Overview

Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles, causing patchy hair loss on the scalp, beard, eyebrows, and eyelashes. It has notably higher prevalence in Arab and GCC populations. Hair loss is often not permanent and many patients regrow hair with treatment, but the condition can recur unpredictably.

Symptoms

• Round or oval smooth bald patches on the scalp; patchy beard loss in men
• Loss of eyebrows or eyelashes; nail pitting, ridging, or brittleness
• Exclamation mark hairs at patch borders — a diagnostic sign
• Severe forms: alopecia totalis (full scalp) or universalis (all body hair)

Causes & Risk Factors

• Autoimmune: immune system attacks hair follicles causing them to shrink
• Family history; personal/family history of thyroid disease, type 1 diabetes, vitiligo
• Stress is a frequently reported trigger

Complications

• Alopecia totalis or universalis in severe cases
• Significant psychological impact — hair loss is tied to identity and appearance in GCC culture
• Nail abnormalities

Diagnosis

Clinical exam and dermoscopy (trichoscopy). Blood tests: thyroid function, CBC, autoimmune markers. Scalp biopsy occasionally to confirm or rule out other causes.

Treatment

• Intralesional corticosteroid injections — most effective for limited disease
• Topical corticosteroids and minoxidil
• JAK inhibitors (baricitinib, ritlecitinib) — first FDA-approved oral medications for alopecia areata, effective for severe cases
• PRP injections; wigs and hairpieces for significant cosmetic impact

Prevention

• Cannot be prevented; manage stress to reduce flare frequency
• Regular thyroid monitoring; seek early treatment to maximise regrowth
• Protect bald areas from UV with hats or scalp sunscreen

Ready to take the next step? Book a consultation today