Talking to Your Dermatologist About Treatment-Resistant Alopecia Areata


Alopecia areata is an autoimmune skin disease that causes patchy spots of hair loss on the scalp and other parts of the body.

 It is estimated that around 700,000 Americans currently have some form of alopecia areata.

Treatments vary depending on the severity of the condition, and every individual with the diagnosis responds differently to different techniques. Many patients will regrow hair without treatment. Others experience hair regrowth from options such as topical or injected corticosteroids, oral medications, topical immunotherapy, or Janus kinase (JAK) inhibitors that change the way a person’s immune system responds.

Sometimes alopecia areata doesn’t respond to first-line approaches. When you’ve tried a number of these therapies without noticeable hair regrowth, you might be said to have “treatment-resistant” alopecia areata, says Alexandra Bowles, DO, a board-certified dermatologist at MONA Dermatology in Cincinnati.

“When those treatments don’t work, it doesn’t mean there’s no hope,” she says. “It just means the condition is a bit more stubborn and may require a different approach.”



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