Alopecia And Treatment: Find the Best Treatment for Alopecia!

 

Dermatologists are experts in diagnosing and treating different types of hair loss, including alopecia areata. How do they diagnose it? By carefully examining the areas where hair loss is happening and assessing your nails.

 They might also use a dermatoscope to get a closer look at the underlying issues. Your dermatologist will ask about your overall health and family history of similar conditions. Sometimes, they may need to take hair samples or do a biopsy. 

A blood test might be needed too, to check for thyroid disorders and nutrient levels. Once all the information is gathered, your dermatologist will confirm if you have alopecia areata and discuss treatment options with you. 

It’s important to know that there isn’t one cure for this condition, and sometimes no treatment is necessary.

The approach your dermatologist adopts will be tailored to your specific circumstances, taking into account:

1. The extent of hair loss you’ve experienced.
2. The duration of time you’ve been grappling with hair loss.
3. The areas on your body where hair loss has occurred.
4. Your age (as treatment approaches can differ for children).

When it comes to treating bald spots, there are a few things to consider. If you’ve had one or two spots for less than a year, your dermatologist might suggest waiting and watching. It’s important to know that many people, especially kids, see their hair grow back on its own without any treatment. 

Sometimes the regrowth happens slowly and doesn’t meet expectations. If you’re not happy with how your hair is growing back, your dermatologist may recommend a prescribed medication. 

This medication can be applied directly to the areas where more regrowth is needed. A common treatment involves using a corticosteroid at first to stimulate regrowth and then following up with minoxidil (Rogaine®) to maintain the newly grown hair. 

 

For kids aged 10 and under, it’s important to know that their hair can grow back naturally. But when treatment is necessary, dermatologists may suggest these options: 

1. Corticosteroid application: Dermatologists recommend using prescription-strength corticosteroids to stimulate hair regrowth. This medication is applied once or twice daily and works great on its own for children.
2. Minoxidil: Another option is minoxidil, a medication that helps preserve newly regrown hair. It’s used after stopping corticosteroid treatment and has minimal side effects, making it safe for kids. Let your child’s beautiful locks thrive with these effective treatments!When dealing with children above the age of 10, the choice of treatment often hinges on the extent of their hair loss.

For older children experiencing noticeable hair loss, dermatologists may recommend contact immunotherapy or a JAK inhibitor. It’s important to mention that JAK inhibitors are specifically approved for treating alopecia areata in patients aged 12 and above.

1. Corticosteroid injections: a game-changer for adults. Watch as a skilled dermatologist targets those hair loss areas with precision. Results start showing in just 3 months after the first injection, giving you back your confidence. This treatment is perfect for patchy hair loss cases – and it works wonders! In fact, over 80% of our patients experienced at least a 50% regrowth within only 12 weeks. Don’t let discomfort hold you back; this treatment is exclusively designed for adults like you.
2. Want to see those bald spots disappear? Look no further than topical corticosteroids. This powerful medication, when applied as directed by a dermatologist once or twice a day, works wonders in children. Don’t settle for less effective treatments – choose what really works!
3. Apply Anthralin directly to the affected areas, as prescribed by your dermatologist. Let it work its magic and then rinse it off. Watch as regrowth begins. It may cause a little skin irritation, but don’t worry – that’s just a sign it’s working! And for even better results, try minoxidil once your hair starts growing back.
4. Minoxidil: After hair regrows, minoxidil application can assist in maintaining the regrowth. To achieve effectiveness, application of this medication 2 to 3 times daily is necessary. Minoxidil can prove beneficial for the scalp, beard region, and eyebrows.

Dealing with Severe Hair Loss: 

• Don’t let hair loss dent your self-confidence. Alopecia areata is more than just a few isolated bald patches; it can result in complete baldness on the scalp (alopecia totalis) or even the loss of all body hair (alopecia universalis). But here’s the silver lining: there’s hope! Seeking professional help is the key to regaining your hair after extensive loss. A comprehensive treatment plan might incorporate contact immunotherapy, a groundbreaking approach that puts a halt to the immune system’s attack on your precious hair follicles.

• Dermatologists have been employing this method successfully for years, with regrowth rates ranging from 17% to an impressive 75%. However, there’s an important caveat: consistency is paramount. Regular visits to your dermatologist and unwavering commitment to your appointments are crucial for effective treatment and preventing further hair loss.

• During contact immunotherapy, a skilled dermatologist or nurse applies a special chemical directly to the areas affected by hair loss. This initiates a reaction in your body that kickstarts the regrowth process. The chemical is then reapplied weekly for a 48-hour period, so be sure to keep those treated areas covered! While you may experience some temporary discomfort, such as developing a rash lasting approximately 36 hours, it’s a small price to pay when you witness your beautiful locks growing back even stronger than before.

• Contact immunotherapy continues on a weekly basis until one of the following outcomes is achieved:

1. 1. Complete regrowth of your hair.
   2. The treatment proves ineffective in regrowing hair by the end of 6 months.

• To enhance the efficacy of this treatment, your dermatologist may also prescribe an additional at-home treatment.
• JAK Inhibitors: These powerful medications calm an overactive immune system, helping hair to grow back. They are a game-changing treatment for people with extensive hair loss. Multiple studies prove that JAK inhibitors can lead to significant regrowth, often exceeding 50%. But that’s not all – JAK inhibitors also work wonders on eyebrows and eyelashes. The U.S. Food and Drug Administration (FDA) has given the green light to two JAK inhibitors for treating alopecia areata.

1. 1. Barcitinib is prescribed for adults with severe alopecia areata. It is administered as a once-daily oral pill.
   2. Ritlecitinib has received approval for the treatment of alopecia areata in adults and children aged 12 and above, particularly for cases resulting in extensive hair loss. It is taken in the form of a daily oral pill.

• Unleash the transformative power of alternative systemic medications. Say goodbye to one-size-fits-all solutions for hair regrowth. Your dermatologist may recommend orally administered medications that ignite your immune system into action. With options like prednisone, methotrexate, cyclosporine, and other immunomodulatory drugs, prepare for a remarkable journey towards revitalized hair growth.

If you’re facing the challenge of thinning eyelashes, your dermatologist can suggest several options to address this issue:

1. Synthetic Eyelashes: These can be used to fill in areas where your natural lashes are missing.
2. Eyeglasses: Not only do glasses provide eye protection, but they can also help conceal the loss of eyelashes.
3. Bimatoprost (or a similar medication): Originally developed for glaucoma and high eye pressure, this prescription medication has gained FDA approval for promoting longer eyelash growth.
4. JAK Inhibitor: If you’ve experienced significant hair and eyelash loss, your dermatologist may recommend this medication. Research indicates it can effectively promote the regrowth of both eyebrows and eyelashes.

Eyebrow Thinning: If alopecia areata results in partial or complete eyebrow loss, your dermatologist may propose one of the ensuing options:

1. Intralesional Corticosteroids: A dermatologist can administer this medication through injections to stimulate the regrowth of eyebrows. If successful, applying minoxidil as instructed may assist in maintaining the regrowth.
2. JAK Inhibitor: If a substantial loss of scalp hair and a portion of your eyebrows has occurred, your dermatologist might prescribe this medication. Research has shown that individuals experiencing significant loss of eyelashes, eyebrows, or both, may observe noticeable regrowth with the use of JAK inhibitors.
3. Synthetic Eyebrows: These can be used to conceal lost eyebrows and can be applied and removed on a daily basis.
4. Semi-permanent Tattoo: Also known as microblading, this technique employs micro-pigments instead of traditional tattoo ink to craft natural-looking eyebrows. Unlike a conventional tattoo, the outcome is not permanent.

 

How do dermatologists address nail changes associated with alopecia areata?

Nail changes are often less conspicuous than hair loss, leading many patients to not mention their concerns to their dermatologist.

If you’re troubled by nail changes, it’s important to communicate this to your dermatologist.

In cases of alopecia areata where nail changes, such as tiny dents, brittle nails, or crumbling, occur, dermatologists have several treatment options for adults:

1. Prescription Medications: Dermatologists may prescribe medications like corticosteroids or tazarotene, which are applied topically to the nails.
2. Injectable Corticosteroids: Another approach is to directly inject the affected nails with corticosteroids or prescribe corticosteroid pills for a brief period.

For children with nail changes due to alopecia areata, dermatologists often recommend a watchful waiting approach, as nail changes in children may spontaneously improve.

Alternatives for Concealing Hair Loss

Numerous options are available for concealing hair loss, as patients seek these options for various reasons:

1. Time-consuming treatments.
2. Desire to avoid potential treatment side effects.
3. Ineffectiveness of treatment or continued hair loss despite treatment.

Concealment options include:

1. Styling Products: Products like gels, mousses, powders, and sprays are used to maintain hair in place, effectively concealing hair loss and adding volume.
2. Wigs, Hairpieces, or Scalp Prostheses: These are designed to mask scalp hair loss and can resemble natural hair. Scalp prostheses are custom-made wigs ensuring a perfect fit.
3. Shaving: Some individuals opt to shave their heads to eliminate the patchy or diffuse appearance associated with hair loss. Shaving can effectively hide areas of hair loss on the scalp, beard area, or other parts of the body.
4. Artificial Eyelashes: Available as individual lashes, clusters, and strips, these can be attached using special glue to fill in missing eyelashes or provide fuller coverage.
5. Eyebrow Makeup: Eyebrow powder, a makeup product, can be used to fill in sparse brows, creating a natural, full appearance. It should be removed before bedtime and reapplied as needed.
6. Artificial Eyebrows: Crafted from synthetic or human hair, these can conceal extensive hair loss when adhered with wig glue. They should be removed nightly and reapplied the next day.
7. Microblading for Eyebrows: For a semi-permanent solution to thin or missing eyebrows, microblading is an option. Unlike traditional tattoos, microblading uses micropigments for a more natural look and lasts around 6 months to a year.

It’s important to note that microblading can have complications, including pigment misapplication, pigment migration, and color changes. Consult your dermatologist if considering microblading.

What can someone expect when dealing with alopecia areata?

In many cases, hair spontaneously regrows without the need for treatment. This natural regrowth is more common when individuals have a few isolated patches of alopecia areata, especially if they have been present for less than a year.

Hair loss can also exhibit a pattern of halting for extended periods or recurring intermittently. However, there are instances where hair fails to regrow. Given the uncertainty surrounding alopecia areata, consulting a board-certified dermatologist is advisable. They can assess your specific situation and provide guidance on the best course of action.

Most individuals affected by alopecia areata maintain good overall health. Nevertheless, some may have a heightened risk of developing other autoimmune diseases. Consequently, it is crucial to adhere to scheduled appointments with your dermatologist for ongoing monitoring.

Self-care practices also hold significance for those with alopecia areata. To learn more about the recommendations made by dermatologists for self-care in alopecia areata, please refer to: “Alopecia areata: Self-care.

References

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3. Daruwalla SB, Dhurat RS, et al. “All that a dermatotrichologist needs to know about hair camouflage: A comprehensive review.” Int J Trichology. 2022 May-Jun;14(3):77-83.
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6. Piliang M, Lynde C, et al. “Sustained scalp, eyebrow, and eyelash hair regrowth with ritlecitinib through week 48 in patients with alopecia areata: Post hoc analysis of the ALLEGRO phase 2b/3 study.” Presented at: American Academy of Dermatology Annual Meeting 2023; March 17-21, New Orleans, LA. Poster 42005.
7. Lipner SR, Scher RK. “Letter to the editor: Alopecia areata.” J Am Acad Dermatol 2018;79:e9-e10. Funding sources: None. Conflicts of interest: None disclosed.
8. Otberg N, Shapiro J. “Alopecia areata.” In: Kang S, et al. Fitzpatrick’s Dermatology. (ninth edition) McGraw Hill Education, United States of America, 2019:1517-9.
9. Pratt CH, King LE Jr, et al. “Alopecia areata.” Nat Rev Dis Primers. 2017 Mar 16;3:17011.