What’s the best treatment for alopecia areata?
This depends on the type and extent of alopecia areata you have. There’s no cure for alopecia areata yet, but there are several treatments that can help promote hair regrowth:
- Corticosteroids: The primary treatment for alopecia areata is corticosteroids, which are anti-inflammatory medications. Corticosteroids can be used topically (on the surface of the skin) or injected into the patches of alopecia areata.
- Minoxidil: Over-the-counter minoxidil (Rogaine) helps promote hair regrowth but needs to be used continuously. Oral minoxidil is not FDA approved for alopecia areata but has been used off-label to treat hair loss.
- Diphenylcyclopropenone: Topical diphenylcyclopropenone is a chemical irritant that stimulates an allergic reaction on the scalp to promote hair growth.
- Anthralin: Topical anthralin can reduce inflammation and encourage hair growth. But it can also stain your skin and hair brown, so it’s mainly used for people with darker hair types.
- Platelet-rich plasma therapy: This treatment has recently been used to treat hair loss. It involves injecting a concentrated solution of your blood platelets into your scalp to promote hair growth.
- Janus kinase (JAK) inhibitors: JAK inhibitors are the latest class of drugs used to treat alopecia areata.
Your dermatologist can help you pick which treatment is best for you.
What’s the latest treatment for alopecia areata?
Exciting research studies are being done for the treatment of alopecia areata. In 2022, the FDA approved the first oral JAK inhibitor for alopecia areata: baricitinib (Olumiant).
Other JAK inhibitors, including tofacitinib (Xeljanz) and ruxolitinib (Jakafi), have also shown promise in research as potential treatments.
JAK inhibitors specifically target certain immune cells (T cells) thought to be involved in damaging hair follicles in alopecia areata. They appear more effective when taken by mouth than when applied directly to the scalp.
Dupilumab (Dupixent) is another drug that’s FDA approved for treating atopic dermatitis and is also being studied for alopecia areata. A recent case report showed that after 8 months of treatment, dupilumab caused almost full hair regrowth in a 16-year-old with alopecia totalis (all of the hair on his scalp, eyebrows, and eyelashes was missing).
Dupilumab is given as an injection and targets a specific type of immune cell called interleukin-4.
It’s likely even more treatments will become available for alopecia areata as research continues.
What’s the best home remedy for alopecia areata?
There are no proven home remedies to treat alopecia areata, but don’t worry — there’s a lot you can do to help yourself:
- Stress is a major trigger for alopecia areata. Reducing stress will help prevent alopecia areata patches from developing. Consider trying meditation, yoga, exercise, or mindfulness activities.
- Eating a balanced diet that includes plenty of protein, vitamins, and minerals can help support healthy hair growth.
- Avoiding harsh chemicals or treatments on your hair is recommended, as is using gentle hair care products free of sulfates and other potentially damaging ingredients.
- Massaging the scalp with gentle pressure may help increase blood flow to the hair follicles, which can promote hair growth.
- Some essential oils, such as lavender, rosemary, and peppermint, have been suggested as natural remedies for hair loss. However, there’s limited scientific evidence to support their effectiveness. You can also have an allergy to certain essential oils, so test a small patch of skin before applying it to your entire scalp.
Are there any recommended shampoos or scalp products for alopecia areata?
There are currently no hair care products specifically designed for alopecia areata, but there are certain products and routines that might be useful if you have this condition:
- Sulfate-free shampoos can keep your scalp clean without causing scalp irritation.
- Conditioners without harsh chemicals can help moisturize your scalp.
- Scalp oils, such as coconut or tea tree oil, can be beneficial in reducing scalp inflammation.
Nioxin is a brand of hair care products that claims to create an environment for optimal hair regrowth by clearing the scalp of sebum that might contain high levels of dihydrotestosterone (DHT), a hormone that’s linked to hair loss.
However, there are no known scientific studies that demonstrate the clinical effectiveness of the ingredients in Nioxin products in promoting hair growth or maintaining hair counts. This is why I don’t recommend Nioxin products to my patients who have alopecia areata.
Will hair ever grow back after you have alopecia areata?
Most of the time, YES! If you have a mild form of alopecia areata, sometimes your hair will grow back without any treatment at all!
Most types of alopecia areata lead to some hair growing back, but the rate of hair growth varies from person to person. Once your hair does grow back, it looks as good as new.
Sometimes you will develop another patch of alopecia areata at the same spot in the future. You can also develop alopecia areata patches elsewhere on your scalp or body.
Occasionally, your hair might not grow back or it might grow back in a different color (poliosis). This isn’t super common and shouldn’t be a cause for concern in most cases.
In fact, the less you stress about your hair loss, the more likely you won’t get any more alopecia areata patches. Remember that stress is a strong trigger for alopecia areata, so stress management is super important in controlling this condition.
What kind of doctor or other healthcare professionals should I see about treating alopecia areata?
Whenever you have a new health concern, the first person you should speak with is your primary care physician. They know you the best and should always be informed if you’re experiencing a concerning symptom like persistent hair loss.
After discussing your hair loss concerns with a primary care doctor, the specialist that deals with alopecia areata most often is a dermatologist. Some dermatologists are hair specialists called trichologists. Most dermatologists are skilled in treating alopecia areata, but if you have a severe case, they might refer you to a trichologist.
Sometimes alopecia areata can be associated with certain internal diseases, such as diabetes or thyroid disease. These conditions can be managed by either your primary care doctor or an endocrinologist.
The order of doctors who you should see about alopecia areata is:
- primary care doctor
- dermatologist
- trichologist
- endocrinologist
Dr. Joan Paul is an ABMS board certified dermatologist who specializes in psoriasis, skin cancer, skin of color, and global health. She has also completed seven medical missions in the countries of Haiti, Trinidad and Tobago, Mexico, Malawi, Uganda, India, and Botswana.
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