Understanding your options is the first step
Treatment Options
While the cause is unknown, there is neither a cure or a single treatment for Alopecia Areata - your dermatologist will recommend the best option for you by understanding the genes, hair follicle development, immune treatments, and stem cells in the skin. Some people even find that medications approved for other purposes can help hair grow back, at least temporarily.
Please consult your health care professional about the best option for you.
Please consult your health care professional about the best option for you.
JAK inhibitors are immunomodulatory drugs. They target the immune system pathway that is overactive in alopecia areata. Immunomodulatory drugs — specifically, Janus kinase (JAK) inhibitors — are a new type of therapy being tested for Alopecia Areata. Two JAK inhibitors are TGA-approved for alopecia areata:
+ Baricitinib (Olumiant®, from Lilly), approved for adults 18 and older.
+ Ritlecitinib (Litfulo®, from Pfizer), approved for adolescents 12 years old and up (the only JAK inhibitor currently TGA-approved for use in children.)
+ Baricitinib (Olumiant®, from Lilly), approved for adults 18 and older.
+ Ritlecitinib (Litfulo®, from Pfizer), approved for adolescents 12 years old and up (the only JAK inhibitor currently TGA-approved for use in children.)
Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. They can be delivered via local injections, oral tablets or topical ointments. Which option your dermatologist might suggest will depend on the type and extent of your Alopecia Areata.
Topical sensitizers are medications that, when applied to the scalp, provoke an allergic reaction that leads to itching, scaling, and eventually hair growth. Two topical sensitizers are used in Alopecia Areata treatment; squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP).
Oral Minoxidil comes as a tablet in 2.5 mg, 5 mg, or 10 mg strengths Minoxidil is used in the treatment for male and female pattern hair loss and may also be useful in promoting hair growth in Alopecia Areata. It is most often used in combination with other treatments, such as intralesional corticosteroids or JAK inhibitors. Can also come in a topical solution, applied twice daily may be used on the scalp, brow, and beard areas.
Topical immunotherapy—also known as contact immunotherapy—is primarily prescribed for extensive cases of Alopecia Areata, though it is sometimes used for moderate forms of the condition.
The treatment works by triggering a deliberate allergic rash, similar to poison ivy, on the areas where it is applied. This allergic contact dermatitis alters the immune response around your hair follicles, which stimulates hair regrowth, though scientists still do not fully understand the exact mechanism behind it. The most frequently used chemicals for this treatment are squaric acid dibutyl ester (SADBE) and diphencyprone (DPCP).
The treatment works by triggering a deliberate allergic rash, similar to poison ivy, on the areas where it is applied. This allergic contact dermatitis alters the immune response around your hair follicles, which stimulates hair regrowth, though scientists still do not fully understand the exact mechanism behind it. The most frequently used chemicals for this treatment are squaric acid dibutyl ester (SADBE) and diphencyprone (DPCP).
PRP therapy for hair loss is a treatment that involves withdrawing a patient’s own blood, processing it so that only the enriched cells (platelet-rich plasma) remain, and injecting it into the scalp. As a concentrated source of autologous platelets, PRP contains several different growth factors and other cytokines that can stimulate healing of soft tissue. It is a relatively new form of treatment being used for Androgenetic Alopecia (also known as male or female pattern baldness) and is being assessed as a treatment for Alopecia Areata.
Alternative Therapies
When drug treatments fail to bring sufficient hair regrowth, some people turn to alternative therapies. It is important to note that alternative therapies are often not backed by clinical trials. You should always consult with your qualified health care professional before trying alternate therapies.
Alternative therapies for treating Alopecia Areata can range from acupuncture, reiki, meditation, thought field therapy, aroma therapy, evening primrose oil, zinc, vitamin supplements, to Chinese herbs. Some people with Alopecia Areata recommend a holistic approach to bodily health, and suggest checking things like digestive health and overall stress and lifestyle factors.
Alternative therapies for treating Alopecia Areata can range from acupuncture, reiki, meditation, thought field therapy, aroma therapy, evening primrose oil, zinc, vitamin supplements, to Chinese herbs. Some people with Alopecia Areata recommend a holistic approach to bodily health, and suggest checking things like digestive health and overall stress and lifestyle factors.
Trichologists specialise in all forms of hair loss, hair shaft breakage, scalp disorders, and the scalp environment. Academic trichology is a paramedical area of health care that embraces both naturopathic & western medicine, endocrinology and dermatology.
Scalp Micro Pigmentation (SMP), is a specialised tattooing process during which tiny deposits of pigment are positioned within the dermal layer of the skin. This creates the same visual effect as a shaved head. Can be very effective at disguising the appearance of hair loss.
There are many hair growth products on the market that claim to regrow hair. It is important to understand the type of Alopecia Areata that you have and review the hair growth products that are aligned to your condition.
A roadmap from diagnosis to treatment
What could your treatment pathway look like? This is a perfect document to reference with your healthcare professional.
Health care professionals
Each link alongside will take you to directories to find a health care professional in your local area.
Digital dermatology connects individuals with specialist skin and hair care online. Securely share photos of the scalp and receive an expert treatment plan without leaving home.
Latest medical information
ASAMI Study: Findings from a worldwide expert agreement on factors influencing Alopecia Areata severity
Treatment Algorithm for Alopecia Areata
FAQ
Treatment is determined by your Dermatologist and if you decide to undergo treatment for hair loss (alopecia areata), there are some things you’ll want to ask your GP and Dermatologist before getting started. Have a read of the article linked on 17 important questions regarding risks and side effects, costs, and alternatives to treatment.
Both Baricitinib and Ritlecitinib have received TGA approval for alopecia areata in Australia. However, neither is currently subsidised through the Pharmaceutical Benefits Scheme (PBS), which means out-of-pocket costs can be significant. AAAF continues to advocate for PBS listing to improve access for Australians.
Speak to your dermatologist about whether a JAK inhibitor may be appropriate for you and what access options are currently available.
Speak to your dermatologist about whether a JAK inhibitor may be appropriate for you and what access options are currently available.
As with any medication, JAK inhibitors carry risks and these should be discussed carefully with your doctor. Regulatory agencies including the TGA have issued warnings advising cautious use for people with a history of cardiovascular disease, increased cancer risk, or those aged 65 and above. It is worth noting that much of the safety data comes from studies on rheumatoid arthritis patients, who differ from the Alopecia Areata community in age profile and other health factors. Research into JAK inhibitor safety specific to alopecia areata is ongoing.
A warning does not mean a drug is inappropriate. It means the decision requires a thorough conversation between you and your healthcare provider, taking your individual circumstances and medical history into account.
A warning does not mean a drug is inappropriate. It means the decision requires a thorough conversation between you and your healthcare provider, taking your individual circumstances and medical history into account.
*This information is provided for general awareness only and does not constitute medical advice. Always consult a qualified health professional.
