Beard Alopecia Treatment – Can a Hair Transplant Help?

Beard alopecia, also known as alopecia barbae [1], is an autoimmune condition that impacts facial hair growth. In some cases, hair loss is short-term and will self-correct; in others, where damage to the follicles is permanent, a beard transplant may be an option.

The complication is that many people with alopecia barbae see patches of hair loss, which can have a detrimental impact on their self-esteem – but that, equally, a hair transplant isn’t necessarily always the right solution, especially if there is strong potential for the hair to regrow naturally.

In this article, we look at how alopecia barbae impacts your facial hair, the solutions and treatments available, and some of the many factors that will influence the recommendations we make during a cost-free consultation.

Understanding the Symptoms and Causes of Beard Alopecia

Hair loss in your beard and facial hair can profoundly affect your confidence. The most typical sign that this type of hair loss is linked to alopecia barbae is the appearance of patches of hair loss, usually in a circular pattern.

The positive is that beard alopecia is fairly rare. It impacts around 2% of men – but that doesn’t mean that the side effects aren’t significant or that treatment may be just as important to you as for a person with alopecia areata, causing hair loss to the scalp. [2]

To dispel some of the many misconceptions about beard alopecia:

• Symptoms usually start around the jawline, although patches of hair loss could appear around the cheeks, sideburns, and chin.
• Alopecia barbae is an autoimmune condition, which means your body is attacking the follicles. It isn’t the same as alopecia areata because these issues affect different areas of hair growth, with the latter causing hair loss in the head.
• Researchers believe that beard alopecia is a stress response in some men, although there are also indications that autoimmune issues can be associated with inflammatory defence responses activated by a shortage or dysfunction within the white blood cells that fight disease.

Having another autoimmune disorder doesn’t necessarily mean you are predisposed to develop alopecia barbae. Still, there are some case studies that highlight that patients might experience beard alopecia alongside other disorders like thyroid conditions, vitiligo and atopic dermatitis. [3]

Contrasts Between Alopecia Barbae and Alopecia Areata

We often use the term ‘alopecia’ as a blanket phrase, but beard alopecia is a separate sub-condition of alopecia areata. Dr Matee, Director of Surgical Services for KSL Clinic, explains:

‘Alopecia barbae is similar to alopecia areata in that both are caused by autoimmune responses. The big difference is that beard alopecia only impacts facial hair and does not correspond or correlate with alopecia to your hair.

That means for the vast majority of people, beard alopecia will stay contained to your facial hair, and there isn’t any definitive chance you’ll start to see alopecia elsewhere. In more rare scenarios, and if both conditions are present, this is called alopecia totalis – but the risk of this degree of hair loss is far less common and impacts around 0.03% of people. [4]

Another differentiating factor is that alopecia areata can affect people of all genders, whereas beard alopecia can only impact men, or people assigned male at birth, who have natural hair follicles around the face.’

Restoring Facial Hair Growth After Hair Loss Caused by Beard Alopecia

One of the difficulties in managing or correcting facial hair loss is that alopecia barbae isn’t always permanent. Like many instances of alopecia areata, the hair will regrow after short spates of hair loss that tend to last three to six weeks.

Flare-ups are more common during times of elevated stress, but they can’t always be predicted. Hair loss might be sporadic, with extended periods of no hair loss followed by rapid and sudden onset.

This is why treatments for alopecia barbae must be bespoke. A hair transplant isn’t always an ideal approach, especially where we can see that follicles remain active and likely to produce new hair or that a transplant would have a minimal chance of success.

Potential Treatment Options for Beard Alopecia Hair Loss

As a snapshot, we have summarised below some of the many solutions we may suggest following a private consultation:

• Topical treatments like minoxidil, which are also used to slow hair loss due to androgenetic alopecia or alopecia areata. This treatment improves the blood flow to the affected hair follicles, which can help promote healthy growth without being a solution that can stop hair loss altogether.
• Follicle-activating non-surgical therapies like laser hair treatments and platelet-rich plasma therapy may be appropriate, usually in conjunction with topical medications. These therapies give the follicles a better chance of regrowing new hair and stimulate inactive follicles that are currently dormant.
• Lifestyle changes to reduce high-stress levels, balance nutrition and hydration, and keep skin in optimal condition can help. Some men also opt to wear their beards shorter, which makes the visible signs of beard alopecia less noticeable.

There are some situations where a permanent, minimally invasive hair transplant may be suitable, often only when the beard alopecia is under complete control, or you haven’t seen a flare-up or any sign of hair loss for an extended period.

It could also be a way to replenish your facial hair if repeated bouts of alopecia barbae in the past have caused permanent damage to some follicles, in which case replenishing those areas with healthy donor follicles may achieve the appearance you aspire to.

However, professional clinical advice is essential since a beard transplant is not always suitable, and a future flare-up could limit its effectiveness.