Unconventional Therapies For Alopecia Areata
Atanaskova Mesinkovska stated that in an attempt to better control their disease, patients with AA often seek alternative and somewhat unconventional therapies. The internet search engine results yielded a plethora of promising products, many obtained without medical advice, whereas others require prescription or a visit with a physician. Alternative treatments that have recently gained popularity among patients with AA include anti-histamines, cryotherapy, and low-dose naltrexone . These unconventional AA remedies pose a challenge for patients and physicians alike, as they are not part of the standard AA therapeutic repertoire. In addition, there is inadequate data evaluating their efficacy and even safety in AA. Available evidence about the mechanisms of these therapeutic options pointed to a potential, but unproven, role in AA.
The authors concluded that the information on emerging unconventional therapies for AA should be interpreted and utilized with a sense of caution. Clinical studies are needed to better understand their mechanisms and potential role for AA.
Patients Who Are Eligible To Be Scheduled For A Hair Loss Clinic Appointment Should Have One Of The Following Issues:
- Patients with a clinical diagnosis by a dermatologist OR biopsy-proven scarring alopecia:
- Lichen planopilaris
- Central centrifugal cicatricial alopecia
- Discoid Lupus Erythematosus
- Dissecting cellulitis of the scalp
- Scarring alopecia or scarring hair loss
- Patients with moderate to severe alopecia areata, affecting 30% or more of the scalp
- Patients with chemotherapy or cancer therapy induced alopecia
- Patients with alopecia due to graft versus host disease
If you meet eligibility, you must register as a Mass General patient to make an appointment.
It is required that patients provide one of the following to our office by faxing to 617-726-7768 Attn. Hair Loss Clinic:
2) A biopsy report confirming one of the following diagnoses:
- Lichen planopilaris
- Central centrifugal cicatricial alopecia
- Discoid Lupus Erythematosus
- Dissecting cellulitis of the scalp
- Scarring alopecia or scarring hair loss
- Chemotherapy induced hair loss
For less severe forms of hair loss or for patients who are not eligible for our Hair Loss Clinic appointments, you may request a consultation with one of our general dermatologists.
At Mass General Dermatologys Hair Loss Clinic, our board-certified dermatologists are highly specialized in the diagnosis, management and treatment of hair loss that affects both adolescents and adults. For most people, it is normal to shed 100-150 hairs a day however, if you are noticing bald spots or excessive hair loss, it may be a sign of alopecia.
How Will A Healthcare Provider Diagnose Hair Loss In Women What Tests Are Done
The tests performed to diagnose hair loss in women can be simple or complicated:
- Gently pulling on your hair to see how many hairs come out.
- Blood tests. These check for vitamin and mineral levels and hormone levels .
- Scalp examination under a microscope and trichoscopy.
- Scalp biopsy to remove and examine a very small piece of scalp skin.
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Why Doesn’t Insurance Cover Hair Loss
More than 40 percent of the population acknowledge that they are suffering from hair loss. Male and Female hair loss are common in young and older individuals alike.
Anyone can experience hair fall and other such hair loss problems. Fortunately, there are treatments available today that really work. Regrettably however, health insurance does not cover hair loss related treatments whether they are non-surgical or surgical. Simply put, elective procedures and conditions that are not associated with any health related problems are not covered by insurance companies. Because treating hair loss is not a medical necessity, health insurance providers simply wont provide any help with this condition. Ultimately, health insurance companies were created to help offset costs for treatments related to keeping individuals at their optimal health so they can continue working and being a constructive part of society. Since balding does nothing to prevent individuals from living a healthy lifestyle and working, treatments for hair loss and surgical hair transplantation simply does not fit in line with what health insurance companies cover.
Treatment Is Cosmetic In Nature
As mentioned above, hair loss can be due to various reasons. A few of these underlying causes can be treated by medication. Surgery is required only in cases which require hair transplants. However, the surgery is cosmetic in nature, hence excluded from coverage. In recent times, many cosmetic treatments are increasingly being included by major health care insurance providers worldwide. However, hair transplant still remains excluded.
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What Are The Treatments For Hair Loss
Although remedies promising to restore hair to balding heads have been around since ancient times, most men and women with thinning hair can do little to reverse the process. For cosmetic purposes, or after hair loss from surgical or drug treatments, many people turn to wigs, hairpieces, and hair weaving. Some people get tattoos to simulate lost eyebrows and eyelashes. Certain drugs may slow hair loss, and alternative treatments may bolster the health of remaining hair, but no treatment is likely to replace a full head of hair. Learn more about what you can do to help stop a receding hairline.
Some people may benefit from the following hair loss treatments:
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How Can I Get My Insurance To Pay For A Wig
For insurers other than original Medicare, coverage for a wig for chemotherapy-related hair loss may be possible by one of these avenues:
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Carefully check your policy and call your insurer. Wigs may be listed among cancer treatment items eligible for reimbursement in full or up to a certain amount.
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Work with a wig specialty retailer that has a track record of successfully filing insurance claims for clients and familiarity with the rules of particular insurers.
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Wigs sometimes require prior authorization, which will likely depend on a doctors prescription or letter. Sometimes, the physician will denote that the wig is a cranial prosthesis for hair loss related to cancer treatment. Ask your insurer about specific terminology.
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Retain your receipt for the wig purchase and file a claim.
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If a Medicare Advantage plan claim is denied, wigs still may be reimbursed successfully through the appeals process. For a private insurance denial, resubmit the claim with a photo without hair to accompany your appeal and ask for a medical review.
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Are There Complications/side Effects Of Treatment
Minoxidil may irritate your scalp and cause dryness, scaling, itching and/or redness. See your dermatologist if this happens.
With Minoxidil you might also see hair growing in other places other than your scalp . Wash your face after you apply Minoxidil and make sure you avoid other areas when you apply it.
Options For Inexpensive Or Free Wigs
If you know in advance that your insurance will not help with a wig purchase, shop around for inexpensive wigs . Contact your local chapter of the American Cancer Society about donated wigs that may available to you at no cost. A number of other organizations also offer free or discounted wigs, and a social worker or patient navigator at your cancer center may help direct you to the appropriate source.
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Why Does Cancer Treatment Cause Hair Loss
Cancer treatments affect hair in different ways.
- Chemotherapy works by targeting growing cells. This includes healthy cells, such as your hair follicles , as well as cancer cells. You dont always lose your hair with chemotherapy. But if you do, it can vary from just a small amount to total hair loss. It usually happens gradually, within a couple of weeks of your first session, but sometimes it can be more sudden. Your hair will usually start to grow back once your treatment is over.
- Radiotherapy can cause hair loss in the areas where youve been treated. This may be where the radiation beam enters your body as well as where it leaves. Whether your hair grows back and how quickly depends on how much radiotherapy youve had and the area of your body affected.
- Hormonal and targeted therapy can make your hair thinner. It nearly always goes back to how it was after youve finished treatment.
What Are The Common Causes Of Hair Loss In Women
What causes hair loss?
- Hair style: Your style of hair can cause hair loss when your hair is arranged in ways that pull on your roots, like tight ponytails, braids, or corn rows. This type of hair loss is called traction alopecia. If hair follicles are damaged, the loss can be permanent.
- Vitamin deficiency.
- Over processed scalp hair .
What causes anagen effluvium hair loss?
- Toxic substances, including chemotherapy, radiation therapy and some medications. These cause sudden hair loss that can occur anywhere on your body. It happens to hair in the growth stage. Sometimes, this type of hair loss can be permanent if your hair follicles are damaged.
What causes telogen effluvium hair loss?
- Extreme physical stress or shock to your body: This causes temporary hair loss. This category includes events like losing a lot of weight, surgery, anemia, illness and having a baby.
- Extreme emotional stress: mental illness, the death of a loved one, etc.
- An abnormal thyroid.
- Medications and supplements: blood pressure medicines, gout medicines and high doses of Vitamin A.
- Hormone changes caused by pregnancy, menopause or birth control pills.
What causes FPHL ?
- Genes: Your familys genes can cause thinning of hair along the top of your head.
- Aging: Hormone changes as you age can cause balding.
- Menopause: This type of hair loss often gets worse when estrogen is lost during menopause.
There are also some conditions that affect hair loss:
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Health Insurance And Dermatology
1. Get a referral through the NHS:2. Get a referral to a private dermatologist:3. Make an appointment directly:
- How much cover you have for dermatology
- The size of the deductible you will need to pay
- Whether anything is excluded from your policy
- For any extra requirements, such as getting a GP referral
Prostaglandins For The Treatment Of Peri
An UpToDate review on Management of alopecia areata states that Prostaglandin analogues — Hypertrichosis of the eyelashes may occur as a side effect of glaucoma therapy with the topical prostaglandin analogues latanoprost and bimatoprost. Knowledge of this effect led to clinical studies of the efficacy of these drugs for alopecia areata involving the eyelashes and eyebrows. The majority of studies, including a 16-week randomized trial of 11 patients, have shown no benefit of these drugs for this disease. However, a non-randomized, prospective study reported benefit with a longer course of therapy. Of 44 patients with eyelash alopecia treated with latanoprost ophthalmic solution for 2 years, complete or moderate regrowth occurred in 17.5 and 27.5 %, respectively. None of the 10 patients who did not receive the drug attained similar levels of response. Additional studies are necessary to determine whether prostaglandin analogues should be utilized for the treatment of periocular alopecia areata.
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Ways To Cope With And Potentially Treat Hair Loss
- Join a Support Group Alopecia UK says that meeting and talking to other people in the same situation as yourself can be a valuable experience. You can gain support from people who have a personal experience with hair loss and they can give you insight and advice on living and dealing with it.
- Be Patient According to the NHS, many types of hair loss are temporary. Although they do also say that regrowth is unpredictable and could take years, and that the new hair can be any texture and colour.
- Cover Up You can look into hiding your hair loss with hair extensions, wigs, makeup and scarves. However, make sure that the hair piece you choose is not too tight as prolonged tension and tight hairstyles or extensions can also cause hair loss known as traction alopecia, according to the Independent.
- Talk About It The NHS advises to talk about hair loss with your friends and loved ones, letting them know about how you feel and what kind of support you need. They also advise therapy or counselling if your hair loss is affecting your relationship with your partner. If you prefer to talk to others online, there are also forums you can join such as Alopecia UKs discussion forum.
- Medication There are various medications available to treat hair loss. However, NHS warns that such medications dont work for everyone, they will usually only work as long as theyre used, they arent available on the NHS and they can be expensive.
How Do They Work
Cold caps offer scalp cooling therapy that doctors may also refer to as scalp hypothermia. These devices narrow the blood vessels under the scalp to limit the amount of chemotherapy that reaches the hair follicles. Less exposure to chemotherapy can reduce the risk of hair loss.
A 2017 study found that women with breast cancer who received chemotherapy and underwent scalp cooling maintained most of their hair. However, those who did not get scalp cooling experienced substantial hair loss.
A 2017 review found that scalp hypothermia can reduce alopecia and appears to be effective for people receiving chemotherapy for breast cancer and solid tumors.
A more recent 2018 article suggests that cold cap treatment works better in individuals undergoing taxane-based chemotherapy than in those receiving anthracycline. These are two different types of chemotherapy drugs.
Cold caps are available at various prices, which depend on the manufacturer, the number of chemotherapy sessions, and the duration of the scalp cooling therapy.
Most cold caps cost $380450 per month , but there may also be additional costs for shipping and refundable security deposits.
A scalp cooling system can cost $2,0002,200 for a full course of treatment. People who opt for this method may also have to pay a fee to the facility.
Aetna is a health insurance company that may provide coverage for scalp cooling to prevent hair loss.
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Prescription Terminology Is Important
A prescription from your oncologist is often needed for insurance to cover the cost or part of the cost of a wig, but the terminology is important. Most companies require an order that says “hair prosthesis” or “cranial prosthesis.” While this terminology can sound frightening , it’s just the way that insurance companies prefer to label a chemotherapy-required wig. The insurance company may also require that you purchase the wig first, send in the receipt, and file a claim. When you file the claim, it can also be a bit challenging knowing how to classify your new hair. In some cases, a cranial prosthesis classifies as “durable medical goods.”