Seventy-five percent of patients with moderate to severe alopecia areata—an autoimmune disease that causes patchy and, less frequently, total hair loss—had significant hair regrowth after treatment with ruxolitinib, reported researchers from Columbia University Medical Center (CUMC). By the end of their treatment, average hair regrowth was 92 percent. Read more: http://newsroom.cumc.columbia.edu/blo…
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Sometimes, it can lead to the complete loss of hair on the scalp (alopecia totalis) or, in extreme cases, the entire body (alopecia universalis). The condition can affect anyone regardless of age and gender, though most cases occur before the age of 30.
The most common form of alopecia areata treatment is the use of corticosteroids, powerful anti-inflammatory drugs that can suppress the immune system. These are mostly commonly administered through local injections, topical ointment application, or orally.
Other medications that can be prescribed that either promote hair growth or affect the immune system include Minoxidil, Anthralin, SADBE, and DPCP. Although some of these may help with the re-growth of hair, they cannot prevent the formation of new bald patches.
Alopecia areata does not directly make people sick, nor is it contagious. It can, however, be difficult to adapt to emotionally. For many people, alopecia areata is a traumatic disease that warrants treatment addressing the emotional aspect of hair loss, as well as the hair loss itself.
Alopecia areata has been compared by some to vitiligo, an autoimmune skin disease where the body attacks melanin-producing cells, leading to white patches. Research suggests that these two conditions may share a similar pathogenesis, with similar types of immune cells and cytokines driving the diseases and common genetic risk factors.
Preliminary research in animals has found that quercetin, a naturally occurring bioflavonoid found in fruits and vegetables, can protect against the development of alopecia areata and effectively treat existing hair loss.
The condition occurs when white blood cells attack the cells in hair follicles, causing them to shrink and dramatically slow down hair production. It is unknown precisely what causes the body’s immune system to target hair follicles in this way.
While scientists are unsure why these changes occur, it seems that genetics are involved as alopecia areata is more likely to occur in a person who has a close family member with the disease. One in five people with the disease has a family member who has also developed alopecia areata.
Other research has found that many people with a family history of alopecia areata also have a personal or family history of other autoimmune disorders, such as atopy, a disorder characterized by a tendency to be hyperallergic, thyroiditis, and vitiligo.
Despite what many people think, there is very little scientific evidence to support the view that alopecia areata is caused by stress. Extreme cases of stress could potentially trigger the condition, but most recent research points toward a genetic cause.
There are some people that recommend rubbing onion or garlic juice, cooled green tea, almond oil, rosemary oil, honey, or coconut milk into the scalp. While none of these are likely to cause harm, their effectiveness is also not supported by research.
The most prominent symptom of alopecia areata is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected, though, including the beard and eyelashes.
The loss of hair can be sudden, developing in just a few days or over a period of a few weeks. There may be itching or burning in the area before hair loss. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. People who experience just a few patches of hair loss often have a spontaneous, full recovery without any form of treatment.
About half of patients recover from alopecia areata within 1 year, but many will experience more than one episode. Around 10 percent of people will go on to develop alopecia totalis or alopecia universalis.
Alopecia areata can also affect the fingernails and toenails, and sometimes these changes are the first sign that the condition is developing. There are a number of small changes that can occur to nails:
If, after an initial clinical examination, the doctor is not able to make a diagnosis, they can perform a skin biopsy. If they need to rule out other autoimmune diseases, they might perform a blood test.
Article last updated by Adam Felman on Fri 22 December 2017. Visit our Dermatology category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Dermatology. All references are available in the References tab.
Açıkgöz. G, Yeşil, H., Çalışkan, E., Tunca, M., & Akar, A. (2013, October 9). Targeted photochemotherapy in alopecia areata [Abstract]. Photodermatology, Photoimmunology & Photomedicine, 29(6),318-22. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24102724
Nilforoushzadeh, M. A., Keshtmand, G., Jaffary, F., & Kheirkhah, A. (2012, July 1). Diphencyprone induced vitiligo: A case report [Abstract]. 2012:356236. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22811720
Wikramanayake, T. C., Villasante, A. C., Mauro, L. M., Perez, C. I., Schachner, L. A., & Jimenez, J. J. (2012, March). Prevention and treatment of alopecia areata with quercetin in the C3H/HeJ mouse model [Abstract]. 17(2):267-74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22042611
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Although there are currently no treatments that work for everyone with alopecia areata, some treatments are effective for some people. Depending on which type of alopecia areata you have, your age and the extent of hair loss, there are a variety of treatment options available. The main goals of treatment are to block the immune system attack and/or stimulate the regrowth of hair. This can be effective, especially for people with milder forms of the disease (less than 50% hair loss).
For those who have more than 50% hair loss on their scalp or other areas of the body, there are also oral (taken as a pill) and topical (applied to the skin) medications available as well as phototherapy or light treatments.
While none of the medications or devices commonly used to treat alopecia areata are approved specifically for this disease by the Food and Drug Administration (FDA), they have been approved for other diseases. It’s important to know that while these therapies may offer benefits to some people with alopecia areata, there is no single option that will work for everyone. Even if your hair is regrown, there is no guarantee that it won’t fall out again once treatment is stopped.
This is not an extensive review of all possible treatments, just an overview of the more common ones you are likely to encounter. It’s best to discuss all of your options for treatment with a dermatologist, who can work with you to find the right medications or therapies for your particular type and severity of alopecia areata.
There are a variety of treatments for both mild and severe alopecia areata — it’s important to stay informed, so you and your doctor can choose the best course for yours. Goals of therapy include stopping active hair loss and regrowing hair.
This method of treatment — the most common form of treatment for alopecia areata — uses corticosteroids that are injected into bare patches of skin with a tiny needle. These injections are repeated about every four to six weeks and are usually given by a dermatologist.
Corticosteroid injections, like all treatments for alopecia areata, do not prevent new hair loss from developing. While there are few reported side effects related to this kind of treatment, temporary depressions (called “dells”) in the skin may result from the injections. However, these usually improve with time. People may experience slight discomfort from the needle pricks and tingling from the medication, but usually there is no other pain or discomfort after leaving the dermatologist’s office.
With this form of treatment, a 5% topical minoxidil solution is applied once or twice a day to help stimulate hair on the scalp, eyebrows and beard to regrow. Two and 5% topical minoxidil solutions are available but aren’t usually effective for alopecia areata when used alone, but when applied in combination with topical corticosteroid medications, some people see improved results.
This synthetic, tar-like substance — also widely used for psoriasis — is a common form of treatment for alopecia areata. Anthralin is applied to the hairless patches once a day and then washed off typically after a short time (usually 30-60 minutes later) or in some cases, after several hours.
This form of medication may irritate the skin and cause a temporary, brownish discoloration of the skin that’s been treated. However, some patients can reduce these side effects by using anthralin for shorter periods of time, without decreasing the treatment’s effectiveness.
In alopecia areata, corticosteroids are thought to decrease the inflammation around the hair follicle. Topical steroids can come in different brands, strengths and preparations, such as solutions, lotions, foams, creams, or ointments.
Studies have shown that there is a reduction of hair loss when using topical steroids. In addition, improved regrowth of approximately 25% has been observed with the use of highly potent topical corticosteroids. They can be good adjunct medications especially when treating children with alopecia areata.
There are many therapies which can offer benefits for someone with alopecia areata, however there is no single option proven to work for everyone. Some people with alopecia areata may choose accessories, wigs, or cosmetic alternatives to address their hair loss, while others opt not to cover affected areas.
Healthy, young adults can usually tolerate corticosteroid pills with few side effects. However, doctors do not prescribe corticosteroid pills as often as other treatments for alopecia areata, because of the health risks and side effects associated with using them for a long period of time. It’s important to talk to your doctor about your goals for treatment and possible side effects of the medication, to be sure the benefits of using corticosteroid pills in your case are greater than the risks. As with other options, hair regrown with corticosteroid use may fall back out once treatment is stopped.
Topical immunotherapy is used to treat extensive alopecia areata, alopecia totalis and alopecia universalis. This form of treatment involves applying chemicals such as diphencyprone (DPCP), dinitrochlorobenzene (DNCB) or squaric acid dibutyl ester (SADBE) to the scalp. This causes an allergic rash (allergic contact dermatitis) that looks like poison oak or ivy, which alters the immune response.
Patients who successfully regrow scalp hair usually must continue treatment in order to maintain the regrowth. Side effects — redness, itching and a rash at the site of application — are common. Topical immunotherapy isn’t widely available and is typically performed and prescribed by dermatologists. The National Alopecia Areata Foundation can help you find a specialist who offers this treatment in the U.S.
Immunomodulatory drugs — specifically, Janus kinase (JAK) inhibitors — such as tofacitinib (Xeljanz) and ruxolitinib (Jakafi), are a new type of therapy being tested for alopecia areata. These medications were originally approved to treat certain blood disorders and rheumatoid arthritis. They are not approved by the FDA for alopecia areata yet, and are only available right now in the form of an oral medication. A topical formulation is currently in clinical trials in the United States.
Oral immunomodulators have proven to be effective at helping some patients with extensive alopecia areata regrow hair — even if they’ve had the disease (and hair loss) for many years. This has been observed in the small number of patients studied so far.
Because this is a new form of therapy, there isn’t a lot of information known about the side effects of taking this medication. Clinical trials are being done in order to evaluate the oral and topical medication’s effectiveness and safety in treating alopecia areata.
Patients with alopecia areata, alopecia totalis and alopecia universalis can be treated based on age and severity of the condition. This algorithm outlines an approach that can be used from mild to severe forms of the disorder. There are now choices that the patient can decide on what is best for them based on efficacy, cost and side effect profile.
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About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss in women often has a greater impact than hair loss does on men w, because it’s less socially acceptable for them. Alopecia can severely affect a woman’s emotional well-being and quality of life.
The main type of hair loss in women is the same as it is men. It’s called androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic “M” shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman’s hairline rarely recedes, and women rarely become bald.
There are many potential causes of hair loss in women , including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it’s important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. You may also want to ask your clinician for a referral to a therapist or support group to address emotional difficulties. Hair loss in women can be frustrating, but recent years have seen an increase in resources for coping with the problem.
Clinicians use the Ludwig Classification to describe female pattern hair loss. Type I is minimal thinning that can be camouflaged with hair styling techniques. Type II is characterized by decreased volume and noticeable widening of the mid-line part. Type III describes diffuse thinning, with a see-through appearance on the top of the scalp.
Almost every woman eventually develops some degree of female pattern hair loss. It can start any time after the onset of puberty, but women tend to first notice it around menopause, when hair loss typically increases. The risk rises with age, and it’s higher for women with a history of hair loss on either side of the family.
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it’s important to measure androgen levels in women with clear female pattern hair loss.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair’s growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See “Life cycle of a hair.”) That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called “follicular miniaturization.” As a result, thicker, pigmented, longer-lived “terminal” hairs are replaced by shorter, thinner, non-pigmented hairs called “vellus.”
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (B), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin’s surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft.
A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman’s hair loss.
Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can’t restore the full density of the lost hair. It’s not a quick fix, either for hair loss in women . You won’t see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you’ll need to keep using it to maintain those results. If you stop, you’ll start to lose hair again.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that’s provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don’t shampoo for at least four hours afterwards.
Some women find that the minoxidil solution leaves a deposit that dries and irritates their scalp. This irritation, called contact dermatitis, is probably caused not by the minoxidil itself, but rather by the alcohol that is included to facilitate drying.
Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.)
Because the patent on Rogaine (the brand-name version of minoxidil) has expired, many generic products are available. They all contain the same amount of minoxidil, but some include additional ingredients, such as herbal extracts, which might trigger allergic reactions.
Anti-androgens. Androgens include testosterone and other “male” hormones, which can accelerate hair loss in women. Some women who don’t respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you’re a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.
Hair transplantation, a procedure used in the United States since the 1950s to treat androgenic alopecia, involves removing a strip of scalp from the back of the head and using it to fill in a bald patch. Today, 90% of hair-transplant surgeons use a technique called follicular unit transplantation, which was introduced in the mid-1990s.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger “plugs” associated with hair transplants of yesteryear.
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Massachusetts General Hospital (MGH) physicians are reporting an unexpected side-effect from treatment with dupilumab, which is FDA approved for the treatment of moderate to severe eczema, also called atopic dermatitis. In their case report published in JAMA Dermatology, the physicians describe how their 13-year-old patient, who has alopecia totalis—a total lack of scalp hair—along with eczema, experienced significant hair regrowth while being treated with dupilumab, a drug marketed under the brand name Dupixent.
“We were quite surprised since this patient hadn’t grown scalp hair since the age of 2, and other treatments that can help with hair loss did not in her case,” says Maryanne Makredes Senna, MD, of the MGH Department of Dermatology, senior author of the JAMA Dermatology report. “As far as we know, this is the first report of hair regrowth with dupilumab in a patient with any degree of alopecia areata.”
In addition to longstanding alopecia, this patient had experienced extensive, treatment-resistant eczema since the age of 7 months. Treatment with prednisone and methotrexate, medications that can suppress the overactive immune system, led to limited improvement in the patient’s eczema but no hair regrowth and was therefore discontinued. In July 2017 she began to be treated with weekly injections of dupilumab, which had recently received FDA approval. After six weeks of treatment, which led to significant improvement in eczema symptoms, she also noticed that fine light hairs called vellus hairs were appearing on her scalp.
After seven months of dupilumab treatment, the patient had grown a significant amount of the pigmented hair that typically grows on the scalp. Because of a change in her insurance coverage, she had to discontinue dupilumab for a two-month period, during which she noticed shedding of the recently regrown hair. But after she could resume treatment in April 2018, the hair growth resumed and has continued.
Senna explains that dupilumab’s mechanism of targeting a key immune system pathway known to be overactive in eczema could explain its action against alopecia, since recent studies have suggested other elements of the same pathway may induce autoimmune hair loss. “Right now, it’s hard to know whether dupilumab could induce hair growth in other alopecia patients, but I suspect it may be helpful in patients with extensive active eczema and active alopecia areata,” she says. “We’ve submitted a proposal for a clinical trial using dupilumab in this patient population and hope to be able to investigate it further in the near future.” Senna is the principal investigator of the Hair Academic Innovative Research (HAIR) clinical research unit at MGH and an instructor in Dermatology at Harvard Medical School.
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Historically, hair loss solutions and hair loss research has been male-focused, so women may not be familiar with androgenetic alopecia and hair regrowth programs. In fact, dermatologists and trichologists identify 6 types of alopecia hair loss in women. In women, androgenetic alopecia, which is hereditary hair loss – sometimes called female pattern baldness – causes thinning hair all over the crown. For women with androgenetic alopecia, if there are hair follicles that have not produced hair in 2-7 years or more, a topical drug such as minoxidil for women may be required for hair regrowth.
With androgenetic alopecia in women, it is important to face the problem immediately and take action to slow down thinning hair at the first signs of excess hair shedding and hair loss. Prevention is the key.
Before your hair loss is so advanced that you have to resort to treatment with a drug, prevent thinning hair with a clinically proven hair vitamin supplement formulated especially for women. Hair growth vitamins change hair follicles by actually increasing the diameter of hair strands and increasing the number of hairs. Hair growth supplements such as Viviscal Extra Strength work by increasing the length of the hair growth cycle.
Hair growth supplements are best for women with thinning hair who want 100% drug free hair loss solutions that work in line with the natural hair growth cycle. Hair vitamins are also good to prevent thinning hair due to temporary hair loss due to post-pregnancy, menopause, poor diet or vitamin deficiency, or damage from over-styling and heat-styling. Hair growth supplements nourish thinning hair with vitamins, minerals and marine extracts derived from key marine proteins.
When searching for hair regrowth treatments, solutions range from hair transplant surgery, to topical drugs like Women’s Rogaine minoxidil, to drug free hair growth vitamin supplements like Viviscal Extra Strength.
Hair transplant surgery has long-term results but it is invasive and expensive. Topical minoxidil treatments regrow hair in most women. However, once women begin taking minoxidil for alopecia or other types of hair loss, they cannot stop taking it or their hair loss will come back. Dietary supplements for hair loss promote existing hair growth from within, and suddenly stopping hair growth supplements will not immediately result in more hair loss. Hair growth supplements work in line with your natural hair growth cycle, which is why they may take 3-6 months to produce results. If you are looking for a drug free treatment that works by supplying hair follicles with a blend of vitamins, minerals and marine extracts, hair supplements a good choice.
Use: sooner or later each take a small amount of essence in front of the mirror carefully applied to the hair root, if the effect is quick, can be coated 4 to 5 times a day. Under normal circumstances the use of 1 to 2 months hair will be improved, the normal use of the state of a bottle (30ml) available for a month, such as the use of increased area, the use of increased or increased use of the number of times with the use of time to reduce.
99% of people have the effect (another 1% of the people are: skin injuries such as burns, scars, etc. no effect, seeking truth from facts!), As long as you insist on, there will be a surprise, of course, if you want a few days and nights Want to see the effect that is unlikely, and what things should be a process, but also the law of natural growth, unlike the description of the eyebrow, fake beard, a little down on the line, anxious to see the effect of a few days do not shoot (The owner can not help you).
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I have been Alopecia Free for 2 years! I am excited that my hair is growing and flourishing. I measure the length in this length check video for you. Enjoy! xo AlopeciaFree
JOURNEY WITH JASS:
Vlog Channel: https://www.youtube.com/channel/UC0J2…
Email Me: [email protected]
Last Video: https://www.youtube.com/watch?v=Shq8G…
Alopecia Free With Jass | https://www.youtube.com/user/Alopecia…
Watch My Big Chop Video Here: https://www.youtube.com/watch?v=nlb7-…
I Did My Final Big Chop- March 26 2013
Why Did I Big Chop?- Due To shedding/hair loss/alopecia/damaged hair
Hair Goals?- I would like to grow my hair for 3 years without cutting it off again ~*~*~**~*~*~*~**~*~Watch More Natural Hair Videos*~**~*~*~*~*~*
****Natural Hair Set Backs: *****
https://www.youtube.com/watch?v=Imlm-… ************ I have Alopecia Areata**********
https://www.youtube.com/watch?v=JGsZ-… *******Hair Growth Aid Review Videos (for hair loss):********* Onion Juice for Hair Regrowth: https://www.youtube.com/watch?v=uWwwz… Monistat for Hair Growth : https://www.youtube.com/watch?v=BsEuS… Sulfate Shampoo: https://www.youtube.com/watch?v=hS2zS…
Alopecia Free With Jass | https://www.youtube.com/user/Alopecia…