You’ve spent years growing, grooming and nourishing a beard to be proud of. Facial hair that looks great and is thick, even and worthy of the investment of both time and money that you’ve put into it. Then all of a sudden you find a bald patch starts to develop. One small hairless spot becomes two, and before you know it, that once magnificent beard has become sparse. It’s an extreme scenario, but one that can play out in those that suffer from Alopecia Barbae.

What is alopecia barbae?

Alopecia barbae is a specific form of alopecia areata, which is hair loss caused by an autoimmune condition that affects the beard area and leads to patchy hair loss. 

Alopecia barbae is an autoimmune disease, which is when your body’s immune system mistakenly attacks healthy cells. In this case it attacks the hair follicles of the face, causing sudden, small, circular bald patches.

While Alopecia barbae isn’t harmful, it can be very distressing and impact your self-confidence. The severity and duration of the condition varies and some men experience spontaneous regrowth of hair while others endure recurrent or persistent hair loss.

What Causes Alopecia Barbae?

The cause of Alopecia Barbae remains somewhat of a mystery, however we do know that it’s an autoimmune response where the immune system mistakenly attacks healthy beard hair follicles. Researchers believe that it occurs as a result of a combination of causes, including genetics and mental and physical stress.

If you have a family history of asthma, allergies, or other autoimmune conditions your risk of suffering from Alopecia Barbae increases. Those who have high levels of mental and physical stress, either on a daily basis or for an extended period of time, are also susceptible. There’s also a link between viral illness or infections that can lead to the activation of the autoimmune response. If you combine multiple of these factors, your risk of getting Alopecia Barbae goes up even more.

What are the symptoms of alopecia barbae?

Contrary to other skin conditions that cause hair loss, like dermatitis or fungal infections, alopecia barbae doesn’t usually have the classic signs of inflammation like redness, swelling or itching. The bald patches are usually smooth, without signs of irritation. Alopecia Barbae generally presents as sudden, uneven hair loss in the beard area, often along the jawline. Its severity and progression varies from person to person with some having just a single bald spot in their beard while others develop more extensive beard hair loss. 

The most common symptom of alopecia barbae is the appearance of small, round bald patches within the beard. They usually occur quickly and might expand over time. When the hair begins to regrow, it might appear lighter in colour than previously, before potentially returning to your natural shade. Some men experience uneven regrowth, with some spots taking longer to regrow than others. Typically, sufferers will have only one or two bald patches in their beard, but some may see the hair loss spread.

How common is alopecia barbae?

Alopecia barbae is quite uncommon, with around 2% of the male population globally experiencing it at some point in their life. 1 in 5 of those who suffer from it have a previous family history of autoimmune disorders and the average age of men who are affected by it is between 20 and 40 years old.

Is there a cure for alopecia barbae?

Unfortunately, there is no permanent cure for alopecia barbae, however many sufferers will see the hair regrowing without any medical intervention. That said, there are treatments that are used to help stimulate regrowth and to calm the immune system. While there is no definitive research to say these treatments work, the anecdotal evidence suggests they may improve the rate or regrowth.

Treatments for alopecia barbae

There are several treatments that have increasing evidence that suggests they may improve hair regrowth for alopecia barbae sufferers.

1. Corticosteroid creams 

Corticosteroid creams and ointments that are applied directly to the bald patches may reduce the underlying inflammation in the skin. They are typically a prescription medication and require frequent applications for several weeks before you may see results.

2. Minoxidil

Minoxidil, which is the generic name for Rogaine®, is a hair loss treatment that can also be used for alopecia barbae. This medication works by stimulating blood flow to hair follicles and may help dormant hairs start to grow.

3. Immunotherapy medications

In cases of extensive or recurrent alopecia barbae, a dermatologist may prescribe more aggressive immunotherapy medications, such as diphencyprone (DPCP). This acts by triggering an immune response that distracts your immune system from attacking hair follicles. Similarly for those suffering from more extreme cases, Janus kinase (JAK) inhibitors might be prescribed. JAK inhibitors target the immune pathways involved in alopecia areata. Oral JAK inhibitors have been shown to be effective in severe cases of alopecia areata and in clinical trials the topical versions have shown positive results too.

4. Reduce your stress

Another action to take should you suffer from alopecia barbae is to reduce the stress in your life. Anything you can do to help your wellbeing is beneficial not just for your chances of reducing or reversing the impacts of alopecia barbae, but for your overall health. Regular exercise, meditation, healthy eating and good sleep habits are things most of us can easily do.