6 Treatments for Alopecia and Hair Loss

If you often wear a hairstyle like braids or a tight bun that puts prolonged strain or stress on the hair follicle, that can cause a type of permanent hair loss called traction alopecia.

Several serious diseases also attack the hair follicle, says Robert Brodell, a dermatologist at the University of Mississippi Medical Center.

Alopecia areata is an autoimmune disease that causes hair to fall out in nickel- or quarter-size patches. You may notice bald spots on your scalp. “Your body’s immune system is attacking the hairs,” Brodell says.

Alopecia areata tends to be asymptomatic aside from the hair loss, Brodell says: “No itching, no irritation, no pain. You just notice hairs coming out in patches.”

By contrast, scarring alopecia, another autoimmune disease that causes hair loss, is often accompanied by itchiness, tenderness and scaling of the scalp. Scarring alopecia is the most devastating type of hair loss, Mirmirani says, because it permanently destroys the hair follicles.

If you have alopecia, can your hair grow back?

A variety of treatments have been developed to help regrow hair and thicken existing hair on patients with alopecia, dermatologists say. Their effectiveness largely depends upon what type of alopecia you have and how quickly you start treatment.

Generally speaking, the sooner you start treatment, the more options you have and the better your results, dermatologists say.

What are the best treatments for alopecia?

Dozens of over-the-counter supplements and products purport to reverse hair loss, making it tough for patients to know which ones work and which don’t.

Some small, limited studies have found that certain supplements and shampoos could be helpful, dermatologists say. However, your best bet if you’re suffering from hair loss is to see a board-certified dermatologist who can determine what’s causing your alopecia and then recommend a treatment plan.

The following five evidence-based treatments have been shown to help reverse hair loss:

1. Intralesional injections

If you catch alopecia areata early when you have only a few small bald spots, your doctor can inject steroids into those areas to stimulate hair regrowth. “We put a little steroid right into the dermis,” Brodell says. “You start to see hair growing right in those tufts. It works great.”

However, if a patient waits too long to seek treatment, Brodell says, “the problem is, you can’t inject with a needle in 10,000 areas.”  

2. Topical minoxidil (Rogaine and generic)

A large body of research has shown that these over-the-counter creams and foams, applied to the scalp daily, are effective at stimulating hair growth, increasing hair density and halting hair loss over time. Most users see results after consistent use for about two months.

3. Prescription oral medications

Doctors often prescribe oral medications to be used along with topical minoxidil because studies show the combination boosts hair production. Low-dose oral minoxidil (prescribed off-label) has been found to be effective and safe for most patients, Mirmirani says. Other oft-used drugs include finasteride (Propecia) and spironolactone. If you have scarring alopecia or alopecia areata, your doctor may recommend an anti-inflammatory medication such as the JAK inhibitor Olumiant (baricitinib) to help tamp down your immune system. 

4. Light or laser therapy

These treatments that emit red- or near-infrared light are believed to stimulate hair follicles to help hair grow, with a lower risk of side effects compared to topical creams and oral medications.

A 2021 review of 15 studies — including several large randomized control trials that are the gold standard for medical research — found that laser therapy increased hair count in both men and women. You can either purchase over-the-counter laser devices to use at home or receive the treatments from a provider.

5. Platelet-rich plasma injections

This procedure involves placing blood in a machine that separates out the plasma, which is rich in platelets that contain growth factors, and then injecting the plasma into the patient’s hair follicles.

A review study published in 2022 found that it significantly increases hair diameter and hair count in patients with several types of alopecia. It typically isn’t covered by insurance, and it can be expensive, Mirmirani says.

6. Hair transplants

If you have healthy hair on the back or side of your head, a doctor can surgically remove hair strands from those areas and graft them into your scalp in a bare area. It’s another expensive treatment that isn’t generally covered by insurance, but it tends to be a long-lasting solution.

What makes alopecia worse?

If you have alopecia, you can help hold onto your tresses by avoiding behaviors that are known to contribute to temporary and permanent hair loss, Mirmirani says.

Minimize the use of high-heat styling tools, hair extensions and harsh treatments like perms. Avoid hairstyles like tight buns and braids that pull on your scalp, potentially causing traction alopecia.

Finally, keep in mind that the same healthy habits recommended for maintaining your physical health will also help your hair. Try to find ways to manage stress, and strive for a well-balanced diet that includes plenty of fruits and vegetables.

“Eating well, sleeping well, exercising, not smoking — all of those are important to hair,” Mirmirani says.