how do I fix bald spots in my beard
Patchy hair loss in the beard is called alopecia barbae. Treatment aims to limit activity of the immune cells in order to reduce damage to hair cells

Patchy hair loss in the beard is called alopecia barbae. Alopecia barbae is an autoimmune disorder where the immune system misidentifies healthy hair cells and starts attacking them, leading to damage. Hair loss occurs in small circular patches along the beard, although sometimes it can affect the hairline or other parts of the body.

What causes bald spots in the beard?

Although the exact cause of alopecia barbae is unknown, studies have shown the following causes to be associated with increased risk of developing the disease.

  • Autoimmune disorders: This includes diseases such as type I diabetes mellitus, psoriasis, and lupus. As the immune cells are already dysfunctional in these cases, it can increase risk of autoimmune hair loss.
  • Genetic history: Having a positive family history of autoimmune conditions can put you at greater risk of developing alopecia barbae.
  • Increased stress: Studies have shown that both physical and psychological stress can lead to hair loss.

What are associated symptoms of alopecia barbae?

The most obvious symptom is a sudden patchy loss of hair in the beard or along with the beard. Sometimes, the patchy hair loss extends to the hairline as well.

Hair loss takes place over the course of a few days to weeks. Skin around the bald patches may appear white and have mild itching Sometimes, the skin may also have signs of inflammation, such as redness, pain, or roughness.

How is alopecia barbae diagnosed?

Your doctor will examine you and confirm a diagnosis after conducting certain blood tests and skin scrapings.

  • A dermatologist will note and mark the involvement of the skin and pattern of hair loss from the beard.
  • Blood tests may be ordered to rule out conditions such as diabetes mellitus, thyroid imbalances, and anti-lupus antibodies. 
  • A scalp or skin biopsy may be done to check for fungal infections.
  • Hair samples can be taken from the affected area for examination.

How can bald spots in the beard be treated?

There is no specific treatment option for alopecia barbae. Treatment aims to limit activity of the immune cells in order to reduce damage to hair cells. The immune process responsible for hair loss can be halted so that new hair grows.

Medications commonly prescribed include:

  • Corticosteroids: Help reduce the activity of the immune system, limiting hair damage and loss.
  • Rogaine (minoxidil): Works as a vasodilator by increasing hair follicle size and growth rate when applied topically over the affected area 2 times a day for at least 3 months.
  • Diphencyprone: Causes a localized allergic reaction that induces redness, swelling, and itching. This is thought to trick the immune system to send white blood cells to the surface of the skin to reduce inflammation and keep the hair follicles active, preventing hair loss.
  • Anthralin: Applied topically to the affected area to promote new cell generation. It causes slight skin irritation.

QUESTION

It is normal to lose 100-150 hairs per day. See Answer

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Medically Reviewed on 11/10/2021
References
Image Source: iStock Images

American Academy of Dermatology. Hair Loss Types: Alopecia Areata Diagnosis and Treatment. https://www.aad.org/public/diseases/hair-loss/types/alopecia/treatment

Pototschnig H, Madl MT. Successful Treatment of Alopecia Areata Barbae with Platelet-rich Plasma. Cureus. 2020;12(4):e7495. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193229/

Messenger AG. Patient education: Alopecia areata (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/alopecia-areata-beyond-the-basics/print