Dr. Imran Majid – Alopecia areata – what is new?

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Alopecia areata Alopecia areata (AA) is defined as a chronic, recurrent and non-scarring alopecia. It is the second commonest cause of hair loss after androgenic alopecia. It is thought to be autoimmune in origin.

A number of important facts about Alopecia areata are still unknown including the exact pathogenesis of the disease. A number of significant developments have been reported over the last few years regarding alopecia areata and its management.

The commonest scoring system used for assessing alopecia areata is known as Scalp Area (SALT score) but interestingly this score can only assess the severity of alopecia areata on scalp. Alopecia areata involving the eyebrows, eyelashes, beard hair or body hair cannot be assessed by SALT score. To overcome this limitation, a new score known as Alopecia Areata Severity Index (AASI) has recently been proposed and published in Journal of Cosmetic Dermatology.

On the management front, many new drugs and procedural treatments have been fond useful in the management of alopecia areata. The most significant among them is JAK inhibitors like Tofacitinib. These molecules are used really commonly now in alopecia areata especially in progressive or severe disease. Other notable additions to treatment include Hydroxychloroquine, Apremilast and procedural treatments like Fractional laser resurfacing and Platelet rich plasma therapy.