In short: treatment depends on how much hair is lost, age, and how fast it's spreading. For a few patches, steroid injections into the patch are the usual first choice in adults. For extensive or long-standing alopecia, newer JAK inhibitor tablets have changed what's possible. All of these need a dermatologist. None is a permanent cure, and relapses can happen.
This page is about alopecia areata. For pattern hair loss (sometimes called "androgenetic alopecia"), see men or women.
Treatments at a glance
| Treatment | Used for | How it's given | Evidence | Main side effects | Cost in India |
|---|---|---|---|---|---|
| Steroid injections (e.g. triamcinolone) | Limited patches, adults; beard; eyebrows | Small injections into the patch every 4–6 weeks | Strong for limited disease | Temporary skin thinning (dents), pain | price being updated per session |
| Strong steroid creams / lotions | Children; mild cases; add-on | Daily on patches | Moderate | Skin thinning with long use | price being updated |
| Minoxidil | Add-on to support regrowth | Solution or foam | Limited alone | Scalp irritation | price being updated → Minoxidil |
| Contact immunotherapy (DPCP) | Extensive, long-standing | Weekly applications in clinic | Moderate | Itchy rash, swelling, lymph nodes | price being updated |
| Oral steroid pulses | Rapidly spreading cases | Short courses or pulses | Moderate; relapse common after stopping | Weight gain, mood, sugar, BP, bone (with repeated use) | price being updated |
| Methotrexate, cyclosporine, others | Extensive, as steroid-sparing options | Tablets, with blood monitoring | Moderate | Depends on the drug; needs monitoring | price being updated |
| JAK inhibitors (baricitinib, ritlecitinib, deuruxolitinib) | Severe (≥50% loss), totalis, universalis | Daily tablets | Strong in large trials | Infections, acne, blood test changes; regulator warnings on heart, clot and cancer risk in some populations | price being updated per month |
| PRP | Under study | Injections | Limited | Pain | price being updated |
JAK inhibitors: the newer option
- How they work: they calm the immune signals attacking the follicles.
- Evidence: in large trials of severe alopecia areata, a meaningful share of patients regrew most of their scalp hair over 6–12 months.
- Approvals: baricitinib (adults), ritlecitinib (12+), and deuruxolitinib are approved for severe alopecia areata in some countries.
- Before starting: blood tests, screening for TB and hepatitis, a review of your heart and clot risk, and vaccinations. Regular monitoring follows.
- Hair may fall again if treatment stops. Plan the long-term cost with your doctor.
Choosing with your dermatologist
| Your situation | Typical starting point |
|---|---|
| Adult, 1–3 small patches | Steroid injections |
| Child | Steroid creams; watchful waiting |
| Beard or eyebrows | Careful injections or creams |
| Spreading quickly | Short oral steroids, then a longer-term plan |
| Extensive or long-standing | JAK inhibitor or immunotherapy |
Ayurveda, homeopathy and home remedies
People often search for these, so here's what we found: no good-quality trials show they regrow hair in alopecia areata beyond natural regrowth. Onion juice, garlic and herbal oils have only small, low-quality studies. They're unlikely to harm you if you only apply them, but they can irritate the skin, and they shouldn't delay proper treatment if patches are spreading.
Questions to ask your dermatologist
- How extensive is my alopecia, and is it likely to spread?
- What's the plan if this treatment doesn't work in 3 months?
- What does a year of this treatment cost?
- Which side effects should I watch for, and which tests do I need?
- What happens when we stop?
See a doctor soon if you have: round bald patches that appear suddenly · hair coming out in clumps · redness, pain, pus, scaling or scarring on the scalp · hair loss with fever, weight loss, irregular periods, acne or new facial hair · eyebrow or eyelash loss · hair loss in a child.
Sources
- King B, et al. N Engl J Med. 2022;386:1687–99 (baricitinib, BRAVE-AA1/AA2).
- King B, et al. Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata. Lancet. 2023;401:1518–29.
Medical review pending: not yet reviewed by a dermatologist. Medical disclaimer
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