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Alopecia | What you need to know

Accurately diagnosing the cause of alopecia is the most important first step to approaching an effective treatment plan. Read more...




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What is the best way to approach alopecia?

Accurately diagnosing the cause of alopecia is the most important first step to approaching an effective treatment plan. There are several causes with different treatment options. Ultimately the best way to think about hair loss is to think about the scalp as though it is a farm- if the soil is not healthy, ie., if the scalp is not healthy, then it cannot grow strong hair follicles.

What is the most effective treatment plan for alopecia?

The best treatment in my opinion is knowledge. Understanding hair loss is so important because the stress of hair loss often leads to more hair loss! If it is telogen effluvium then recovery will often occur without treatment and just time alone. If there is an autoimmune component, then steroid injections or topical can be of benefit.

The most beneficial option for management is minoxidil. I do not recommend biotin as it did not necessarily show significant results and the FDA issued an alert last year that it can affect lab tests ().

Are there any symptoms besides hair loss that could present with alopecia?

Part of the process of diagnosing hair loss correctly is looking for other clinical signs or cues as to cause. Stress-induced hair loss or telogen effluvium may not limit itself to the scalp. It may even involve eyebrows or other areas. Alopecia areata is a form of autoimmune hair loss that can also cause pitting of the nails for example. Alopecia associated with lupus gives a characteristic pattern of hair thinning referred to as “lupus hairs” and can be accompanied by systemic signs or symptoms of lupus.

At what point should someone contact their doctor to inquire about hair loss?

Alopecia should be evaluated by a Board Certified Dermatologist. I have seen so many cases of scarring alopecia that could have been prevented had early intervention been considered. Many non-dermatologists may not be experienced in diagnosing the cause and may not necessarily understand the impact on our well-being when our hair is affected. Hair is not just cosmetic. It plays a significant role in our identity and it is very personal for all of the patients I have seen who present with hair loss concerns. It is most important to not shrug this off and think there is nothing you can do. We have many options however early intervention is paramount to the success of therapy.


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