Alopecia areata is a non-scarring hair loss mediated by T cells. 1 Alopecia areata is a very common skin disease that accounts for 25% of all hair loss patients and can occur at any age. 2 Alopecia areata usually manifests as a single or several round, oval, or irregular hair loss areas with clear boundaries, and the local scalp is normal and smooth. For many patients, hair loss not only affects external appearance and beauty, but also psychological problems. It may cause anxiety, depression, and even suicidal tendencies in severe cases. 3 The cause of alopecia areata is not fully understood, and it is currently believed to be related to autoimmune, genetic, emotional stress, and endocrine factors. Some extracts from plants have been evidenced that might be effective in the treatment of alopecia areata. Topical capsaicin can stimulate the scalp, improve blood circulation, and promote hair growth. A randomized controlled trial (n = 50) conducted by Ehsani et al. compared capsaicin ointment (once a day for 2 weeks, then