Patient Burden
There are currently no FDA-approved treatments for alopecia areata1
Current treatment guideline recommendations include topical immunotherapy, topical corticosteroids, intralesional corticosteroids, oral corticosteroids, phototherapy, and systemic therapies2,3
There are a host of complex needs that are unmet for patients with alopecia areata1,4-17:
- Psychiatric co-morbidities (such as anxiety, depression, and suicide) and impacts on relationships (bullying, family, and places of employment)
- There are multiple sociocultural implications (religious significance, cultural stigma, social symbols of youth/vigor, representation of sexual maturity and reproduction) and physical co-morbidities (temperature control, environmental protection, sense of touch, and autoimmune and inflammatory disorders) that impact quality of life
- There is also a potential for significant financial considerations in managing alopecia areata.18
Related resources
Chapter 1: Unmet needs in Alopecia Areata
This video animation summarizes the unmet needs of patients with alopecia areata.
References
- U.S. Food & Drug Administration. The voice of the patient: a series of reports from FDA’s patient-focused drug development initiative: alopecia areata. Accessed March 5, 2019.
- Strazzula LC, Chun Wang EH, Avila L, et al. An appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018b;78:15-24. doi:10.1016/j.jalopecia areatad.2017.04.1142
- Meah N, Wall D, York K, et al. The alopecia areata consensus of experts (ACE) study: results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123-130. doi:10.1016/j.jaad.2020.03.004
- Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3:17011. doi:10.1038/nrdp.2017.11
- Strazzula LC, Chun Wang EH, Avila L, et al. Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018a;78:1-12. doi:10.1016/j.jalopecia areatad.2017.04.1141
- Liu LY, King BA, Craiglow BG. Alopecia areata is associated with impaired health-related quality of life: a survey of affected adults and children, and their families. J Am Acad Dermatol. 2018;S0190-9622. doi:10.1016/j.jalopecia areatad.2018.01.048
- Fricke ACV, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015;8:397-403. doi:10.2147/CCID.S53985
- Lee YB, Lee WS. Alopecia areata and itch: a retrospective analysis of 312 cases. J Eur Acad Dermatol Venereol. 2019;33:e317-e319. doi:10.1111/jdv.15591
- Vélez-Muñiz RDC, Peralta-Pedrero ML, Jurado-Santa Cruz F, et al. Psychological profile and quality of life of patients with alopecia areata. Skin Appendage Disord. 2019;5(5):293-298. doi:10.1159/000497166
- Abedini R, Hallaji Z, Lajevardi V, et al. Quality of life in mild and severe alopecia areata patients. Int J Womens Dermatol. 2017;4(2):91-94. doi:10.1016/j.ijwd.2017.07.001
- Layegh P, Arshadi HR, Shahriari S, et al. A comparative study on the prevalence of depression and suicidal ideation in dermatology patients suffering from psoriasis, acne, alopecia areata and vitiligo. Iran J Dermatol. 2010;13:106-111.
- Jagtiani A, Nishal P, Jangid P, et al. Depression and suicidal ideation in patients with acne, psoriasis, and alopecia areata. J Mental Health Hum Behav. 2017;22(1):50-54. doi:10.4103/0971-8990.210700
- Buffoli B, Rinaldi F, Labanca M, et al. The human hair: from anatomy to physiology. Int J Dermatol. 2014;53(3):331-341. doi:10.1111/ijd.12362
- Santos Z, Avci P, Hamblin MR. Drug discovery for alopecia: gone today, hair tomorrow. Expert Opin Drug Discov. 2015;10(3):269-292. doi:10.1517/17460441.2015.1009892
- Azzawi S, Penzi LR, Senna MM. Immune privilege collapse and alopecia development: is stress a factor? Skin Appendage Disord. 2018;4(4):236-244. doi:10.1159/000485080
- Karthikeyan K. Tonsuring: Myths and facts. Int J Trichology. 2009;1(1):33-34. doi:10.4103/0974-7753.51927
- BBC. The Five Ks. Published 2009. Accessed August 25, 2020. https://www.bbc.co.uk/religion/religions/sikhism/customs/fiveks.shtml
- Li SJ, Mostaghimi A, Tkachenko E, Huang KP. Association of out-of-pocket health care costs and financial burden for patients with alopecia areata. JAMA Dermatol. 2019;155(4):493-494. doi:10.1001/jamadermatol.2018.5218
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