Alopecia areata, patches of baldness, starts as a small area and seems to enlarge. Then you see another, then another. Your hair stylist says, “Did you know there’s this large area in the back…?”
Your teenager is despondent. Her social life is ruined. College, of course, is off the table for now.
You go online and do some research.
You learn that alopecia areata (AA) is very common, it can run in families, and (optimistically and unpredictably) can regrow. You also learn that it is one of the hundred or so other autoimmune diseases, a mild one fortunately, like Hashimoto’s thyroiditis (affecting the thyroid only), with AA, the immune system attacks hair follicles.
Certain medications can trigger AA, most commonly Adderall. So if your AA or your kid’s appeared after starting Adderall (or a recent dose increase), give this a consideration. Other hair loss villains are unconscious hair pulling, stress, and a bad diet. Sometimes AA is just a message from your body that certain aspects of your life need a change.
Your dermatologist generally begins her treatment with cortisone creams and injections into the affected areas, basically to suppress the immune system locally. She may also recommend topical minoxidil, also safe and effective but all treatments require patience. This is why you’re all called “patients.” Hair transplants don’t work for AA so look for the door marked “Exit” if you hear one being recommended.
The WholeHealth Chicago Approach
“Skin” and “gut” are one continuous organ, and the naturopathic medicine mantra is “All illness begins in the gut.” Here at WholeHealth Chicago, rather than starting treatment by suppressing your immune system with steroids (although steroids can be effective, they’re not getting to the root cause <pardon the pun>).
We’ll talk about your digestion, try to eliminate as many ultra processed foods from your life as possible and check levels of certain vitamins associated with AA. Vitamin D is often overlooked by dermatologists.
You’ll likely be instructed through a “Gut Rehab Program” treating the controversial condition (well, not controversial to us) called “Leaky Gut”.
As topical treatment, I recommend the Thymuskin Med products (you’ll want “MED” designed for AA) made in Germany. This can be shipped from overseas but may be at Merz Drugs in Lincoln Square.
For nutritional supplements:
Flaxseed Oil, one tablespoonful daily (sprinkle over salad, rice, mix into smoothie, etc)
And now, a rather important last word. The FDA and Big Pharma announced the auto immune suppressant (called a JAK inhibitor) Ritecitinib (marketed as Litfulo) specifically for alopecia areata. In a simple once a day tablet at a mere $50,000 a year, it is also approved for children as young as 12. Although side effects were rare (headaches, acne, nausea), the package insert contains the usual boxed warning for other JAK inhibitors which I will share with you:
Ritlecitinib labeling includes the boxed warning about the risk for serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis.
You might prefer instead to clean up your diet, take supplements and reduce stress first.
David Edelberg, MD