New Alopecia Areata Guidelines Issued in Australia

A team of researchers from across Australia has issued new guidelines for Alopecia Areata, the autoimmune disorder which causes varying degrees of hair loss.

The aim is to encourage medical practitioners to identify which patients may benefit from receiving appropriate Alopecia Areata treatment.

Areas affected by hair loss shown in blue

Whilst this may seem obvious, currently the approach GPs in Australia take is based on the fact that the majority of cases are likely to clear up naturally. As senior study author Professor Rod Sinclair from the University of Melbourne, advises, “It’s a bit of a renaissance in alopecia areata. We know 70% [of cases] will get better by themselves, but we’ve flipped it around to say: what about the 30%? In our clinic ... this has been transformational.”

As their new approach is also the methodology Belgravia has always used when dealing with autoimmune-related hair loss - to recommend appropriate solutions to those presenting with scalp-only Alopecia Areata (AA) even if it is just a single patch that they are concerned about - we concur that this is certainly a positive step.

Psychological distress of Alopecia Areata can contribute to the condition

Their work has been published in the Australasian Journal of Dermatology and notes that:

"While 40% of all affected individuals only ever get one patch and will achieve a spontaneous complete durable remission within 6 months, 27% will develop additional patches but still achieve complete durable remission within 12 months and 33% will develop chronic AA.

Without systemic treatment, 55% of individuals with chronic AA will have persistent multifocal relapsing and remitting disease, 30% will ultimately develop alopecia totalis and 15% will develop alopecia universalis.

The unpredictable course and psychological distress attributable to AA contributes to the illness associated with AA."

Although the causes and exact mechanisms involved in all types of Alopecia Areata remain a mystery, various triggers have been identified. Sudden shock, trauma, extreme stress and allergies, as well as a hormonal and genetic element, can all potentially spark the condition. When this happens, the body turns against its own hair follicles and the hair growth cycle is prematurely shunted into the resting 'telogen' phase during which no active hair growth takes place.

Click to View Belgravia Alopecia Areata Treatment Success Stories (Results May Vary and Are Not Guaranteed)

Systemic treatment to be offered in all cases

Whilst it advises there are a number of topical therapies for the mild-to-moderate form of Alopecia Areata, when it only affects the scalp, not the rest of the head or body, including steroids, immunotherapy and minoxidil, there are also various potential systemic treatments available for the more advanced phenotypes, despite none being MHRA licensed nor FDA approved for this purpose. These include glucocorticosteroids, methotrexate, ciclosporin, azathioprine, dapsone, mycophenolate mofetil, tacrolimus and sulfasalazine.

Knowing when to advise treatment for patients should now be based on sufficient clinical indications, including active patches of hair loss, exclamation mark hairs, and results from pull tests. In cases where the hair loss is rapid and/or extensive - affecting over 50% of the scalp or body - and should additional issues identified as "chronic disease, severe distress or a combination of these factors" be identified, systemic treatment should also be explored.

Further information was also provided to guide doctors and dermatologists with regards to patient satisfaction and when to stop treatment.

Anyone concerned about sudden hair fall, patchy hair loss or bald spots should contact a specialist as soon as possible for prompt advice. Once a diagnosis has been established, suitable hair loss treatment solutions can be recommended based on the findings and the individual's medical profile. Unlike genetic hair loss, in cases of scalp-only Alopecia Areata, once the hair regrows, treatment can generally be stopped with appropriate supervision.