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Review
. 2023 Jun;9(3):179-186.
doi: 10.1159/000529389. Epub 2023 Mar 8.

Alopecia Areata Barbae in a Nutshell

Adaeze Nwosu  1 , Mariya Miteva  1
Affiliations
Review

Alopecia Areata Barbae in a Nutshell

Adaeze Nwosu et al. Skin Appendage Disord. 2023 Jun.

Abstract

Beard alopecia areata, or alopecia areata barbae, (BAA) is a subset of alopecia areata, a T-cell mediated inflammatory disease that disrupts the hair follicle cycle leading to early onset of catagen. The aim of this review is to help strengthen clinicians' skills in the evaluation, diagnosis, and management of BAA. We performed a literature review according to the modified PRISMA guidelines, using a combination of relevant key words in electronic databases. According to the data from the 25 articles on BAA reviewed here, BAA mostly affects middle-aged men (mean age 31 years) who typically experience patchy hair loss in the neck region, which spreads to the scalp within 12 months. Similar to AA, BAA is associated with autoimmune diseases such as H. pylori and thyroiditis; however, BAA has no clear genetic pattern of inheritance which is observed in alopecia areata. Common dermoscopic findings in BAA include vellus white hairs and exclamation mark hairs, which may help distinguish it from other pathologies affecting facial hair. In clinical trials, the ALBAS tool offers clinicians an objective metric to evaluate BAA severity. Until recently, topical steroids have been the mainstay therapy; however, topical and oral janus kinase inhibitors are achieving improved results, with up to 75% beard regrowth in an average of 12 months.

Keywords: Autoimmune disorders; Beard alopecia areata; Dermoscopy; Hair follicle immunology; Janus kinase inhibitors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Evaluation of BAA using ALBAS tool (illustration by author). a The chin area is weighted 8% in the ALBAS scale and has a combined score of 2.3/10. b The sides are weighted 19% in the ALBAS scale and has a combined score of 5.2/10. The sides of the beard are second most affected area. c The neck area is weighted 50% according to the ALBAS scale and patches are most likely to present in this area.
Fig. 2
Fig. 2
a BAA − there are several well-defined round patches involving the left jaw line, upper cheek, and neck. b There is decreased hair density, with yellow dots, black dots, and broken hairs (FotoFinder, Bad Birnbach, Germany, at ×20). c Note the presence of vellus hairs in a different patch (FotoFinder, Bad Birnbach, Germany, at ×20).
See this image and copyright information in PMC

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Grants and funding

The authors have no funding sources to declare.