The emotional toll of alopecia areata can be devastating. But there are treatments that can help you remain positive, manage your symptoms, and thrive.
For Dan Kaplan, 43, who has been living with alopecia areata for a quarter century, Dupixent (dupilumab), a drug approved for the treatment of moderate-to-severe eczema, has been a game changer.
For years, he kept the condition under reasonable control with regular cortisone injections, but “it was like playing a game of whack-a-mole at the fair: We’d hit one bald patch and respond to it, then another one would crop up,” he recalls. His alopecia got dramatically worse during the COVID-19 pandemic, when he couldn’t get to his dermatologist’s office for his shots. By early 2022, he’d lost about half of the hair on his scalp.
Mr. Kaplan despaired, but his doctor had a solution: The doctor referred him to the Mount Sinai Alopecia Center. He met with the world-renowned expert in inflammatory skin diseases including alopecia, Emma Guttman, MD, PhD, Waldman Professor of Dermatology and Clinical Immunology, and System Chair of the Kimberly and Eric J. Waldman Department of Dermatology, at the Icahn School of Medicine at Mount Sinai. She examined him and noticed that he also had small patches of eczema. She recommended Dupixent to treat both the eczema and alopecia, and Mr. Kaplan began weekly injections of the drug in April 2022. The results were dramatic.
“After about two months, I noticed that areas of my scalp that had never responded to cortisone were beginning to grow hair again,” he says. Following the treatments, he has had about 95 percent hair regrowth.
“When you live with alopecia areata, you always wonder when the other shoe is going to drop and you’re going to lose more hair,” he says. “I’m so thankful now to be able to go about my day normally, without worrying about that.”
Stories like Mr. Kaplan’s are commonplace at the Alopecia Center, according to Dr. Guttman.
The Alopecia Center is also conducting studies in scarring alopecia, a type of alopecia in which the immune system destroys hair follicle cells completely, so that regrowth isn’t possible. One promising drug is ritlecitinib, a first-in-class drug that inhibits JAK3/TEC, an enzyme that interferes with the signals in your body thought to cause inflammation and implicated in alopecia areata.
A 2022 study done by Dr. Guttman and published in the Journal of Allergy and Clinical Immunology found that patients who took ritlecitinib for 24 weeks showed significant improvement in hair regrowth in patients with alopecia areata.
After showing increased JAK3 in scalp biopsies of patients with scarring alopecia, Dr. Guttman and her team are also translating these new developments in alopecia areata to scarring alopecia where she is studying ritlecitinib treatment. “We are so excited about this because up until recently, there were no treatments for scarring alopecia,” Dr. Guttman says. “It’s awful to have to give a beautiful woman the news that there’s nothing to offer her.”
Vicky Miller is one of those patients. The 54-year-old began to experience hair loss about two years ago and was referred to Dr. Guttman and to the Alopecia Center in 2022 by a neighbor who also had alopecia. She began a trial with a Janus kinase (JAK) inhibitor in May 2022.
“After about 12 weeks, all of a sudden the bald spots on the sides of my head began to fill in,” she recalls. “One day there was nothing there, and the next day peach fuzz. I went from 50 percent hair loss to full hair regrowth. I plan to be on this medication for the rest of my life.”
While there’s no cure yet for alopecia, these new treatment advances make it more manageable, according to Dr. Guttman. Other cutting-edge treatments for alopecia areata, for example, include Olumiant (baricitinib), a JAK inhibitor recently approved by the Food and Drug Administration. The Center plans to study Dupixent soon in children with alopecia areata and is investigating other treatment options as well.
“We’re able to offer our patients access to new, investigational therapies such as novel JAK inhibitors that aren’t available anywhere else,” says Dr. Guttman.