How Do I Fix Bald Spots in My Beard? Alopecia Barbae

Although the exact cause of alopecia barbae is unknown, studies have shown the following causes to be associated with increased risk of developing the disease.

• Autoimmune disorders: This includes diseases such as type I diabetes mellitus, psoriasis, and lupus. As the immune cells are already dysfunctional in these cases, it can increase risk of autoimmune hair loss.
• Genetic history: Having a positive family history of autoimmune conditions can put you at greater risk of developing alopecia barbae.
• Increased stress: Studies have shown that both physical and psychological stress can lead to hair loss.

The most obvious symptom is a sudden patchy loss of hair in the beard or along with the beard. Sometimes, the patchy hair loss extends to the hairline as well.

Hair loss takes place over the course of a few days to weeks. Skin around the bald patches may appear white and have mild itching Sometimes, the skin may also have signs of inflammation, such as redness, pain, or roughness.

Your doctor will examine you and confirm a diagnosis after conducting certain blood tests and skin scrapings.

• A dermatologist will note and mark the involvement of the skin and pattern of hair loss from the beard.
• Blood tests may be ordered to rule out conditions such as diabetes mellitus, thyroid imbalances, and anti-lupus antibodies. 
• A scalp or skin biopsy may be done to check for fungal infections.
• Hair samples can be taken from the affected area for examination.

There is no specific treatment option for alopecia barbae. Treatment aims to limit activity of the immune cells in order to reduce damage to hair cells. The immune process responsible for hair loss can be halted so that new hair grows.

Medications commonly prescribed include:

• Corticosteroids: Help reduce the activity of the immune system, limiting hair damage and loss.
• Rogaine (minoxidil): Works as a vasodilator by increasing hair follicle size and growth rate when applied topically over the affected area 2 times a day for at least 3 months.
• Diphencyprone: Causes a localized allergic reaction that induces redness, swelling, and itching. This is thought to trick the immune system to send white blood cells to the surface of the skin to reduce inflammation and keep the hair follicles active, preventing hair loss.
• Anthralin: Applied topically to the affected area to promote new cell generation. It causes slight skin irritation.