Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles, causing hair to fall out in smooth, round patches, most often on the scalp but sometimes on the beard, eyebrows, or body. It affects roughly 2% of people at some point in life and can begin at any age. Because the follicles are not destroyed, hair can regrow, and newer treatments have changed what is possible for people with extensive disease.

What causes alopecia areata?

It is an autoimmune process, meaning immune cells mistakenly target the hair follicle and push it out of its growth phase. There is a genetic component, and it is more common in people with other autoimmune conditions such as thyroid disease, vitiligo, or atopic dermatitis. Stress can precede a flare but does not cause the disease.

What does alopecia areata look like?

One or more coin-sized, completely smooth patches with no scaling or redness. Short 'exclamation point' hairs may be visible at the edge. Nails can show fine pitting. Alopecia totalis is loss of all scalp hair; alopecia universalis is loss of all body hair.

How is alopecia areata treated?

Limited patches are treated with corticosteroid injections into the scalp or potent topical steroids, and many regrow within months. For extensive or rapidly progressing disease, oral JAK inhibitors (baricitinib, ritlecitinib, deuruxolitinib) are FDA-approved and can restore hair in a majority of patients who respond. Treatment is ongoing because the condition can recur.

How Tono treats alopecia areata

Tono's board-certified dermatologists see patients with alopecia areata within days, not months, by video visit in 33 states and in person at Tono clinical centers. We treat alopecia areata with the full range of options, including JAK inhibitors, and we handle prior authorization for you. Injections are done in person at a Tono center; monitoring visits and labs can be done by telehealth. Your visit ends with a written plan, prescriptions sent to your pharmacy, and follow-up scheduled with the same dermatologist. Most insurance is accepted and no referral is required.

When should I see a dermatologist for alopecia areata?

See a dermatologist as soon as you notice a bald patch. Early treatment gives the best chance of regrowth, and rapid or widespread loss should be seen within days.