Many patients want to know if they can grow back their hair if they decide to start a treatment plan. Certainly patients can grow back hair sometimes but growing back hair may or may not be the goal of treatment. I’ve given examples here of three hair loss conditions with very different treatment goals. It’s absolutely essential that patients understand whether they are realistically aiming for compete regrowth or not.
1. Scarring Alopecia – What are the goals of treatment?
For patients with scarring alopecia, the goal of successful treatment is mainly to STOP further loss. While we can occasionally get regrowth when treating scarring alopecia, the main goal is to stop the disease. If the patient has the same hair density after one year of treatment, it means some aspect of the treatment is helping.
2. Androgenetic Alopecia – What are the goals of treatment?
For androgenetic alopecia (AGA), we certainly want to try to get back some amount of regrowth. But it’s important for patients to understand that we rarely reverse the condition fully. It’s wonderful when we can get significant improvement but sometimes we need to accept that we can only stop it from getting worse. While there is a much higher chance of getting regrowth in AGA than scarring alopecia, there are many patients that don’t achieve regrowth but do find that treatment is preventing the hair density from getting any worse.
3. Alopecia areata – What are the goals of treatment?
For alopecia areata, our hope is to get regrowth and often the goal is complete regrowth. From the very beginning, we are trying to design a treatment plan that we regrow the hair completely. In fact, if the patient does not experience regrowth, the clinician usually considers changing the treatment plan.
4. Telogen Effluvium – What are the goals of treatment?
Telogen effluvium refers to excessive hair shedding. A variety of triggers can cause hair shedding including low iron, thyroid disease, weight loss, surgery, medications and diets. For patients with telogen effluvium, the goal of successful treatment is to figure out exactly what caused the shedding (ie determine the trigger) and then fix or remedy things to correct whatever it was that set off the shedding in the first place. If the telogen effluvium was due to weigth loss, the only real way to correct the telogen effluvium is to maintain a steady healthy . The goal of treating a telogen effluvium is to get the density back.
Summary
In summary, patients with hair loss should ideally know if their hair loss condition is associated with high chances for regrowth or whether the main goal is to simply stop it from getting worse. Hair loss conditions like alopecia areata and telogen effluvium are associated with high changes of regrowth, conditions like androgenetic alopecia are associated with moderate chances. For those with scarring alopecia, chances of regrowth are much lower and the main goal is to stop the condition from getting worse.
