How to Do Microblading on Alopecia Patients – What’s Good to Know

By Emily M.| Last updated on May 20, 2022
How to Do Microblading for Alopecia Patients - What’s Good to Know
⏱️ 5 min read

One of the biggest advantages of microblading over other brow treatments is the fact that it can reconstruct brow arches from scratch for clients who have very little to no brow hairs. Brow loss can happen due to numerous causes, and alopecia areata is a relatively common one.

It is estimated that close to 150 million people worldwide suffer from alopecia areata which can cause hair loss on the scalp, but also on the face, leaving patients with sparse, patchy brows, or no brows at all.

For them, microblading isn’t just a practical way to enhance your look – it can change their lives.

With alopecia affecting such a huge number of people, chances are, every microblading artist will get alopecia clients sooner or later. So here’s a list of things to bear in mind when doing microblading on alopecia patients.

What Is Alopecia Areata?

Alopecia areata is an autoimmune disorder that causes the hair on your scalp, face and body to fall out, either in clumps, or more diffusely, causing the hair to thin out rather than bald patches to emerge.

With this condition being an autoimmune disorder, it causes the body to attack hair follicles. As a result, hair falls out either permanently, or temporarily, growing back out but possibly falling out again at some point.

What causes alopecia areata is yet to be completely explained, but it’s likely to be a genetic condition passed down from ancestors. It can’t really be cured, but it can be treated with various meds. The success of the treatment isn’t guaranteed, however, so many patients have to seek ways to camouflage their hair loss.

In terms of brow loss, the most effective camouflage is brow PMU.

About Alopecia Areata And Effective Camouflage With Brow PMUImage source: Instagram @phibrows_mersy

Is Microblading Safe for Alopecia Patients?


There are no contraindications against getting microblading for people suffering from alopecia areata, but some other conditions which often emerge alongside alopecia might make microblading unsafe (mainly thyroid disease).

What you should know, though, is that alopecia patients tend to be more prone to infections, so warn them they should be extra careful with aftercare.

It may also take longer for their brows to heal, so the touch up should be booked towards the 8 week mark.

How Should Microblading Be Done on Alopecia Patients?

For starters, we should note that some artists claim they noticed premature pigment fading on their alopecia clients. So many of them advise going darker with the pigment, to ensure it lasts as long as possible.

Then, since some alopecia patients have no brows, the microblading needs to be as natural-looking as possible, and it’s something only advanced artists can pull off right.

But the severity of hair loss is not the same for everyone, so let’s see how brows should be microbladed for each stage of alopecia.

For Partial Brow Loss

The easiest issue to camouflage.

Alopecia may not take away the entire brows; the hairs may fall off in spots and cause patches. These patches can be filled in with microblading strokes relatively easily, depending on the severity of the hair loss.

It’s important to place strokes with precision, so they blend into the existing hairs. They need to follow the same pattern as the natural brow hairs.

How Should Microblading Be Done on Alopecia Patients?
Image source: Instagram @brows_and_beauty_bysarah

For One-Sided Brow Loss

Certain types of alopecia cause the loss of only one eyebrow. One of the brows is lost almost completely, while the other one is either intact, or is only thinned out a bit.

These are the toughest cases to microblade. Although the two can never look identical, as the microbladed brow isn’t 3D, the microblading needs to imitate the look of the existing brow as closely as possible.

The artist has to be very skilled and have extensive knowledge of color theory to be able to match the color of the pigments to the color of the other eyebrow.

The best advice we can give is to go somewhat darker with the pigment color, as the microbladed brow will inevitably become lighter than the actual one at some point, but it’s best to postpone this moment as much as possible.

Alopecia Patients Microblading For One-Sided Brow LossImage source: Instagram @kutsevolova_anna

For Complete Brow Loss

Creating brows from scratch using microblading strokes is a challenge. Since the client has no brows, any mistake will be very noticeable, as there are no hairs to disguise it. It takes a lot of practice mastering total brow reconstruction, and extensive knowledge of microblading patterns and mapping.

Every client has unique wishes, but the best microblading pattern for recreating brows from scratch is hyperrealism brows, a pattern recognizable for its fluffiness and the illusion of depth. Hyperrealism brows are less dressy, messier, so they look like naturally thick brows.

The strokes are drawn in clusters, which adds to their realistic look. If you think about it, natural brows get crossed and almost tangled, so strokes should be drawn in such a way, since there are no actual hairs to merge with them.

The thing about hyperrealism brows, though, is that they should be done with a machine. Manual microblading cannot offer the precision it takes to draw hair stroke clusters.

Alopecia Patients Microblading For Complete Brow LossImage source: Instagram @karenhicksbrowspecialist

Side-Note: Machine Strokes May Be a Better Option, Especially for Men

The biggest debate in the PMU industry at the moment – are nano brows better than microblading?

While both treatments definitely have their pros, in the case of alopecia clients, nano brows take the win.

There are several reasons for this. Nano brows, or strokes created with a machine, look better on clients who have very little to no brow hair, as they’re thinner and look more realistic. The patterns that can be created look more natural if there are no actual hairs for the strokes to blend into.

Then, there’s the issue of blurring over time. Microblading strokes can blur on some patients, especially if the brows are microbladed continuously, whenever they fade (and for people with no brows, that’s often the case). As the skin is saturated with pigment, at one point, the pigment residues will merge into a shadow and new strokes won’t look crisp and defied anymore, but rather like brow makeup.

This looks very prominent on people with no brow hairs the shade could blend into.

For female patients, that’s not such a huge issue, as they can just switch to combo brows which imply shading, but for men who mostly don’t want the makeup look, it can be a problem.

Blurring is much less frequent with digital hair strokes due to the precision of machine application, so nano brows are definitely the way to go for alopecia patients.

For a more detailed description of nano brows, check out this guide.

Nano Brows For Alopecia ClientsImage source: Instagram @dora_hollos

Final Piece of Advice

If the alopecia isn’t so severe and the client’s brows are just thinned out or have some bald spots, most artists will do a good job. But clients who have no brows or only have 1 brow should only be microbladed by advanced artists who can do a realistic brow to ensure satisfaction.

Cover image source: Freepik



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