Noticing round, coin-shaped bald spots on your scalp can be alarming. This is the classic sign of alopecia areata — an autoimmune disease that causes spot baldness, and one where delaying treatment can allow the patches to spread across wider areas of the scalp. The condition is regarded as hereditary.
In this article based on his educational video, Dr. John Watts — dermatologist, trichologist and hair transplant surgeon in Hyderabad — explains what alopecia areata is and the different ways to deal with it.
What happens in alopecia areata?
In alopecia areata, the cells that provide immunity start attacking healthy hair follicles, mistaking them for a foreign body. The extent of the attack determines the name of the condition.
"If the entire scalp is affected, we call it Alopecia Totalis but if the entire body is affected, we term it Alopecia Universalis," informed Dr. Watts.
The danger of crude home remedies
Dr. Watts cautions that many sufferers turn to a traditional crude treatment using Jatropha seeds (Nepali ginjalu) — and these are not safe.
"This treatment sometimes works as it creates a mild irritant and induces inflammation. This helps in hair growth in the affected region but it often leads to adverse consequences like a wound with pus formation, leading to permanent hair loss," he informed.
The safe treatment ladder
Instead of crude irritants, Dr. Watts lays out a step-by-step medical approach:
Step 1 — Medically formulated mild irritants. These are safe irritants available as lotions or tinctures. "Once you apply this to the affected region, it induces mild inflammation and stimulates hair growth," informed Dr. Watts.
Step 2 — Intra-dermal steroid injections. If the topical irritants fail, steroid injections into the affected region can stimulate hair growth.
Step 3 — Immunomodulator creams. If both methods fail, immunomodulator creams may help. "There are some brands available that may help but it needs to be used only with a doctor prescription," he advised.
Step 4 — A course of mild steroids. If all three options fail, a doctor may prescribe a course of mild steroids over time. Dr. Watts also mentions a promising drug called CTP-543, though it is yet to be available on the market.
"One of the above options will work for an Alopecia Areata patient," he assured.
Why a hair transplant is a bad idea right now
If you have active alopecia areata, do not opt for a hair transplant — it may backfire. "One must first treat Alopecia Areata condition before opting for a hair transplant. Else even healthy transplanted hair may be lost," warned Dr. Watts. Since the immune system is attacking follicles, even newly transplanted healthy hair can fall victim.
The bottom line
Alopecia areata is an autoimmune condition, not ordinary baldness — and it has a clear, safe treatment ladder: medical irritants, steroid injections, immunomodulator creams, and mild steroids if needed. Avoid crude remedies like Jatropha seeds that can cause permanent damage, and postpone any thought of a transplant until the condition is treated. Early treatment matters, because delay can let the patches spread.
This article is for educational purposes only and is not a substitute for professional medical advice. Consult a qualified dermatologist for diagnosis and treatment.
Frequently asked questions
What is alopecia areata?
It is an autoimmune disease in which immune cells attack healthy hair follicles, mistaking them for a foreign body. It causes round bald spots on the scalp. When the entire scalp is affected it is called Alopecia Totalis; when the whole body is affected, Alopecia Universalis.
Are home remedies like Jatropha seeds safe for alopecia areata?
No. While the irritation they cause sometimes triggers hair growth, they often lead to wounds with pus formation and permanent hair loss. Medically formulated mild irritants are the safe alternative.
What treatments work for alopecia areata?
A stepwise approach: medically formulated mild irritant lotions, then intra-dermal steroid injections, then immunomodulator creams, and finally a course of mild steroids if needed. One of these options will work.
Can I get a hair transplant if I have alopecia areata?
No — the condition must be treated first. Otherwise even healthy transplanted hair may be attacked and lost.
