Alopecia Areata Dermatologist2019-11-08T17:39:43+00:00

Feel in charge of your skin

PERSONALISED DERMATOLOGY TREATMENT PLANS

Alopecia areata is a type of non-scarring hair loss that affects around 2% of the population

IN THESE VIDEOS, I EXPLAIN THE SYMPTOMS AND CAUSES OF HAIRLOSS – AND HOW TO TREAT IT

In the videos above, I explain things in a simple way that applies to most people who have alopecia areata. Of course, no video or website can replace the value of a personalised consultation. At your consultation, you can have your skin carefully examined and get an expert recommendation to help you resolve your condition.

Treatment helps people of all ages take control of their skin condition and get their life back.

How does alopecia areata impact people on a day-by-day basis?

ALOPECIA AREATA IS A DISTRESSING AND UNPREDICTABLE CONDITION

Hair loss often occurs suddenly and without any symptoms

You may notice a tingling sensation before the hair loss. Sometimes, your affected skin might appear a bit red. The hair loss in alopecia areata typically occurs in small round patches on the scalp. It can also affect the eyebrows, eyelashes, beard area and other hair-bearing parts of the body.

Alopecia areata can be quite a distressing condition to have

Sometimes, your hair loss will be more extensive. It might affect all of your scalp (alopecia totalis), or the whole of your scalp and body (alopecia universalis). If your hair grows back, it is often initially white and fine, but usually regains its colour with time.

In some, alopecia areata can get worse

If only a few patches of hair loss appear, 4 out of 5 people can expect full hair regrowth within the first year. However, the condition can recur in future. If the initial hair loss is more extensive, the prognosis is not as good. Another factor that can affect the prognosis is a predisposition to atopy (that is, eczema, asthma and or hayfever).

An upredictable cosmetic effect

Alopecia areata can be quite a distressing condition to have, due to its resulting cosmetic appearance and its unpredictability.

I can help you with your alopecia areata

I have a wide variety of treatment options at my disposal that can help treat your hair loss. These range from ointments to injections and tablets.

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

FIND OUT HOW TO GET THE SKIN YOU WANT

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FEEL IN CHARGE OF YOUR SKIN IN 3 EASY STEPS

STEP 1 – CALL US
STEP 2 – LET’S MEET
STEP 3 – RESOLUTION
CONTACT MY STAFF

Give us a call on 01183735198 and we’ll help guide you towards a first appointment.

MEET WITH ME

I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about alopecia areata

FOR THOSE WHO WANT THE DETAILS

Alopecia areata is a type of non-scarring hair loss that affects around 2% of the population.

It is thought to be an autoimmune process.

It most often begins in childhood or before the age of 40.

Alopecia areata can occur suddenly and can affect the scalp or other parts of the body.

The condition can be unpredictable in how it responds to treatment and prognosis.

Hair loss often occurs suddenly and without any symptoms.

Some people notice a tingling sensation before the hair loss. Sometimes the skin affected appears a bit red.

The hair loss in alopecia areata typically occurs in small round patches on the scalp. It can also affect the eyebrows, eyelashes, beard area and other hair-bearing parts of the body.

Sometimes it is more extensive, affecting all of the scalp (alopecia totalis), or the whole of the scalp and body (alopecia universalis).

Hair that does grow back is often initially white and fine, but usually regains its colour with time.

Alopecia areata can be quite a distressing condition to have, due to its resulting cosmetic appearance and its unpredictability.

If only a few patches of hair loss appear, 4 out of 5 people can expect full hair regrowth within the first year. However, the condition can recur in future.

If the initial hair loss is more extensive, the prognosis is not as good. Another factor that can affect the prognosis is a predisposition to atopy (that is, eczema, asthma and or hayfever).

Alopecia areata is thought to be an autoimmune condition, meaning that the patient’s immune system does not recognise the hair follicles as its own and attacks them, resulting in hair loss.

The condition is thought to have a genetic component as it can run in families.

Patients with alopecia areata will more commonly have other autoimmune conditions such as thyroid disease or vitiligo when compared to the rest of the population.

Stress can be a trigger in some people with a predisposition to alopecia areata.

I will take a history of symptoms, and the pattern of your hair loss and medical history. I will follow this with an examination of the scalp and other affected areas (with the aid of an instrument known as a dermatoscope) to determine the type and extent of hair loss.

I typically make a diagnosis of alopecia areata through clinical examination. Rarely, I may need to take a scalp biopsy.

I will usually offer you a blood test to check for other autoimmune conditions such as thyroid disease, diabetes and vitamin B12 deficiency.

Small patches of alopecia areata can self-resolve with time.

Alternatively, I can prescribe a potent scalp application or ointment to apply directly to the affected areas for a period of 6 weeks to 3 months.

If this is not effective, I can inject small amounts of a steroid solution known as triamcinolone into the affected bald patches on the scalp.

The procedure is minimally invasive. I can perform it on the same day as your consultation without the need for local anaesthetic.

When hair loss on the scalp is more extensive, treatment with diphencyprone can be helpful. This treatment works by sensitising the scalp to make you allergic to diphencyprone. An increasingly stronger concentration of diphencyprone is then applied to the scalp on a weekly basis to stimulate hair growth. This treatment is only available in specialised centres.

Topical dithranol is sometimes used to achieve the same result.

I sometimes use oral steroids for 6-8 weeks in extensive cases of alopecia areata. Unfortunately, once you discontinue oral steroids, the regrown hair often falls out again. Prolonged use of oral steroids is best avoided due to the medical risks associated with oral steroid use.

Oral immunosuppression with tablets like methotrexate and ciclosporin is sometimes used to treat severe alopecia areata. The risks associated with immunosuppression therapy, however, often outweigh the benefits.

Researchers studied the effects of a group of drugs known as Janus Kinase (JAK) inhibitors (such as tofacitinib) on alopecia areata. They found these drugs to improve alopecia areata when patients took them systemically for other conditions.

Currently, these are prohibitively expensive and have the potential for some side effects. Work is underway to produce a topical formulation of JAK inhibitors for the treatment of alopecia areata in future.

Some people find that use of hair fibres, hair extensions or wigs can improve their confidence. There are also hair salons that specialise in hair systems for people with alopecia.

“Can alopecia areata be cured?”

Unfortunately, there is no cure for alopecia areata. It is an autoimmune condition.

Treatment can result in regrowth of bald patches but cannot cure the condition altogether. That means you may get another episode in future.

“How can I prevent a recurrence of alopecia areata in future?”

Alopecia areata is an unpredictable condition. Unfortunately, there is no reliable way of preventing future episodes of alopecia areata.

Current treatment options for alopecia areata, therefore, focus on achieving regrowth of already lost hair.

“Where can I get support for my condition?”

Many people suffering from alopecia areata find it an extremely distressing condition and have difficulty coping with its unpredictable nature and cosmetic appearance.

There are a number of patient support groups that can help:

Affiliations and memberships

I AM PROUD TO BE ASSOCIATED WITH THE FOLLOWING ORGANISATIONS

Questions and answers

RELEVANT AND INFORMATIVE VIDEOS AND ARTICLES

About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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