a man with alopecia areata barbae in his beard

Alopecia Barbae – How Do I Fix the Bald Spots in My Beard?

Generally, people only know about Alopecia Barbae if they have it or know someone with the condition. It’s a rare form of facial hair loss that can affect men at any stage of their life.

This type of beard hair loss typically occurs in people with other forms of alopecia or other types of autoimmune diseases. Here we explore what causes it, and what the best treatment methods are.

Summary

  1. What Is Alopecia Barbae?
  2. What Causes Beard Alopecia?
  3. Here Are the Best Alopecia Barbae Treatments?
  4. Conclusion

What Is Alopecia Barbae?

Alopecia Barbae causes hair to fall in round bald patches in the beard. These bald spots are caused by an autoimmune disease of the hair follicle which consequently inhibits hair growth. Antibodies attack the hair roots because it identifies them as foreign cells.

The number of bald spots depends on the severity of your condition. Beard hair loss can appear as 1 or 2 patches, or more throughout your facial hair. Hairless patches on your neck, cheeks, moustache and beard are common symptoms.

This beard alopecia is a form of Alopecia Areata (AA) that only causes symptoms in the beard area. As a result, it is also medically known as Alopecia Areata Barbae (AAB).

What are the symptoms?

Beard alopecia symptoms vary in severity, so some patients may lose all of their beard hair while others may only lose small patches. However, the condition usually begins with one or two patches.

The main symptoms of Alopecia Barbae are:

  • Circular, coin-sized smooth bald patches
  • Only white hairs (if any) left in the bald areas
  • Exclamation mark hairs surrounding the patches
  • A tingling sensation in the affected areas
  • Itchiness

What Causes Beard Alopecia?

Just like the cause of AA, it’s unknown why the immune system starts to attack a man’s beard hair. Patients have often thought that it’s triggered by an injury, shock or by another kind of autoimmune disease. Furthermore, research is still being conducted to determine why the hair follicles are rejected by the immune system.

The main Alopecia Barbae causes include:

  • Autoimmune disease – If you have an autoimmune disease (including atopic dermatitis, thyroid disease, anaemia, psoriasis, etc) you are indeed more likely to develop Alopecia Barbae.

    A study carried out by Muller and Winkelmann concluded that the formation of organ-specific autoantibodies that play a pathogenic role are active in both alopecia and other autoimmune disorders.
  • Genetics – There is a greater risk of developing beard alopecia if there is someone in your family who also has a form of alopecia.
  • Other alopecias – If you have a form of alopecia that’s affecting your scalp hair or someone else on your body, then there is a chance that it can develop into AAB.

How do you know if you have alopecia from an autoimmune disease?

There are some common medical conditions that are frequently misdiagnosed as Alopecia Areata Barbae. In fact, the clinical symptoms of AAB are very similar to ringworm, and the side effects of chemotherapy.

Ringworm

Symptoms of ringworm include scaly bald patches within your beard (or anywhere on your body), itchy skin, hair loss and a ring-shaped rash. Ringworm is an infection caused by dermatophyte fungus, typically called Tinea Barbae.

Chemotherapy

This cancer treatment has a side effect of hair loss (called chemo-induced alopecia). Not everyone loses their hair from chemo, however, others experience hair shedding on their scalp, beard, eyebrows and eyelashes.

Here Are the Best Alopecia Barbae Treatments

There isn’t a cure for people with Alopecia Areata Barbae, but there are treatment options that help the symptoms go away.

  • PRP Treatment
    In April 2020, Hanno Pototschnig and Maximilian T Madi published a study of the successful treatment of Alopecia Barbae with Platelet-Rich Plasma (PRP) treatment. PRP has been considered an effective treatment for some types of alopecia ie. Androgenic Alopecia.
  • Immunotherapy
    Contact immunotherapy treatments are designed to cause skin irritation which distracts the immune system, thus preventing it from attacking the hair follicles.

    To illustrate, the intention of this treatment is to trigger an allergic skin reaction that stimulates hair regrowth in the bald spot within your beard.
  • Corticosteroids
    Steroid injections and topical steroid creams are prescribed for various types of alopecia. For Alopecia Barbae, steroid cream is also effective treatment for stimulating hair regrowth.

Is a beard transplant effective for Alopecia Barbae recovery?

AAB is caused by an autoimmune disease that doesn’t recognise the body’s own hair follicles so attacks them. Therefore, unfortunately, if your hair is moved and transplanted into another area of your beard, your immune system will continue to destroy your hair. Because of this, a hair transplant isn’t recommended for Alopecia Barbae.

On the other hand, if you have a patchy beard that isn’t caused by AAB, then a beard hair transplant is recommended in this case. If you would like to thicken or fill in any gaps in your beard, then this method of hair restoration is ideal.

Conclusion

Although Alopecia Barbae is a rare autoimmune condition, it has a significant impact on a man’s quality of life. Sparse bald spots in the beard can cause insecurities and low self-esteem, especially as they are in such a visible location. Therefore, it is natural to want a fast solution to make it go away.

On the whole, this alopecia is difficult to treat because it is caused by an autoimmune disease and at the moment it’s not fully understood. Therefore, treatments are available including steroid creams, however, this may work for one man, but not for another. Consequently, you need to try various methods before finding the more effective one for you.

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