Alopecia areata is a common form of hair loss believed to be an autoimmune disease. It can affect men, women and children, and typically affects the scalp in patches. If the condition affects the face, or beard, it is called alopecia areata barbae. Treatment for alopecia areata barbae is the same as treatment for alopecia areata of the scalp. Treatment typically includes the use of corticosteroids. However, treatment is not always necessary, as alopecia areata has a habit of clearing up on its own.
As there is no definitive cure for alopecia areata there is thus no cure for alopecia areata barbae. The effectiveness of treatment varies from person to person. The best method of treating alopecia barbae is to keep the face clean shaven. Since alopecia areata is typically characterised with sporadic loss and regrowth of hair, making careful observations of the patterns of loss and regrowth in the beard area will help you determine if treatment is necessary. Should the condition begin to affect the scalp or if it becomes severe enough in the beard to warrant treatment, corticosteroids may be used.
The primary method of treatment for alopecia areata is corticosteroids (typically cortisone), which work by duplicating the effects of hormones released by the adrenal glands. Monthly injections are given directly into the bald patch just underneath the epidermis. Side effects are minimal, and include localised pain and skin atrophy, though this is usually reversible.
In the event of severe hair loss, corticosteroids administered in pill form (systemic corticosteroids) may be prescribed. Improvement can typically be seen within four weeks. Unlike standard injections, the side effects of systemic corticosteroids can be severe. They include migraines, mood swings, cataracts, high blood pressure, osteoporosis and diabetes. They are typically only used for a few weeks, and only as a last resort.
The number of therapies and treatments available are immense, and include topical immunomodulator therapy and biologic therapy. Drugs being studied include topical pimecrolimus, topical cyclosporine, and infliximab. Many of these new treatments focus on the immune system, as alopecia areata is thought to be a symptom of an immune system deficiency.