Alopecia Areata Disease

Alopecia Areata: An Evaluation of Therapeutic Modalities and a Summary of Available Treatments

Numerous hereditary disorders linked to hair loss affect people globally. Alopecia Areata (AA) is included in the group of disorders referred to as autoimmune diseases. Usually, this condition manifests as patchy or circular bald patches that leave no scars. It occasionally also causes the nails to become pitted or brittle.

According to the report of NIH in 2021, The prevalence of alopecia areata is 100–200 per 100,000 people, and the lifetime risk is roughly 2%. For men and women, respectively, the average age at which alopecia areata is diagnosed is 32 and 36 years old.

Alopecia areata affects about 20.2 persons per 100,000 person-years on average. By the time they are 50 years old, about 50,000 out of 100,000 Caucasian males have androgenetic alopecia. At 70 years of age, this number increases to ~80,000 per 100,000.

Alopecia areata, sometimes called alopecia, is a skin disease that is immune-mediated and chronic. It is characterized by sudden hair loss on the scalp, beard, and occasionally the eyebrows, eyelashes, and body hair. Another way to put it is as bald patches or spots. The erratic nature of this patchy hair loss is attributed to its sudden recurrence of hair growth that resumes at any time.

The extent of hair loss and other symptoms determine the type of alopecia areata. The most prevalent type of alopecia areata is patchy. One or more coin-sized patches of hair loss on the scalp or body are its defining feature. Alopecia totalis is the term used to describe complete scalp hair loss. When a patient loses all of the hair on the body including on the face and scalp have alopecia universalis.

The sudden and unexpected thinning of hair occurs throughout the scalp, not just in one spot or area when diffuse alopecia areata. Either male or female pattern hair loss appears. Another name for it is alopecia areata incognita. Ophiasis is a condition where there is a band-like loss of hair around the outside of the head, especially where the temporal and occipital bones meet. A band of hair loss around the sides and lower back of the scalp is a symptom of ophiasis alopecia.

Causes

The most frequent cause of hair loss is an aging-related genetic condition. Male-pattern baldness, female-pattern baldness, and androgenic alopecia are the names given to this condition. There are other conditions, such as hormonal changes brought on by pregnancy, childbirth, menopause, and thyroid issues, that result in either temporary or permanent hair loss. Medical conditions include ringworm, an immune system-related alopecia areata that results in patchy hair loss, and trichotillomania, a disorder that causes excessive hair pulling.

It is also caused by to side effects of medicines used in the treatment of cancer, arthritis, depression, heart problems, gout, and high blood pressure or due to radiation therapy and very stressful events. A common side effect of physical or emotional shock is general hair thinning, which occurs in many cases several months later. This kind of hair loss is transient.

Sign and Symptoms

Depending on the underlying cause, Alopecia Areata appears with a variety of symptoms. It strikes suddenly or gradually, affecting the entire body or just the scalp.

Some of the signs and symptoms include:

Gradual thinning on head: The most prevalent form of hair loss that affects people as they age is gradual thinning on top of the head. Men's hair frequently starts to recede at their forehead hairline. In women's hair, the part usually gets wider. A receding hairline (frontal fibrosing alopecia) is a pattern of hair loss that is becoming more and more common in older women.

Patchy or circular bald spots: On the scalp, beard, or eyebrows, some people experience patchy or circular bald spots. Before the hair falls out, the skin starts to hurt or become itchy.

Unexpected hair looseness: Hairs suddenly become loose due to an emotional or physical shock. When brushing or washing hair, or even just after giving it a little tug, handfuls of hair fall out. Although temporary, this type of hair loss typically results in overall hair thinning.

Total body baldness:  Hair loss is a side effect of certain medical conditions and treatments, like chemotherapy for cancer. Usually, the hair grows back.

Scaling patches that extend throughout the scalp are indicative of ringworm. Broken hair, redness, swelling, and occasionally seeping accompany it.

Diagnostic Analysis of Alopecia Areata

• Scalp Biopsy- During a scalp biopsy, at least two tiny specimens of scalp follicles and tissue are taken out for examination. The specimens are not much larger than the eraser on a pencil. After that, the specimens are sent to a skin pathologist who specializes in making diagnoses related to hair loss.

• Blood test- A blood test is used to identify medical conditions that are causing hair loss.
• Light microscopy- A physician examines hairs that have been clipped at the base using a specialized tool. Possible problems with the hair shaft are found via microscopy.
• Physical Examination- A thorough clinical examination should involve a macroscopic examination of the body and scalp, including particular attention to the areas that bear hair and the nails to identify the pattern and affected areas of hair loss. Although AA is characterized by a patchy pattern of hair loss, diffuse hair loss is seen in fewer instances. To rule out other differential diagnoses, the skin inside the lesions should also be examined for indications of scarring, scaling, erythematous papules, pustules, or crusts.

Treatment Analysis for Alopecia Areata

Certain types of hair loss have viable therapies available. It stops or at least slows hair loss. Both medication and surgery are used as treatments for hair loss.

Medications

• Minoxidil (Rogaine)- It is a popular OTC medication that is used off-label. It is available in shampoo, foam, and liquid forms. Use the product twice a day for men and once a day for women on the scalp skin for optimal results. Applying foam while the hair is still wet is preferred by many. Many people find relief from hair loss, reduced hair loss, or both with products containing minoxidil. Just that it helps those with mild cases of alopecia areata is supported by evidence. It usually takes 4-6 months to achieve results. Irritation of the scalp and undesirable hair growth on the hands and face's surrounding skin are potential side effects.
• Anthralin (Dritho-Scalp)- The medication Anthralin (Dritho-Scalp) causes skin irritation to promote the growth of new hair.
• Corticosteroid Creams- Hair follicle inflammation is reduced by corticosteroid creams, lotions, foams, and ointments like Clobetasol (Impoyz).
• Finasteride (Propecia)- This medication is prescribed for males. When using finasteride, many men see a slowdown in their hair loss and some, new hair growth. It takes several months to determine its effectiveness. For any benefits to last, the patient must continue taking it. For men over 60, Finasteride does not function as well. A higher risk of prostate cancer and decreased sex drive and sexual function are uncommon side effects of finasteride. Pregnant women should refrain from handling broken or crushed tablets.
• Steroid Injection- To help bald spots, and regrow hair, steroid injections are a popular treatment for mild, patchy alopecia. The steroid is injected into the bald area by medical professionals using tiny needles. To promote hair growth, the treatment must be repeated every one to two months; it does not stop new hair loss.

Surgery and Other Procedures

• Hair Transplant Surgery- All hair on the head is affected in the most common type of permanent hair loss. Make the most of the hair that remains with a hair transplant or restoration surgery. A cosmetic surgeon or dermatologist removes hair from a hair-producing area of the head and transplants it to a bald spot during a hair transplant procedure. Micrografts and minigrafts are hairs that range in number from one to several in each hair patch. Larger skin strips with several hair groupings are occasionally removed. Bleeding, bruises, swelling, and infections are among the possible risks.
• Laser and Light Therapy- A light sensitizer or phototherapy with particular ultraviolet light wavelengths is used in light therapy, also known as photochemotherapy, to achieve its therapeutic goals. To promote the growth of new hair, a laser treatment applies precise radiation doses. Both treatments are regarded as secure and successful.

Alternative Treatments

Acupuncture, aromatherapy, vitamins, and supplements like zinc and biotin, essential oils like coconut, tea tree, and castor oil, and applying onion juice to the scalp are some natural treatments, and probiotics are examples of possible alternative treatments. Dietary adjustments are also beneficial in treating alopecia areata.

Regulatory Framework

Current updates to the regulatory guidelines offered by DiseaseLandscape Insights services are very beneficial for expanding companies. These updates make sure that businesses streamline their marketing and product development processes, stay compliant with evolving industry standards, and stay out of potential legal hotspots.

• The FDA has approved Pfizer’s LITFULOTM (Ritlecitinib), a once-daily oral treatment for severe alopecia areata in patients 12 years of age and older. For LITFULO, a recommended dose of 50 mg is authorized. For teenagers (12+) with severe alopecia areata, it is the first and only FDA-approved treatment.
• The FDA approved baricitinib (Olumiant) oral tablets in 2022 as a treatment option for adult patients suffering from severe alopecia areata. This was the first time a systemic treatment for the disorder had been approved by the FDA.
• However, in May 2023, TGA also approved Eli Lilly Australia Pty Ltd’s Oluminant for the treatment of severe alopecia areata (AA) in adult patients.

Clinical Trial Assessment

The DiseaseLandscape Insights consultancy firm provides valuable support in future market trends on the development of new pharmaceutical products. This support helps to streamline the planning and execution of clinical trials of novel medications and treatments, implement effective patient recruitment strategies, ensure regulatory compliance, and increase the likelihood of successful trial outcomes.

The below table gives information about some currently ongoing clinical trials, including their study titles and respective stages:

Conclusion

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Companies get valuable insights into the demand for products and services within the healthcare sector by monitoring various factors such as disease causes, prevalence, diagnostic options, treatment patterns, regulatory guidelines updates, clinical trial assessments, and research and development advances. Equipped with this understanding, companies optimize their growth potential and maintain a competitive edge in the market by carefully positioning themselves, creating focused marketing campaigns, and funding the creation of novel solutions.

With the help of DiseaseLandscape Insight Services, businesses take advantage of expanding opportunities by arming themselves with critical healthcare market information. Through a comprehensive understanding of disease patterns, treatment requirements, and technological advancements, companies customize their offerings to meet changing market needs and promote growth and success.