New drugs for alopecia areata may help reduce the inflammation that leads to hair loss. It may help treat hair loss all over the body.
Alopecia areata is an autoimmune condition that causes patchy hair loss. With alopecia, your immune system mistakenly attacks the hair follicle, leading to inflammation. This causes the hair to fall out.
Alopecia can affect anyone at any stage of life. Having a family member with alopecia may increase your chances of developing it. You may also be
But for many people with an alopecia diagnosis, there’s no family history or obvious trigger.
Alopecia is an unpredictable condition. Some people living with alopecia may experience periods of hair loss only once or twice in their life. Others may have more frequent episodes of hair loss. There’s usually some hair regrowth. It’s impossible to predict how much hair will grow back or whether it will fall out again.
Although there are different treatment options, they don’t all work for everyone. Ongoing research helps build knowledge about alopecia and how to treat it.
Here’s what to know about the latest in alopecia research and treatments.
Alopecia areata is an autoimmune condition. Each type of autoimmune condition affects different parts of the body. It’s unclear what causes an autoimmune disease to develop in the first place.
Typically, the immune system is designed to protect your body from harmful invaders. For some reason, the immune system in a person with an autoimmune condition gets mixed up. It attacks an otherwise healthy part of the body, leading to inflammation, which damages the area.
In alopecia, the immune system mistakenly attacks the hair follicles, causing hair to fall out.
The immune system is complicated. Many treatments for autoimmune conditions work to reduce the overactive immune response. They can be helpful but don’t always fully address the underlying issue.
Targeted treatments modify a specific immune response. There was hope that a targeted treatment option called biologic drugs may help treat alopecia. These medications are used to manage some other autoimmune and inflammatory conditions. So far, biologics have not been shown to help treat alopecia.
However, recent research found that a part of the immune system called the
With this knowledge, researchers were able to move forward with creating more targeted treatments, known as Janus kinase (JAK) inhibitors, to help with alopecia.
It’s the first FDA-approved systemic treatment for alopecia. This type of systemic treatment helps treat hair loss all over the body.
Before this drug’s approval, alopecia treatments only targeted a specific area of hair loss. Treating one area of hair loss does not prevent hair loss or promote hair growth in other parts of the body. This can be a very frustrating part of living with alopecia.
Baricitinib is a type of drug called a JAK inhibitor that’s taken orally.
Researchers identified how the JAK pathway is involved in alopecia: Cytokines are small proteins released by the immune system. In alopecia, cytokines activate the JAK pathway, causing inflammation that damages hair follicles. JAK inhibitors, like baricitinib, help block cytokines from reaching the JAK pathway. This supports hair regrowth.
Baricitinib was approved based on a target of scalp hair recovery after 36 weeks. Adequate scalp hair coverage was defined as 80% of the scalp. This was achieved in
Alopecia areata is a new indication for this drug. Baricitinib has been used to treat rheumatoid arthritis since 2018.
There’s hope a second systemic treatment for alopecia will gain FDA approval in the next year or two.
Concert Pharmaceuticals has finished two successful phase 3 clinical trials. The trials are called THRIVE-AA1 and THRIVE-AA2.
The medication is currently known as CTP-543 in clinical trials. CTP-543 is another JAK inhibitor. This is the same drug class as baricitinib.
Both clinical trials used a target of at least 80% scalp hair coverage to measure success. THRIVE-AA2 results showed that between 33% and 38.3% of study participants met this goal after 24 weeks. The range in scalp hair coverage depended on the medication dose.
Concert Pharmaceuticals plans to submit CTP-543 for FDA approval in 2023.
You may already be familiar with the term “gut microbiome.” It refers to the colonies of microscopic living things that reside in your digestive system. They play a part in digesting your food and protecting your health.
There’s still debate about what a “healthy” gut microbiome looks like. In general, more
When the gut microbiome gets out of balance, it’s known as dysbiosis. Dysbiosis has been linked with a variety of health conditions. It’s unclear what comes first: Does a disease cause dysbiosis? Or does something shift in the gut microbiome that contributes to disease development?
Most of our immune system actually lives in the digestive system. About
Gut dysbiosis is seen in alopecia as well as other inflammatory skin conditions.
Fecal transplants have been used to restore the gut microbiome in other conditions. It’s a known treatment for Clostridioides difficile (C. diff).
Clinical trials are essential to learning more about alopecia and its treatments. After promising findings in a lab setting, clinical trials are a chance to see how a treatment works in real people.
If you’re interested in joining a clinical trial or just want to stay in the loop with the latest research, check out ClinicalTrials.gov.
Doctors use several other types of treatments for alopecia areata. The goal of alopecia treatment is to regrow hair or slow or prevent hair loss.
There are a few approaches. One is to stimulate hair growth in areas where the hair has fallen out. The other is to reduce the immune system activity that causes hair to fall out.
Current treatment options include:
- topical steroid creams
- topical immunotherapy
- anthralin ointment or cream
- steroid injections
- oral corticosteroids
- immune-suppressing oral medications
Alopecia can be challenging to treat. There’s no way to predict which type of treatment will work best for you. It’s also possible that hair will fall out again after treatment.
Not everyone with alopecia will decide to treat their alopecia. It’s a very personal decision. Discuss treatment options with your doctor. It’s important to understand the benefits and side effects to determine which treatment is right for you.
Alopecia areata is an autoimmune condition that can cause hair loss anywhere on the body. Related hair loss and regrowth can be unpredictable. As a result, alopecia can be challenging to treat. Talk with your doctor to determine which treatment is best for you.
Research into alopecia has led to new treatment options and others on the horizon. The hope is that new knowledge can continue to lead to new treatments and ultimately a cure.