If alopecia areata has not improved after two years, it may be related to one's treatment plan or dietary and lifestyle habits. Some individuals might not have received treatment or used improper treatment methods. Consuming spicy and heavily flavored foods, enduring prolonged periods of staying up late, feeling anxious or stressed, or having poor physical health could all potentially contribute to persistent alopecia areata.

It is advisable to visit a dermatology department at a reputable hospital to examine the hair follicles to see if there is any atrophy or necrosis. If the hair follicles are found to be atrophied or necrotic, the treatment will be more challenging. Generally, the most conventional treatment involving oral medication along with topical applications must be complemented by proper dietary and lifestyle habits. With long-term treatment, it is entirely possible to fully recover. It is essential to maintain a good mood, engage in regular exercise, and boost the immune system.