Alopecia Areata: What NICE Says, When to See a Dermatologist and Where PRP Fits

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What is alopecia areata?

Alopecia areata is an autoimmune condition that causes patchy hair loss. NICE Clinical Knowledge Summaries estimates a lifetime incidence of around 2% (NICE CKS: Alopecia areata). It can affect anyone, at any age, and it is not caused by stress alone or by anything you did wrong.

Will my hair grow back?

For many people, yes. NICE CKS notes that spontaneous remission within a year may be seen in up to half of affected people, and more often in those with limited patches present for less than a year. It also says regrowth is unpredictable and that future episodes can occur. Treatments may help induce regrowth but cannot cure the underlying condition.

New hair often grows back fine and pale at first before returning to its usual colour (NICE CKS).

Your first step: a proper diagnosis

Patchy hair loss has several causes, and the right plan depends on the right diagnosis. A doctor will look at the pattern, check the scalp and ask about your health, your family history and how the hair loss is affecting you. NICE CKS lists psychological and social impact as part of the assessment, because some people find the condition profoundly upsetting.

Want a doctor to confirm the cause? Message us on WhatsApp, book a consultation or call 020 3951 3429.

What the NHS pathway offers

- No treatment is a reasonable choice if hair is regrowing, or if the hair loss is limited, stable and not causing distress (NICE CKS).

- A trial of a potent topical corticosteroid for about 3 months may be considered. Regrowth may not be seen for at least 3 months (NICE CKS).

- Referral to a dermatologist if you want medical treatment, if the hair loss is extensive, long-standing or not responding.

- Specialist options include intralesional corticosteroid injections, commonly triamcinolone acetonide, repeated every few weeks and best suited to limited, patchy hair loss (NICE CKS).

- Psychological support, and a wig prescription route that may require dermatology referral (NICE CKS).

NICE CKS also states that no treatment has been shown to alter the long-term course of alopecia areata, and that trial evidence is limited by small studies and a high rate of spontaneous remission.

Where does PRP fit?

PRP is not among the treatments listed in the NICE CKS alopecia areata pages we reviewed, so it is not a standard first-line option. Evidence for PRP in alopecia areata is still limited. Our doctors will tell you that plainly. Where PRP is better evidenced is in pattern hair loss, and a consultation will tell you which type you have. If PRP is suitable, it is £450 per session or £1,215 for a course of 3.

Checklist for your appointment

- Note when each patch first appeared and whether new ones have developed.

- Take dated photos in the same light, so change is easy to see.

- List medicines, supplements, recent illness, family history of autoimmune conditions and new stressors.

- Write down how the hair loss is affecting you. It is a valid part of the assessment.

- Ask what regrowth would look like, how long to wait and when to review.

Red flags: see a doctor promptly

See a doctor promptly for rapidly spreading patches, hair loss with a sore, scaly or scarred scalp, nail changes, hair loss in a child, or hair loss with tiredness, weight change or other new symptoms.

How to start

A consultation with one of our doctors is £59 by phone (15 minutes), £150 by video or £220 in person at Unit 4, 10 Portman Square, London W1H 6AZ. We will work out the likely cause, explain the free NHS routes, and tell you honestly which options are worth your money.

Frequently asked questions

Is alopecia areata permanent?

Not usually. Remission within a year is seen in up to half of people, though episodes can return (NICE CKS).

Is it caused by stress?

It is an autoimmune condition. Stress can affect how people feel about it, but a doctor should look for the cause rather than assume.

Does PRP cure it?

No treatment cures alopecia areata. Evidence for PRP in this condition is limited.

Can I get treatment on the NHS?

Yes. A GP can assess you and refer to a dermatologist if you want treatment.

Ready to talk to a doctor? Message us on WhatsApp, book a consultation or call 020 3951 3429.

Written by The Wellness Team and medically reviewed by The Wellness Clinical Team. This article is for information only and does not replace a consultation with a doctor.