in 70–90% of treated children and adults.

Topical absorption is more limited compared to intralesional injections.

Studies conducted in children and adults with moderate to severe alopecia areata showed that the application of a topical 0.05% clobetasol propionate foam demonstrated significantly better scalp hair growth, with 70% to 90% of children and adults achieved significant hair regrowth with some of them experiencing complete hair regrowth¹¹.

Topical anthralin (dithranol)

A synthetic compound derived from coal tar.

Though used less frequently today, studies in pediatric alopecia areata have shown regrowth rates exceeding 75% with consistent treatment for at least 6 months.

Research has shown the effectiveness and tolerance of topical anthralin for the treatment of pediatric alopecia areata in treatment duration of at least 6 months to attain a hair regrowth rate exceeding 75%¹².

Intralesional corticosteroids

Often considered the most effective treatment for localized patchy alopecia areata.

• Injected into the deep dermis
• Typically repeated every 4–6 weeks
• Commonly used concentration: 2.5–10 mg (5 mg frequently preferred for scalp and face)

Numerous studies have established the effectiveness of intralesional corticosteroid injections in treating alopecia areata. A particular study reported a remarkable hair regrowth rate of 71% in patients with subtotal alopecia areata with triamcinolone acetonide injections. 

Contact immunotherapy

Reserved for more extensive or treatment-resistant cases. This approach deliberately induces a controlled allergic reaction to modulate immune activity around hair follicles. Treatment requires supervision by an experienced dermatologist. Results vary and therapy may be prolonged.

Is there a cure for alopecia areata?

Dr. Williams says there is currently no definitive cure for alopecia areata.

However:

• Many patients experience spontaneous regrowth
• Others respond well to treatment
• Some experience cycles of remission and relapse

Outcomes vary significantly between individuals.

Conclusion

Stopping alopecia areata from “spreading” is not always possible, but early diagnosis and appropriate treatment offer the best chance of stabilizing the condition and promoting regrowth.

As Dr. Williams emphasizes, prompt care matters — because in autoimmune hair loss, time plays a critical role.

Article References:
https://www.sciencedirect.com/science/article/abs/pii/S0738081X18301822
https://my.clevelandclinic.org/health/diseases/12423-alopecia-areata
https://pubmed.ncbi.nlm.nih.gov/37511468
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418017/
https://pubmed.ncbi.nlm.nih.gov/3674909/
https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365156
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149478/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320486/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002409/
https://pubmed.ncbi.nlm.nih.gov/37326792/
https://www.ema.europa.eu/en/medicines/human/EPAR/litfulo
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556173/