Alopecia Areata Update and Outlook for the Future

ALOPECIA AREATA UPDATE AND OUTLOOK FOR THE FUTURE

ORLANDO, FL (February 27, 1998)-- Alopecia areata is a poorly understood, unpredictable and capricious medical disorder that affects more than 2.5 million men, women and children in the USA and Canada. Affecting 1.7% of the population, it is almost as common as psoriasis. Causing patchy hair loss on the scalp and sometimes elsewhere on the body, this mysterious, noncontagious condition can be treated, but it cannot yet be cured. Alopecia areata is considered a medically friendly condition. However, psychologically, it can be acutely painful, affecting a personís emotional well being and sense of self. Socially, the problems can range from ostracism, to loss of job to divorce.

Speaking today at the American Academy of Dermatologyís 56th Annual Meeting in Orlando, Jerry Shapiro, MD, FRCPC, Division of Dermatology, University of British Columbia, Vancouver, Canada, discussed the disease and the outlook for the future.

Alopecia areata is an autoimmune disease and like many other such diseases, the trigger factors are unknown. It represents an excellent model for studying autoimmune disease in general as it involves an organ and structures that are easily accessible for visual examination and microscopic analysis. "Greater understanding of the pathogenesis of alopecia areata will provide significant insights into other autoimmune disorders such as lupus erythematosus, rheumatoid arthritis and multiple sclerosis," Dr. Shapiro stated.

The disorder appears to be a malfunction of the hair follicle. The affected hair follicle, cells and tissue that give rise to a hair, slows down its production of hair, becomes small, and grows no hair that is visible from the skin surface. Although the hair follicle remains alive, it doesnít receive the signal to grow normal-length hair. This dormant condition may last months or years. However, because the hair follicle remains alive, there is always the possibility of growing normal hair again. In many people, the hair grows back spontaneously. In some, the regrowth is permanent; in others the hair loss recurs months or years later.

The choice of treatment often depends on age, the extent of hair loss, and the desires of the patient. Treatments are designed to prod the sluggish hair follicle to produce normal hair again. People with milder forms of the disorder usually respond better to treatment than those with extensive hair loss. However, treatment does not prevent new bald patches from developing, and it is usually continued until there is a spontaneous regrowth of hair.

Many promising developments in the treatment of alopecia areata have occurred in the past decade. "Advances in therapy have been reported with chronic severe alopecia areata, which was considered untreatable by most dermatologists just 15 years ago," said Dr. Shapiro.

For those with less than 50% loss of scalp hair, treatments include injection of corticosteroids into the bald patches, topical anthralin, minoxidil solution, or topical corticosteroid creams.

For those with more than 50% hair loss, researchers are investigating topical immunotherapy, which causes the body to develop an allergic (immune) response to a sensitizing substance such as diphenylcyclopropenone (DPCP) .

Other treatments include anthralin with or without minoxidil solution, minoxidil solution with topical corticosteroids, and phototherapy. Under exceptional circumstances, oral corticosteroids may be prescribed. "New therapeutic directions for alopecia areata will involve specifically targeted immunomodulatory agents. Rodent models currently available have become an important part of therapeutic research. A variety of phototherapies beyond PUVA may have immunomodulating potential, and are currently being evaluated," Dr. Shapiro said.

The American Academy of Dermatology is the worldís largest organization of dermatologists, representing over 10,000 physicians who specialize in treating skin, hair and nail conditions.

# # #