Reviewed by Mary Lucas, RN
Written by Our Editorial Team
Many men worry about losing the hair on their head, but could the hair on your chin also be in danger? Do you find beard hair falling out when you're combing?
While rarer than balding along the hairline or crown, facial hair loss can happen, leaving your beard looking patchy and incomplete. It’s a particular type of alopecia — alopecia barbae — that’s responsible for this.
The causes of this form of alopecia are both simple and complicated, depending on how far you want to go down the rabbit hole.
But the key to figuring out if and how you might reverse the damage is in understanding alopecia barbae in detail. So, let’s break it down.
To understand alopecia barbae, you need to understand its parent hair loss type: alopecia areata.
Alopecia areata is a type of hair loss caused by autoimmune diseases, which can cause the body to damage hair follicles.
With alopecia areata, your autoimmune system mistakenly sees your hair follicle as an invader and attacks your follicles as if they are foreign bodies.
The damage done by this can cause temporary hair loss, which will eventually become permanent if the damage is not addressed.
Alopecia areata is not contagious, and often develops during a person’s teenage years. It can happen once, or in unpredictable and recurring cycles.
The American Academy of Dermatology Association says that alopecia areata can manifest in a variety of ways, with the hair loss being patchy in one location or widespread.
Worse, those patches of hair loss can even jump from one part of the body to another, healing and reappearing in new places.
Typically, alopecia areata affects the scalp, but it can frequently affect other body hair as well (in these cases, the disease is typically referred to as alopecia universalis).
Alopecia barbae is a particular type of localized hair loss due to alopecia areata affecting just your beard. It is caused by an autoimmune process in the body.
It has been found that people with certain autoimmune disease types, from hay fever to vitiligo, thyroid diseases to atopic dermatitis, asthma and even Down syndrome are at a higher risk of developing alopecia areata and, by extension, alopecia barbae.
Alopecia barbae is sometimes hard to understand, as it can cause patchy beard hair while your full head of hair is intact just inches away.
Autoimmune hair loss can be associated with other diseases, as well.
Some of them include lichen sclerosus et atrophicus, pemphigus foliaceus, morphea, hypothyroidism, Hashimoto's thyroiditis (a type of thyroid disease), Addison's disease, pernicious anemia, lupus erythematosus, lichen planus, endemic goiter, and diabetes mellitus.
It’s not entirely clear who is and isn’t likely to deal with patchy beard hair loss. One study suggests that you’re more likely to suffer from alopecia areata if you’re hispanic or black.
However, the study only included women, and researchers noted a need for more studies to be conducted.
Currently, there are no FDA-approved treatment options for alopecia barbae or alopecia areata — just treatment for the underlying cause and for the symptoms.
Dealing with this condition is about either getting your autoimmune condition under control, or treating the symptoms.
Corticosteroids are one way to treat symptoms. They can either be injected directly into a bald spot, or applied topically.
Both options will need to be prescription strength, and recommended by a dermatology practitioner.
Minoxidil (also sold under the brand name Rogaine® and Theroxidil®) is a topical cream commonly used as a treatment for hair loss.
While its exact mechanism of action is unknown, it’s goal is to encourage hair regrowth in locations where loss of hair has been noted.
It’s not FDA approved for alopecia barbae, but has shown beneficial in some patients.
Because everyone’s treatment strategy for alopecia areata will be different, each patient’s reaction to their individual treatment plan will likely also be different.
In other words, there may be some struggles to find the right treatment — work with your healthcare provider to find the right one for you.
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If you’re seeing patchy hair loss, interrupted beard growth and other signs of alopecia barbae, your first priority should be consulting a healthcare professional — particularly if you have no known autoimmune disorders.
Facial hair loss due to treatable medical conditions is something that needs immediate attention, and autoimmune diseases need to be managed as soon as possible.
A healthcare provider may recommend different treatments, whether for the disease itself or for hair loss — or both.
It’s possible you’ll still see permanent hair loss even with help, and chronic hair loss issues may recur unpredictably.
But having a professional helping to monitor your condition is the best tool to help you combat the beard problems.
Generic for Rogaine®, this FDA-approved over-the-counter version of topical minoxidil is used for regrowth on the crown of the head.
This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.
If you’re looking for something effective but don’t want too many steps in your routine, this once-a-day pill could be right for you.
Clinically proven to regrow hair in 3-6 months, no pills required.
The reality of having an autoimmune condition is that treatment can be a long, arduous process. For many autoimmune conditions, cures simply don’t exist.
If you’re suffering from another autoimmune condition, your beard (learn more: minoxidil beard) may not be your top priority anyway. It might make more sense to shave it while treating your condition. That’s a personal choice.
What’s important is that those patches of hair loss don’t weigh on your confidence while dealing with a serious illness.
But before you buy up every hair growth product in your local drugstore, make sure you take the right first step in dealing with your health concerns: speaking with a healthcare professional who can address your health needs.