Treatment of alopecia areata is not necessary because the condition is not dangerous to a patient’s overall health. However, the disease can have an emotional impact, which may improve through treatment. Recurrent hair growth followed by hair loss is common in people with alopecia areata. There is no cure for the disease, nor are there any specifically approved treatments.

Hair regrowth is always possible for patients, regardless of the severity of hair loss, because follicle production is not affected. Regrown hair is often white and very fine at first, but over time it regains most or all of its normal color and texture. Regrowth of all the hair may take months or years.

Although they do not prevent new bald patches, some medications approved for other purposes may be useful in regrowing hair, including:

• Corticosteroids. Anti-inflammatory drugs that reduce pain and swelling. These allow hairs to regrow by decreasing the activity of the white blood cells attacking the follicles. Corticosteroids suppress the immune system and may be administered to treat alopecia areata in three ways:
  
  
• • Local injection. Hairless patches on the scalp or other areas (e.g., beard) may benefit from the injection of corticosteroids. The injections provide small doses of cortisone to the affected areas, allowing hair to grow. Large, hairless areas typically are not treated this way for a variety of reasons (e.g., number of shots required, increased risk of side effects).
    
    
  • Oral corticosteroids. These are often used to treat cases of more extensive hair loss. Due to the possibility of certain serious side effects (e.g., cataracts, high blood pressure, loss of bone density) oral corticosteroids are typically used over relatively short periods of time.
    
    
  • Topical ointments. Alopecia areata may be treated with ointments or creams containing corticosteroids. However, they tend to be less effective than injections or oral corticosteroids.
    
    
• Topical immunotherapy. A treatment that may be effective for patients with severe alopecia areata. A liquid solution is administered to the scalp once a week, with the concentration of the solution increasing at each session until a mild allergic reaction occurs. Recipients of this treatment frequently experience hair regrowth, though many experience relapses in hair loss as well. Topical immunotherapy may cause certain side effects in some patients (e.g., rash, swollen lymph nodes).
  
  
• Minoxidil (a type of vasodilator [drug used to expand arteries]). A topical solution approved by the U.S. Food and Drug Administration (FDA) to treat hair loss in men and women. Minoxidil may also be effective at growing hair in patients with alopecia areata. When effective, new hair usually grows within about 12 weeks. Minoxidil must be continually used in order to be effective. Any hair growth experienced will fall out if the use of the drug is discontinued.
  
  
• Finasteride. An oral drug used to slow hair loss and sometimes regrow hair. Finasteride inhibits the conversion of testosterone into dihydrotestosterone (DHT), a hormone that shrinks hair follicles. Like minoxidil, the drug must be used continually in order to be effective. Finasteride cannot be used by women who are or may become pregnant due to a risk of birth defects in male fetuses.
  
  
• Anthralin. A tar-like substance that suppresses immune function in the skin. Approved to treat psoriasis, anthralin may also be used to treat alopecia areata in some cases.  It is applied topically to the affected area for short periods of time (approximately 20 minutes to one hour). When effective, results may take as long as eight to 12 weeks. It is often used in combination with other treatments (e.g., minoxidil, corticosteroids) for better results.
  
  
• Sulfasalazine. Often used to treat other autoimmune diseases (e.g., psoriasis, rheumatoid arthritis). Sulfasalazine suppresses the body’s immune system and may be effective in treating alopecia areata. Although this medication may help patients regrow hair, it increases the risk of infection and other serious side effects (e.g., skin cancer). Sulfasalazine may not be the preferred treatment for most patients.
  
  
• Photochemotherapy. A type of therapy that uses drugs, which increase the skin's sensitivity to ultraviolet radiation (photosensitizing agents), followed by exposure to light. Many people receiving photochemotherapy to treat alopecia areata experience hair regrowth. However, many patients undergo treatments several times per week for it to be effective. Photochemotherapy also carries an increased risk for serious side effects (e.g., skin cancer).

The cause of alopecia areata is unknown, making prevention of the disease impossible. Limiting stress may be beneficial for predisposed individuals, as stressful events may have a triggering effect. In addition, taking some preventative measures may minimize the embarrassment and dangers of extensive hair loss. These measures include:

• Applying sunscreen. Exposed areas of the scalp and face may scar or burn when exposed to harmful sunlight. Liberal application of sunscreen can help minimize this risk.
  
  
• Wearing eyeglasses and sunglasses. In addition to protecting eyes from the sun, sunglasses can guard the eyes from harmful debris if eyebrows or eyelashes are missing. Eyeglasses also shield the eyes.
  
  
• Use of hats, wigs and scarves. Wearing these items will protect the scalp from harmful sunlight while keeping the head warm.
  
  
• Use of cosmetics. Colored powders and creams can be applied to the scalp to camouflage areas where hair is missing. Eyebrow pencil can also be used to hide missing eyebrows.

Because hair loss can take an emotional toll on a person, patients may benefit from joining an alopecia areata support group. Counseling from a mental health professional can also help boost a patient’s self-esteem.