Alopecia Areata

Alopecia Areata is a common autoimmune condition that causes hair loss. “Alopecia” means baldness, and “areata” means patchy. As the name suggests, this condition causes patches of hair loss, usually on the face and scalp, but legs, underarms, and other body parts can be affected too. In severe cases, people with alopecia can lose all their body hair, including pubic hair, eyelashes, and eyebrows.

There are different categories of alopecia areata:

Alopecia areata totalis: Total loss of hair from the scalp.

Alopecia areata universalis: Total loss of scalp and body hair.

Diffuse alopecia areata: Scalp hair starts to thin rather than falling out in clear patches. This is hard to distinguish from male or female pattern baldness.

Ophiasis alopecia areata: Hair loss occurs in a band around the sides and back of the head.

 

Signs and Symptoms

Alopecia areata often begins with small round or oval-shaped patches of hair loss on the scalp. These patches look like normal skin, with no redness or rash. The progression of the condition is unpredictable, and it affects everyone differently:

• Some people find their hair regrows within a few months.
• In other cases, more patches may appear and the patches may join together to form larger areas of baldness.
• The disease may progress to alopecia totalis or universalis, with total loss of hair from the scalp and body.
• Some people may develop ridges or pits in their nails too, especially if their hair loss is severe.

Alopecia areata can go into remission for months at a time, or it may become more permanent – everyone has a different experience with the condition.

It’s important to recognize that alopecia areata can be an incredibly stressful condition – especially for teenagers and young children who are already dealing with a lot of physical and emotional changes.

 

Who Gets Alopecia?

According to the National Alopecia Areata Foundation, alopecia is more likely to affect women than men, as is the case with most autoimmune conditions. Women affected by alopecia are also more likely to have another autoimmune disease such as autoimmune thyroid disease (Fricke & Miteva, 2015).

Alopecia frequently occurs in younger people. Around 80% of individuals with alopecia develop it before the age of 40, and 40% develop it before age 20.

Research shows that Asian, Black, and Hispanic people are more affected by alopecia than White people (Sy et al, 2023) although the reasons for this remain unclear.

 

What Causes Alopecia?

Alopecia areata is an autoimmune condition, which means the body is attacking its own hair follicles and causing hair loss.

There is never one simple cause of an autoimmune condition. Autoimmunity is instead triggered by a combination of factors including genetics, gut health, diet, lifestyle, and environmental factors.

Genetics

Alopecia areata is a polygenic disease which means it is linked to several different genes. However, not everyone with these genes will go on to develop the disease. As we know, genetics are just part of the picture of health. It is your diet and lifestyle that determine which genes are activated and which are “switched off”.

 

Gut Health

Your gut lining is the barrier between what you ingest (food, drink, medicines, supplements) and your internal environment. Over 70% of your immune system resides in your gut because your body needs to defend itself against anything you eat that may be harmful.

Gut microbes play a major role in maintaining the gut lining. When the microbiome is disturbed by pro-inflammatory foods, food additives, antibiotics, stress, and alcohol, the lining gets damaged. This can lead to increased intestinal permeability –  commonly known as “leaky gut”.

With a leaky gut larger molecules that wouldn’t normally pass through the gut lining are absorbed into the bloodstream. The immune system responds, and in genetically susceptible individuals autoimmune disorders can occur (Fasano & Shea-Donohue, 2005).

 

Diet

As I mentioned above, pro-inflammatory foods and food additives are some of the things that can damage your gut microbiome and trigger autoimmunity. It is no coincidence that autoimmune conditions are on the rise in countries that eat a typical “Western” diet rich in trans fats, simple sugars, inflammatory refined seed oils, and chemical food additives (Mazzucca et al, 2021).

The Eat Burn Sleep food plan is the opposite of a typical Western diet. It is designed to nourish your gut, reduce inflammation, and support a healthy immune response – no matter what autoimmune condition you are dealing with.

 

Lifestyle

Ongoing stress leads to chronically elevated levels of the stress hormone cortisol. This negatively affects many aspects of health, including gut health, inflammation, and autoimmunity.

You can read more about this in my article on  Cortisol Regulation and tune into my Masterclass ‘How To Reduce Raised Cortisol’.

 

Environmental factors

Toxins from agricultural pesticides, cleaning chemicals, non-stick coatings on pans, body care products, cigarette smoking, and traffic fumes can affect your immune system and genetic expression.

We may not be able to avoid all of these things completely but we can take steps to minimize our exposure and support gut health and toxin detoxification pathways. See the Yalda Loves page for my recommended kitchen and homeware products that are free from plasticizers and non-stick toxins.

 

 

Nutrition Advice For Alopecia Areata

Nutrition advice for Alopecia areata focuses on the common underlying causes of autoimmunity: stress, inflammation, and poor gut health.

 

Foods To Avoid

Ultra Processed Foods and Drinks (UPFDs) like candy, pastries, store-bought pizzas, hamburgers, sodas, ready meals, breakfast cereals, ice cream, and mass-produced bread. Industrially produced UPFDs are associated with at least 32 health conditions and the more of them you eat, the greater your risk of ill health (BMJ, 2024)

Food additives like carrageenan gum, xanthan gum, emulsifiers, artificial colorings, and preservatives. Many of these substances disrupt the balance of the gut microbiome, leading to inflammation and damage in the gut (Zhang et al, 2024).

Alcohol: Excess alcohol intake is associated with increased intestinal permeability, aka “leaky gut” (Engen et al, 2015). As always, moderation is key, and once you have completed Week 2 of the 6-week Reset you may decide to have an occasional drink as a treat. This is fine – after all, life is for living!

 

Foods To Favor

These foods are excellent sources of key nutrients for hair growth, gut health, and a balanced immune response.

Egg yolks, organ meats, and avocado are some of the best sources of biotin, a B vitamin needed for keratin synthesis (keratin is the structural protein that makes up hair and nails).

Salmon, sardines, trout, and mackerel for their anti-inflammatory omega-3 essential fats. Oily fish also provide vitamin D3 for a balanced immune response.

Dark green leafy vegetables are an excellent source of magnesium and B vitamins – important nutrients for managing stress and promoting healthy hair growth.

Good quality meat and seafood are rich in protein to help build new hair and minerals like zinc and selenium that support a healthy immune response. Zinc also aids DNA repair and helps maintain healthy hair growth.

Organic milled flaxseed for its fiber, protein, and healthy fats. Find my favorite brand of milled flaxseed on the Yalda Loves page.

Berries, sweet potato, carrot, turmeric, garlic, rosemary, green tea, chamomile, peppermint. These plant foods provide phytochemicals that nourish gut flora and provide antioxidant nutrients for a healthy immune system (Hodges & Minich, 2015).

I recommend you follow the food lists traffic system to enjoy a broad range of foods that support gut health and hair regrowth.

 

Lifestyle Advice

Stress Management

To manage the impact of stress on your alopecia, you need to relax and engage the parasympathetic side of your nervous system. This part of your nervous system regulates healing, repair, digestion, and a balanced immune response.

Daily movement and meditation help with relaxation and building resilience to stress. Follow the movement and meditation guidelines in the 6-Week Reset and Lifestyle Guide and be sure to include them as part of your daily routine. We have movement videos to suit all levels of ability, from Beginner to Advanced, so you can choose what suits you best.

You can access all of our movement videos and library of guided meditations at any time.

 

Supplement Advice

These are our top supplement suggestions for managing alopecia areata. Many of them are on my Yalda Loves page, as I only recommend high-quality, evidence-backed products.

If you are currently taking medication, we recommend you consult your healthcare practitioner before using supplements. Herbal and nutritional supplements are sometimes contraindicated with certain medications so it is important to check first.

Protein powders are useful for topping up your protein intake. I like to use Nuzest Clean Lean Protein in shakes and smoothies as it provides 20g of protein per serving.

Magnesium: I recommend magnesium citrate or glycinate as highly bioavailable forms. Magnesium glycinate is a good choice if your alopecia is causing anxiety, as glycinate is calming to the nervous system. Go for 200-400mg per day with food.

B vitamin complex with biotin, B12, B6, and B5 for nervous system support and keratin production. A “B 50” formula that contains 50mg (or equivalent) of each B vitamin is a good place to start. Take 1 per day, with either breakfast or lunch.

Zinc: Go for zinc picolinate, 30mg per day. This is a highly absorbable form of zinc. Studies show that severe forms of alopecia are associated with zinc deficiency. Plus, individuals with alopecia have statistically significantly lower zinc concentrations compared to normal controls (Lalosevic et al., 2023).

Omega-3 oils: It is best to get your omega-3 oil from oily fish but if this isn’t possible, use a good quality fish oil supplement instead (1000mg-3000mg a day). See the Yalda Loves page for recommendations.

Vitamin D3: An essential nutrient for a healthy, balanced immune response and for dealing with inflammation. Almost everyone needs to supplement with at least 1000iu D3 during winter and many people need to take it all year round. If your levels are insufficient or deficient, you may need 3000-5000iu daily.

Hair, Skin, Nails Formula. A good-quality hair, skin, and nail formula can provide biotin and silica for hair growth alongside co-factors like copper and vitamin C – see the Yalda Loves page for recommendations.

 

Other Treatments

Acupuncture

Traditional Chinese Medicine Acupuncture is another fantastic healing modality to use alongside the EBS plan.

Acupuncture may alleviate alopecia by improving circulation to the hair follicles, modulating the autoimmune response, and reducing inflammation. This is backed up by preclinical studies that show acupuncture can modulate the balance between immune cell activity and subsequently decrease the release of pro-inflammatory chemicals (Li et al, 2022).

One case study looked at a 62-year-old male with alopecia universalis (complete loss of scalp and body hair). After 3 months of acupuncture treatments, his scalp hair grew normally again. And after a further 2 months, his scalp and body hair was in good condition (Wu et al, 2020).

 

In summary, alopecia areata is an autoimmune condition that causes hair loss on the scalp and other body parts. As with other autoimmune conditions, potential triggers include diet, lifestyle, environmental stressors, and genetic susceptibility.

The Eat Burn Sleep lifestyle has all the tools you need to manage alopecia and other autoimmune conditions. Start with the 6-week Reset to nourish your system and go from there.

You can also find Personalized Advice for other hair loss issues in our Hair Loss Treatments article. This covers hair fall, male and female pattern baldness, seborrheic alopecia, and telogen effluvium.