What it is
Round, sharply edged bald patches that appear suddenly in the scalp or the beard, caused by the immune system turning on the hair follicle. The follicular openings are still present, which is what separates it from a scarring alopecia and is why regrowth is possible. Limited patchy disease is commonly treated with dilute corticosteroid injected into the patch; extent, activity, site and age decide whether that is the right step or whether the conversation moves to systemic treatment.
What this page covers
- Diagnosis, extent scoring and activity assessment of patchy non-scarring hair loss
- Intralesional corticosteroid to scalp and beard patches
- Distinguishing it from tinea capitis, trichotillomania and scarring alopecia
- Screening for associated thyroid disease, vitiligo, iron deficiency and vitamin D
- Eyebrow and beard involvement
- The decision on systemic treatment, including JAK inhibitors — stated openly as prescribed here or referred
- Alopecia areata in children
Honestly
The course is unpredictable: it can regrow on its own and it can return, and that is discussed honestly rather than glossed over. Repeated or over-concentrated steroid at the same point leaves a dip and a pale mark that is more visible on deeper skin, so injections are diluted and spaced and the area around the eye is avoided; extensive, rapidly progressive or childhood disease is a prescribe-or-refer decision made explicitly, and the emotional weight of visible hair loss is treated as part of the visit, not as a side issue.