How Is Alopecia Treated?
Medically reviewed by Brendan Camp, MD
A healthcare provider may prescribe topical treatments, red light therapy, or doxycycline for hair loss due to alopecia. Alopecia is a condition that causes partial or complete hair loss. Treatment is geared toward slowing hair loss, regrowing hair, or reducing inflammation.
A primary healthcare provider or a dermatologist (who specializes in the skin, hair, and nails) can diagnose and provide treatments. Cosmetic methods, such as hair transplants, tattoos, and wigs, can also help make hair loss less visible.
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Related: 10 Treatments for Atopic Dermatitis (Eczema)
Treatments by Alopecia Type
Different types of alopecia can cause different symptoms. Your treatment plan can vary depending on the underlying cause of your condition, as well as the pattern and location of the hair loss. Some people have hair loss on the scalp, face, or other body parts.
The hair loss may be temporary. Some types of alopecia can cause permanent hair loss when there's scarring on your hair follicles (the pores from which your hairs grow). You may want to visit a dermatologist for special treatments.
Androgenetic Alopecia
Androgenetic alopecia is a hereditary form of hair loss. The condition can affect men and women differently, so it's often called male- or female-pattern hair loss. A dermatologist may prescribe one or several medications that commonly manage androgenetic alopecia. Treatments tend to act slowly and may not regrow a full head of hair.
Medications may include:
Aldactone (spironolactone): Dermatologists prescribe off-label spironolactone to treat female-pattern hair loss. It can take months for spironolactone to work.
Propecia and Proscar (finasteride): These are brands of drugs that treat male-pattern hair loss. It requires a prescription and is taken as a daily pill. Some cases of post-menopausal female-pattern hair loss can benefit from off-label finasteride use. It may take about four months until you see an improvement.
Rogaine (topical minoxidil): This is a topical over-the-counter (OTC) medication and common off-label treatment for slowing hair loss and stimulating hair growth. It's also available as an oral pill, for which you will need a prescription. Some people shed more hair upon starting the treatment. It may take about three to six months for it to take effect.
What Is Off-Label Use?
A healthcare provider can sometimes prescribe off-label medications. This means the Food and Drug Administration (FDA) has not approved the drug to treat your condition. The drug's off-label use is most common in clinical practice. Documented case studies and research may support it.
Other treatments may be experimental therapies. These are treatments undergoing research:
Microneedling: This is a procedure for stimulating hair growth alongside drugs. A device with hundreds of small needles massages the scalp. Some studies find this treatment is effective, but more are necessary to confirm. Check with a dermatologist about microneedling. They can perform the procedure safely and correctly.
Platelet-rich plasma injections: This experimental treatment involves drawing a sample of your blood. Scientists take the plasma and cells called platelets and inject them into the scalp. Some evidence suggests that this treatment may be helpful, though more research is needed.
Red light therapy: Some evidence suggests that shining red light onto the scalp may promote hair growth. More studies are needed to confirm whether red light therapy works.
Alopecia Areata
Alopecia areata is an autoimmune disorder by which your immune system attacks the hair follicles, leading to hair falling out. As many as 50% of people enter remission, or a period of little to no symptoms. Remission makes it difficult to judge how well the treatments work. Some people even opt to go without treatment.
Some treatments for patchy hair loss may include:
Corticosteroids: These medications help treat inflammation and stimulate hair regrowth. A healthcare provider can prescribe topical corticosteroids, which you apply to the affected scalp or skin. One example of these is triamcinolone acetonide, two common brand names for which are Cinolar and Kenalog. There are also corticosteroid injections.
Eyelash treatments: A healthcare provider may prescribe medication to help eyelashes grow longer, such as Latisse (bimatoprost).
Other topicals: A dermatologist may prescribe off-label topicals, such as Rogaine, Dritho-Scalp (anthralin), topical squaric acid dibutyl ester (SADBE), or topical Janus kinase (JAK) inhibitors like Opzelura. Talk to a healthcare provider about how to apply the topical and how long to leave it on the scalp or skin.
Treatments for significant hair loss on the scalp or body include:
Contact immunotherapy: This usually involves rubbing a prescription drug on the scalp to help stimulate regrowth. These drugs include diphenylcyclopropenone (DPCP) or squaric acid dibutyl ester (SADBE). This type of treatment, also known as topical immunotherapy, stops the immune system from attacking the hair. As many as 70% of people using this treatment regrow their hair.
Olumiant (baricitinib) and Litfulo (ritlecitinib): These JAK inhibitors treat severe alopecia areata. The drugs are available as oral tablets and are immunosuppressants, meaning it can help prevent your immune system from attacking your hair follicles.
Otrexup (methotrexate): This is an off-label immunosuppressant prescription drug for treating alopecia areata. Methotrexate may be prescribed with a corticosteroid. These medications both come with severe side effects.
Telogen Effluvium
This form of alopecia occurs as a result of physiological or emotional trauma, leading to excessive hair shedding. A healthcare provider may recommend stress management methods, like relaxing or meditating. They may also advise taking supplements if you have any vitamin or mineral deficiencies, which blood tests can determine.
Tinea Capitis
Alopecia may occur because of tinea capitis, a type of fungal infection of the scalp. This form of alopecia is resolved by killing the fungus using treatments.
A treatment regimen may include:
Antifungal drugs: Oral antifungal drugs are prescribed to treat the fungal infection on the scalp. One common type of this is Lamisil (terbinafine).
Antifungal shampoo and creams: These don't typically cure an infection, but they can help prevent the spread of tinea capitis and relieve itching.
Topical steroids: You can apply these to the scalp to help reduce inflammation. You'll need to pair them with an antifungal drug. Using topical steroids alone can worsen a fungal infection.
Traction Alopecia
Repeated tension and pulling of the hair can result in traction alopecia. Some tight hairstyles can lead to this condition. A healthcare provider may advise avoiding some hairstyles and hair products. A common treatment plan can include prescription corticosteroids (either topicals or injections) to reduce inflammation.
Frontal Fibrosing Alopecia (FFA)
This form of alopecia is thought to be caused by immune cells attacking the hair follicles. Treatments for this condition may include:
Corticosteroids: Topical or injected corticosteroids can relieve inflammation. They can also help to regrow eyebrows.
Drugs for slowing hair loss: Prescription medications like Proscar (finasteride) or Avodart (dutasteride) may be taken off-label to slow hair loss. A healthcare provider may also prescribe Loniten (oral minoxidil) pills off-label or recommend Rogaine, which is an OTC medication. These options are taken with other treatments.
Doxycycline: This antibiotic can reduce inflammation. It comes in several brands, such as Doryx, Vibramycin, Acticlate, Monodox, and more. A healthcare provider may prescribe doxycycline for hair loss as an off-label method of treating FFA.
JAK inhibitors: These are drugs can treat several types of inflammatory conditions that affect the immune system. One example is Olumiant (baricitinib), which is FDA-approved for treating alopecia areata. A healthcare provider may prescribe these drugs off-label to treat FFA.
Plaquenil (hydroxychloroquine): This is drug usually treats malaria. A dermatologist may prescribe it off-label for this alopecia to reduce itching, pain, and other symptoms.
Red light therapy: Some evidence suggests that shining red light onto the scalp promotes hair growth. This low-level laser therapy needs further research to confirm its effectiveness.
Trichotillomania
Trichotillomania is a mental health condition that causes a compulsion to pull one's own hair out. A mental health specialist can provide treatments, such as a type of psychotherapy called habit reversal therapy. This therapy helps you become aware of potential triggers while improving mental strategies to reduce hair pulling. A psychiatrist can also prescribe antidepressants off-label for this condition.
Cosmetic Options
You can also try these cosmetic methods or procedures to help manage hair loss:
Concealers: Concealers are OTC sprays or powders that can hide hair loss. You may want to consult with your dermatologist for suggestions.
Hair transplant: This is a surgery by which a surgeon implants donor hair follicles into bald patches on the scalp. New hair may grow back, usually over several months.
Tattoos: You can get tattoos to fill in your hairline (scalp micropigmentation), as well as your eyebrows. Tattoos are permanent, but the ink can fade somewhat after several years.
Wigs: You can wear a wig or hairpiece to help cover permanent hair loss or while hair is regrowing.
Living With and Managing Alopecia
Most people who get alopecia live otherwise healthy lives. Here are some tips for your day-to-day hair care:
Avoid chemical hair products and relaxers.
Avoid using spiral hair ties, which can tug or twist on the hair shaft.
Eat more protein. Low-protein diets can cause hair loss.
Speak with a dermatologist or healthcare provider before taking any supplements. They may cause harm if you do not have a deficiency.
Switch to a gentle shampoo and use a moisturizing conditioner.
Try sleeping on a silk pillowcase, which might be more gentle on hair.
Use soft towels, brush your hair gently, and stop pulling or twirling your hair.
Use the blow dryer only on lower heat settings.
You can also wear hats and scarves to stay warm and protect yourself from sun exposure. The places where you've lost hair may become more sensitive to cold temperatures. You can wear glasses and false eyelashes to protect your eyes if you lose eyebrows or eyelashes.
Try to reduce stress, which can trigger some symptoms of alopecia. It may also help to connect with a therapist or an organization that supports people with alopecia. Many people find the National Alopecia Areata Foundation (NAAF) helpful.
Related: Cellulitis Treatments: 6 Things To Try
A Quick Review
Alopecia is a group of conditions that cause hair loss. Some treatments slow hair loss and help hair grow back. Most treatments are prescribed for off-label use or are experimental therapies that can take a long time to work. Some people with alopecia may use wigs, concealers, or other cosmetic procedures to make the hair loss less apparent.
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