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Home / Conditions / Autoimmune / Alopecia Areata
Autoimmune · condition 03 of 18
Alopecia Areata: Why Patches Appear and What Stops Them
Smooth, round patches that appear quickly. The follicle usually survives.
Clinically reviewed by Dr. Nina Ross, NDServing all of Metro Atlanta
Quick answer
Alopecia areata is an autoimmune condition where the immune system interrupts follicles that are in their growth phase. The result is usually a smooth, round patch that appears over days rather than months, with skin that looks normal rather than scarred.
Read the full answer
Because the follicle itself is not destroyed, regrowth is possible even after a long patch, and hair often returns fine and light before it returns fully pigmented. Patches can also appear in the beard or eyebrows.
At Nina Ross Atlanta in Sandy Springs we confirm the pattern at 200x, look at the systems that keep the immune response stirred up, and track each patch with photographs. Serving all of Metro Atlanta.
- The follicle is usually not destroyed.
- Regrowth often starts fine and light.
- The patch border shows whether it is active.
What you might be noticing
Symptoms in your words, and ours
Tap the one that sounds like you to see why it happens and how we figure it out.
01A smooth bald circle appeared out of nowhere
Well-circumscribed patch of non-scarring loss✋🏾
Why it happens
A round patch that appears over days is commonly linked to immune activity pushing many growing follicles out of their growth phase at once.
How we figure it out
We confirm the pattern at 200x and check that the skin is intact, which separates alopecia areata from scarring conditions.
02Short hairs that look like tiny commas
Exclamation mark hairs at the patch margin✋🏾
Why it happens
Short hairs that narrow toward the scalp are commonly linked to a patch that is still active. The follicle was interrupted mid-growth.
How we figure it out
We read the border at 200x for these tapered hairs, which tells us whether the patch is still spreading.
03The skin there looks totally normal
Preserved follicular openings✋🏾
Why it happens
Normal-looking skin is a good sign. It usually means the follicles are still there, resting rather than scarred.
How we figure it out
Magnification shows whether the openings are present, which is why regrowth stays possible.
04White or fine hairs coming back in
Regrowth of unpigmented vellus hair✋🏾
Why it happens
Fine, light hairs are commonly the first sign a follicle has restarted. Pigment and thickness often return later.
How we figure it out
We photograph the same points each visit, so you can see regrowth before it shows in the mirror.
05Pitting or ridges in my nails
Nail pitting associated with alopecia areata✋🏾
Why it happens
Small pits or ridges in the nails are described alongside alopecia areata in some people, because the same immune activity can reach the nail.
How we figure it out
Tell us about it at your visit. It is part of the systemic picture we look at beyond the scalp.
What causes it
What is actually driving it
- 01
Autoimmune activity
The immune system stops recognizing the growing follicle as its own and pushes it out of the growth phase early.
- 02
Stress and illness as triggers
A major stressor or illness often sits just before the first patch. Stress can be a trigger, and it is rarely the whole cause.
- 03
Other autoimmune conditions
Thyroid disease, vitiligo and other autoimmune conditions show up more often alongside alopecia areata, which is why we look beyond the scalp.1
What we see that others miss
What the patch border tells us at 200x
The edge of the patch is the most informative part.
We photograph the same border every visit, so you know which of those two things is happening.
How we treat it
What care looks like here
We confirm the pattern at 200x, then support the follicle while the immune activity settles. Growth signal therapies and light-based therapy are used where they fit, and the systemic picture is part of the plan. We photograph every patch at each visit so regrowth is measured rather than debated.
- 01Confirm the pattern at 200x
- 02Support the follicle while immune activity settles
- 03Photograph every patch at each visit
Exosome Therapy
Concentrated growth signals delivered to follicles that have gone quiet.
Growth Factors Therapy
Concentrated growth signals applied to the scalp to support follicles that are still active.
Red Light Therapy
Low level light used to calm scalp inflammation and support the growth phase.
One visit. Real answers.
The $99 Hair & Body Discovery
No prepOne visitYour time, your pickNo judgmentServing all of Metro Atlanta
- One-on-one scalp health session with a certified trichologist
- 200x magnification read of your scalp, on screen, while you watch
- A full-body biofeedback scan
- Your Hair & Body Discovery Report, delivered the next day
Our promiseYou'll leave actually seeing what's happening, your scalp at 200x, the systems behind it, with your report the next day. If you don't, the $99 is on us.
Fully HSA/FSA eligible. 0% financing for qualified applicants.
You are welcome here
We are well-versed in us.
Patches read very differently against textured hair and deeper skin, and they get dismissed as breakage more often than they should. We look under magnification and take you at your word.
Relaxers, braids, locs, weaves and heat. Share your full hair history. It is welcomed, never judged.
10 years of specialized care2,500+ clients seenNo judgment
Related conditions
Often confused with this
Telogen Effluvium
Sudden diffuse shedding, usually about three months after a trigger.
Trichotillomania
We treat the scalp. No judgment, no behavioral advice.
Lichen Planus
An immune condition of skin, nails and mouth that can reach the follicle.
Questions, answered
Honest answers before you commit
Will my hair grow back?
The follicle is not scarred, so regrowth is possible. What we cannot tell you is the timeline, because it varies with how widespread the patches are and how long they have been active. Results not typical. Individual results will vary.
Why did it happen so fast?
The immune system interrupts many growing follicles at the same moment, so the hair releases together over days. It feels sudden because it is.
Can it come back after it fills in?
It can. Alopecia areata can return after regrowth, which is why we keep photographing the same points and look at the systems that keep the immune response stirred up.
Is this caused by stress?
Stress often sits just before a first patch and can act as a trigger. The underlying driver is immune activity at the follicle, so we look at both.
Do you treat beard and eyebrow patches?
Patches can appear in the beard or eyebrows too. Bring them to your visit and we read them the same way we read the scalp.
References
Results not typical. Individual results will vary.
Let's find out what your hair is trying to tell you.
You'll see it, or the $99 is on us. Serving all of Metro Atlanta.
Nina Ross Atlanta, 8735 Dunwoody Place, Suite 290, Sandy Springs, GA 30350. Monday to Saturday, 10:00 AM to 3:30 PM.