Alopecia Barbae: Symptoms, Causes, & Treatments

- Reviewed by: Dr. Jae Pak, M.D.

For many men, facial hair is central to their identity. A full, strong beard can be a symbol of strength or manhood for some men, and can sometimes help men succeed in their professional and romantic pursuits.

That’s why experiencing any form of beard loss is a serious red alert for many men. Even if men prefer a cleaner look or a stubbled beard, losing hair from this area of the body is cause for concern, and worth investigating with a medical advisory.

These are cases of alopecia barbae, a serious condition with a range of symptoms and various potential causes. In this article, let’s outline the must-know facts about alopecia barbae, and discuss how to address it the right way with the best medicines and treatments.

What Is Alopecia Barbae?

Unlike hair loss of the scalp, alopecia barbae is more of a catch-all term to describe facial hair loss in men. Several potential underlying conditions can lead to alopecia barbae, so it’s important to recognize the symptoms and get to the bottom of the cause.

However, alopecia barbae is far less common than androgenetic alopecia, or standard male pattern balding. While most of the male population will experience scalp hair loss at some point in their lives, alopecia barbae affects less than 2% of men.

Losing facial hair is a problem nonetheless, and men should look into the exact cause of their condition ASAP in order to get the right treatment and help turn things around.

Symptoms of Alopecia Barbae

Every case of alopecia barbae involves the loss of facial hair, but specific symptoms can vary greatly depending on the person, and the scale of the hair loss can also be wide-ranging.

The most common symptom of alopecia barbae is small patches of hair loss across the chin and cheeks, a place that seems to affect men with this condition the most. Men often report small patches at first — just one or two inches in diameter — before larger patches begin to form.

In rare cases, this trend can continue until the majority of facial hair is depleted with no hair left on the face. More commonly, men will see patchiness subside or shift throughout different regions of the face unpredictably, with hair sometimes returning to areas that were previously left bald.

While many cases of alopecia barbae exclusively entail the loss of facial hair, there tend to be other symptoms that appear prior to the development of patches or during the process of hair loss.

These can range from minor redness and irritation to full-on dermatitis and eczema, with the latter two conditions involving severe flaking, scratching, and discomfort. When skin is inflamed to that degree for a long period, hair can fall victim to a hostile environment, especially when combined with fierce scratching.

Finally, men may experience other signs of physical discomfort or deterioration alongside alopecia barbae. It’s not uncommon for similarly sized bald patches to form on the scalp hair or for hair loss to occur in other areas of the body.

Skin and nails may also be affected concurrently with this condition, as some patients develop indents or cracks in their fingernails or toenails leading up to, or during, an episode.

Causes of Alopecia Barbae

Since alopecia barbae is rare with odd and diverse symptoms, pinpointing a cause can be difficult, with many possible reasons behind the condition.

Alopecia areata, an autoimmune disease that also affects scalp hair and body hair, is considered the most common cause of alopecia barbae. Some doctors will assume that all alopecia barbae instances are the result of areata, while this is not necessarily the case.

While the signs of alopecia areata should be clear, the exact source of the disease remains elusive to the medical community. Research shows that genetic factors are at play, while environmental factors can also catalyze cases of alopecia areata.

The condition is characterized by the body mistakenly attacking hair follicles in an attempt to protect itself. The result is unpredictable patches of lost hair on the beard (alopecia barbae) among other locations on the body.

This is just one way that alopecia barbae can occur, of course. The condition may also be caused by disruption to the endocrine system, as significant shifts in hormone production and regulation can lead to the loss of facial hair, even in typically high-testosterone men.

Given our modern environment with less-than-friendly plastics and pollution, it’s no surprise that men are experiencing hormonal problems more often.

In some cases, the cause-and-effect of alopecia barbae is crystal clear, resulting from an adverse reaction to a medication, a fungal or bacterial infection (such as ringworm), or the result of cancer therapies like chemo.

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Treating Alopecia Barbae

Since alopecia barbae can result from so many possible conditions, patients need to seek out the correct diagnosis before considering treatments.

It’s not just a matter of cost and convenience when it comes to proper treatment selection. These things are key, of course, to ensure that your condition is correctly addressed and that you don’t waste time and money on the wrong things.

Moreover, it’s important to correctly assess the condition to accurately combat the underlying cause of alopecia barbae and hopefully bring back beard hair while minimizing risks and side effects.

Because this isn’t a very common condition, patients are strongly urged to seek out the guidance of a dermatologist or generalist and then once a cause is determined, seek a proven hair loss professional like Dr. Jae Pak, to determine if you are a candidate for a hair restoration procedure.

Only a doctor with hands-on experience with alopecia barbae and related conditions will have the necessary experience required to pinpoint the root cause and work towards a safe, effective fix. With that said, let’s look at top treatments for alopecia barbae, as it appears in its major forms.

Natural Remedies

Not all cases of alopecia barbae require immediate medical recourse. Doctors may suggest that patients administer natural home remedies to help cool and calm an inflamed area and see if they can stimulate some growth.

Essential oils like lavender, peppermint, and tea tree are favorites in the natural hair loss community, with some seeming to be more effective than others. Paired with castor oil and administered with massage, these tools may help support skin and hair health.

Improving one’s lifestyle and general health is always advised, as well. Many patients who suffered from alopecia barbae report living with extreme stress and unhealthy habits, so clearing that up is a smart first step towards better health overall.

Antifungal Medication

Fungal conditions like ringworm are less common causes of alopecia barbae, but legitimate nonetheless. If a doctor identifies ringworm as the root cause, it’s just a matter of waiting while the medication kicks in and solves the core issue.

Other bacterial or viral causes may be at play for beard loss in other situations. Doctors should never rule out these causes when making their assessments.

Steroid Creams and Injections

If alopecia areata is the diagnosis, corticosteroids may be prescribed ASAP in the form of pills or injections. These medications are designed to fortify the body’s natural immune abilities during episodes of autoimmune dysfunction, and combat the effects of inflammation.

Your hair loss doctor will not be the one to administer these treatments, but they often can point you in the right direction and ensure you have the necessary support in place to do so safely.

These treatments are also typically paired with other tactics, medical and otherwise, to tackle the root problem from multiple angles and maximize your results in shorter time frames.

Clinical Skin Therapies

Today’s hair loss solutions go beyond the basic OTC medicines and tap into the latest, most effective therapies. Collagen induction treatments like microchanneling are one example that may prove to be a game changer for alopecia barbae in various forms.

Low-level light therapy is another treatment to consider, tapping into the body’s natural healing capacity and energizing cells at a microscopic level. Work closely with your hair loss doctor to explore all treatments and build a personalized game plan.

Is Beard Transplant the Answer?

Some patients might be eager to undergo a beard transplant at the first sign of alopecia barbae. These procedures have the potential to be transformative, but will not necessarily apply to all patients with these conditions.

Trusted hair restoration experts like Jae Pak, M.D. understand that assessing the patient’s condition is number one, rather than performing surgery with no questions asked, and will always encourage you to see a dermatologist first to get to the root of the problem before determining a solution.

This serves as a reminder to always choose your doctor and clinic based on expertise, experience, and a track record that showcases great service and transparency.

Bring Your Beard Back the Right Way

Alopecia barbae can be scary at first, but it should not be a death sentence for your beard. Use this guide as a reference to navigate your hair loss journey and examine all the options on the table.

In the meantime, work closely with a clinic and doctor you trust, like Dr. Jae Pak, so you have a better idea of how to best proceed, and can make your next move with total confidence.

Sources:

Bald Patch in the Beard | American Family Physician

Alopecia Barbae: What to Do If You’re Losing Your Beard | Men’s Health

Alopecia Areata Signs and Symptoms | AAD

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