How to Care for Your Hair and Scalp When You Have Alopecia Areata

There’s nothing you did to cause your hair to fall out. (Alopecia areata is, after all, an autoimmune disease.) But there are things you can do to retain your remaining hair, as well as speed up the process of hair regrowth.

Contents

1. Wash Your Scalp Regularly 2. Soothe Itchiness With Anti-Dandruff Shampoo 3. Comb With Care 4. Wear Your Hair in a Looser Style 5. Be Careful With Wigs and Hairpieces 6. Be Skeptical of Trendy, Over-the-Counter Products The Takeaway

Along with taking medication, it’s a good idea to give your scalp some extra TLC by using gentle hair-care practices and mineral-rich shampoos, says Amy McMichael, MD, a professor of dermatology at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

Keep reading for more smart strategies for taking care of your hair and scalp.

1. Wash Your Scalp Regularly

Washing your scalp helps keep your remaining hair healthy, says Dr. McMichael. Some people may only need to wash their hair every one to two weeks, whereas others may need to wash it daily, especially if they exercise often and sweat a lot.

If you’re in an active phase of alopecia areata, you’ll see more hair falling out when you wash. But that doesn’t mean hair washing is harmful. The strands you see on your hand or the shower floor were going to fall out soon anyway, because white blood cells already attacked those hair follicles. “That extra agitation [from washing] causes the hair to shed, so it’s very stressful to see it, but you’re not causing it,” says McMichael.

2. Soothe Itchiness With Anti-Dandruff Shampoo

Itchiness and irritation are common symptoms of alopecia areata. To soothe your scalp, McMichael recommends using an anti-dandruff shampoo that contains coal tar, ketoconazole, salicylic acid, selenium sulfide, or zinc.

These ingredients are all-stars for scalp cleansing, but they can dry out your hair, so use them sparingly, says McMichael. Try this strategy: “Wet your fingers, put the shampoo on your fingers, and shampoo it into the scalp. Then, use your regular shampoo for your hair and then rinse that out. And then follow up with your regular conditioner” says McMichael.

3. Comb With Care

When you want to protect every hair on your head, it helps to be gentle. “You shouldn’t be dragging combs or brushes through your hair from the root to the tip,” says McMichael. “Start at the bottom of the hair shaft and work your way up so that you don’t pull out tangles from the root.”

People with curly hair may be particularly prone to hair breakage from combing, she says. So, if this is the case for you, you may be better off wearing your hair curly instead of trying to comb it straight.

4. Wear Your Hair in a Looser Style

Braids can cover patches of hair loss very well, but make sure they’re not too tight, says McMichael. Wash your hair at least every two weeks while the braids are in, she says, and remove them after one month. Tight braids, cornrows, dreadlocks, ponytails, slicked-back buns, and styles that require you to wear rollers to bed can cause more hair loss from traction alopecia, which is caused by prolonged pulling on the hair follicles.

You can still blow-dry, color, and flat-iron your remaining hair, but do it in moderation, especially if your hair is already damaged. Using chemicals or heat can cause hair breakage for anyone, but styling the outside of your hair doesn’t generally damage the scalp, says McMichael.

If you use pomades or other products to smooth damaged hair, apply them to your hair, not to your scalp.

5. Be Careful With Wigs and Hairpieces

If you wear a wig or hairpiece, make sure it fits comfortably and doesn’t cause irritation. “Try not to use glues, combs, or clips that are very tight or that rub your scalp, because that can actually cause more damage to the scalp,” says McMichael. “The hair won’t grow there, because the hair follicles will be damaged.”

6. Be Skeptical of Trendy, Over-the-Counter Products

Social media is flooded with ads for hair and scalp products that claim to support hair growth. But always ask your dermatologist before you slather anything new on your scalp.

“You don’t need to do special treatments to your scalp like oil applications,” says McMichael. “There are a lot of natural, oil-type things on the market that claim to make hair grow, and I can guarantee you that probably 99.9 percent of them are not going to be helpful. And they could actually be irritating to your scalp.”

A better idea is to seek treatment from your dermatologist, who can recommend medications such as topical or oral steroids, topical immunotherapy, or Janus kinase (JAK) inhibitors, which hinder JAK proteins to stop the immune system from attacking hair follicles.

The one over-the-counter treatment McMichael does recommend is minoxidil (Rogaine), a topical medicine that speeds the hair growth cycle. Look for a 5 percent concentration solution or foam to support hair regrowth. “Typically, we think of it as an adjunctive treatment, so not a single treatment to be used alone,” she says.

The Takeaway

Wash your scalp regularly, and consider using an anti-dandruff shampoo if your scalp is irritated or itchy.
Comb your hair gently, and choose hairstyles that won’t cause more hair loss or damage. If you use wigs or hairpieces, make sure they don’t irritate your scalp.
Minoxidil (Rogaine) can help regrow hair and is often used alongside other treatments, such as topical or oral steroids, topical immunotherapy, or Janus kinase (JAK) inhibitors.