Bald Spots

Overview of Bald Spots

Bald spots of the scalp, brow, or beard are commonly caused by a medical condition called alopecia areata. It is also commonly called spot baldness, and it is believed to be an autoimmune disorder that causes the body’s immune system to mistake hair follicles for foreign invaders, and then, attack them as such.

This article reviews the different types of hair loss that affect men and women. The causes and best treatment options for hair loss, hair thinning, and bald spots are also examined, as well as some home remedies that you can try without a doctor’s prescription.

Bald Spots on the Head

Alopecia areata can occur anywhere of the head, body, or limbs. It often presents suddenly as small bald spots on the scalp. Each spot is typically the size of a quarter or smaller. This detracts from hair aesthetics and can cause a lot of psychological stress on the individual.

Like other autoimmune disorders, there is no known single cause of alopecia areata. There is also no known cure for this type of patchy hair loss. However, some risk factors increase its likelihood, including having a family history of hair loss or thinning hair, thyroid disease, or having another autoimmune disease.

Some people regrow hair and have no further episodes of alopecia areata. However, others continue to develop bald spots with no new hair growth for many years.

According to the American Academy of Dermatology (AAD), alopecia areata also:

• Affects about 2% of all people at some point in their lives
• Occurs in men and women in roughly equal numbers
• Affects roughly 0.15% of all people at any one time
• Typically onsets before the age of thirty
• Does not affect life expectancy
• Is not contagious

Do not confuse alopecia areata with other types of hair loss like androgenic alopecia (male and female pattern hair loss), alopecia totalis (loss of all scalp hair), or alopecia universalis (loss of hair on the entire body). While all of these conditions cause hair loss, alopecia areata is most commonly associated with patchy bald spots of the face and head.

Bald Spots in the Eyebrows

Sudden loss of eyebrow hair can also result from several causes; alopecia areata is one of the more common. However, as with other types of sudden hair loss, loss of eyebrow hair can also result from:

• Bacterial, fungal, or parasitic infection
• Hormonal balance fluctuations
• Certain skin conditions
• Nutritional deficiency
• Physical trauma
• Chronic stress

Bald Spots in the Beard

Men with beards that are normally thick and uniform may suddenly develop bald patches. Other men may have bald spots in their beard areas that have never grown facial hair, to begin with.

For those who have never had facial hair in certain spots of their beards, hair transplantation procedures can be effective solutions. Another treatment option, in this case, is the use of hair regrowth formulations like Rogaine® (minoxidil), Xeljanz® (tofacitinib), and others.

However, men who experience sudden onset hair loss in their normally-thick beards are not recommended for hair transplant as a first option. Medical disorders like alopecia areata, an inflammatory condition called lichen planopilaris, and various other conditions can cause this type of hair loss in the beard.

It’s important to consult with your doctor or dermatologist to determine the cause of the hair loss, and then, the best treatment option for you.

Other Causes of Bald Patches on the Scalp, Head, Limbs, or Body

Alopecia areata is certainly not the only condition that can cause hair to fall out. Some of the other common causes of widespread or patchy hair loss are:

• Skin conditions like eczema, seborrheic dermatitis, and psoriasis
• Deficiencies of vitamins A, B7, B12, C, D, or E
• Not getting enough omega-3 fatty acids
• Ringworm of the scalp (Tineas capitis)
• Hyperthyroidism or hypothyroidism
• Leprosy (Hansen’s disease)
• Iron or zinc deficiencies
• Unmanaged stress
• Chronic anxiety

Other causes for bald spots on the scalp, beard, or brows are pregnancy, childbirth, a hormonal condition called telogen effluvium, some chemotherapy agents, a psychological condition called trichotillomania, and the aging process.

Signs and Symptoms of Baldness in Men and Women

Although it is more associated with men, many women also are affected by the hair loss on their scalps and brows. However, alopecia manifests differently between the sexes. Following are the key differences:

Hair Loss In Men

It is normal for both men and women to lose up to one hundred hairs from the scalp every day. Losing more than that could indicate some type of alopecia or other condition that causes the hair to fall out too rapidly.

Interestingly, the average human scalp grows about 100,000 hairs, and so losing one hundred isn’t very significant, especially considering that hair is always in the process of growing, falling out, and then, regenerating new hair to start the process over again.

The Mayo Clinic reports that about 95% of hair loss in men is due to androgenic alopecia (male and female pattern baldness). This condition is very common and involves the destruction of hair follicles by a derivative of the testosterone hormone, called dihydrotestosterone (DHT).

For men that suddenly develop bald spots on the scalp, or lose hair on the eyebrows or beards, the most common treatment is the use of corticosteroid drugs to suppress the immune system. In theory, this slows down the immune system’s attack on the hair follicles and thereby helps to stop hair loss and stimulate hair regrowth.

Hair Loss In Women

Losing hair or developing bald spots is often more difficult for women to deal with than men. Society generally overlooks baldness in men but places a high value on the aesthetic value and sex appeal of hair in women.

Nearly two-thirds of postmenopausal women in the USA have some degree of hair loss or bald spots.

While most men develop a receding hairline that eventually forms the letter “M” in their hairlines, women tend to lose hair in a more dispersed manner. Hair loss in women typically involves gradually thinning hair that starts at the crown, and then, spreads outward and downward.

Dispersed hair loss and bald spots in women over age 50 have several causes, including:

• Hormonal fluctuations, especially during menopause
• Chronic, unmanaged physical or emotional stress
• Hereditary predisposition
• Poor nutrition

To determine the best treatment for bald spots, you need to know what is causing them. It is always best to let a dermatologist diagnose your hair loss before attempting to correct it.

Treating Bald Spots: Surgery, Products, and Home Remedies

There are various surgical and nonsurgical treatment options for correcting hair loss and bald spots. There are also numerous home remedies and hair care products available. First, let’s look at some of the most popular surgical treatments that your doctor might recommend after examining your scalp, eyebrows, or beard.

Surgical Treatments for Bald Spots

The most common surgical treatments for bald spots and hair loss in general are:

• Strip Harvesting
• Neograft
• ARTAS
• FUE

Strip Harvesting Men and women with bald spots can benefit from FUT (follicular unit transplantation), a procedure that involves the harvesting, processing, and surgical replacement of the follicles from a strip of skin, typically from the back of the head, to a bald patch on the scalp, beard, or brow.

FUE FUE refers to “follicular unit extraction”. It is similar to FUT strip harvesting but much less invasive. Instead, individual hair follicles are removed, and then, placed into thinning or balding areas as needed.

Neograft Neograft is a system for hair transplantation that employs the use of robotics to produce accurate follicle extraction. It is a method for increasing the efficiency and successfulness of the FUE process and useful for correcting bald spots, thinning hair areas, and receding hairlines.

ARTAS ARTAS takes the Neograft technologies into the full robotic mode. It is a completely automated technology for facilitating follicular unit extractions. ARTAS has been approved by the Federal Drug Administration (FDA), but only in men with straight, dark hair. It is not classified as surgery and is considered to be minimally invasive.

Non-Surgical Treatments for Bald Spots

Nonsurgical treatment options for bald spots and general hair loss typically involves the use of chemical formulations that increase hair growth, weight, and/or count. The most popular of these today are:

• Finasteride
• Dutasteride
• Tofacitinib
• Minoxidil
• PRP Treatments

Finasteride Finasteride (Proscar, Propecia) is an FDA-approved type II 5a-reductase inhibitor used for androgenic alopecia in men but not women. It decreases serum and scalp levels of DHT. 1 mg/day doses can increase hair growth rate and shaft diameter, typically within about 3 months of use. It may also inhibit further hair loss.

Dutasteride Dutasteride is marketed under the brand name, Avodart®. It is a type I and types II 5a- reductase inhibitor drug primarily used for treating enlarged prostate and urinary retention. However, it is sometimes used off-label for androgenic alopecia in both men and women.

Tofacitinib The brand name for tofacitinib is Xeljanz®. It is an FDA-approved drug used primarily for treating symptoms of rheumatoid arthritis. However, it is also used to treat male and female pattern hair loss.

Minoxidil Minoxidil has been FDA-approved and available on the market as Rogaine® since 1996. It increases hair diameter significantly but has little effect on hair count. Hair enhancement effects cease when use is discontinued. It is used by both men and women.

Platelet-Rich Plasma (PRP) Injections This procedure involves harvesting blood from the patient, processing it so that it has a very high platelet count, and then injecting it into the scalp in areas of hair loss or thinning hair. Research has shown this therapy to increase hair count, and increase hair growth after FUE or other hair transplant surgery.

PRP + Nanofat Injections This procedure combines purified patient fat with the plasma-rich protein already used in PRP injection therapy for hair restoration. It can help to restore normal health in follicles that have been minimized by exposure to DHT or other causes. The nanofat speeds up follicle cell proliferation rates and stimulates rapid angiogenesis in the follicles.

PRP + Acell Injections PRP may also be combined with a porcine-derived powder called Acellular Matrix (Acell). It has been shown to have regenerative effects of cells similar to those of stem cells. When injected into bald spots on the scalp, Acell speeds up healing in damaged hair follicles and encourages thicker hair growth.

Home Remedies for Bald Spots

There are numerous shampoos and other hair care products available that are marketed to help restore hair growth in bald spots and thinning areas. Some of these products have scientific backing for their hair enhancement claims, and most have been used as ingredients for hair restoration for decades.

However, note that surgeries, medical treatments, and home remedies for hair loss are most effective when performed preventatively. If the hair follicles are completely dead (not simply damaged or dysfunctional), then treatment of any type is likely to be marginally effective at best.

Shampoos and Essential Oils

Some of the best-reputed hair regrowth products available contain essential oils including:

• Cedarwood essential oil
• Horsetail plant oil
• Lemongrass oil
• Peppermint oil
• Clary sage oil
• Rosemary oil
• Lavender oil
• Thyme oil

Use all essential oils and products that contain them according to label directions. Some of these natural medicines can cause unwanted side effects in some users. People with sensitive skin and children may experience irritated skin and nausea with certain essential oils, so be sure to read each label before buying. Each essential oil has its list of possible health benefits and side effects. Seek professional advice about essential oils before beginning to use them.