17 Questions to Ask Your Doctor When Considering Treatment for Alopecia Areata

Did you know that a large majority of individuals with alopecia areata will have some degree of hair re-growth?

This is because the cells that supply the hair follicle remain active despite experiencing balding. But you may have an even greater chance at experiencing re-growth if you decide to pursue treatment for your hair loss.

Treatment is determined by your Dermatologist and if you decide to undergo treatment for hair loss (alopecia), there are some things you’ll want to ask your GP and Dermatologist before getting started. These are important questions regarding risks and side effects, costs, and alternatives to treatment.

1. Do I Need a Blood Test?

Hair loss has a number of potential causes. It may be caused by an underlying medical condition, a vitamin and mineral deficiency, or a hormonal imbalance, or it could be alopecia areata, which is what we are here to support with. Read more about alopecia areata here.  When you go to your GP, in the first appointment you may get a blood test done to rule out these other potential causes of hair loss. Then, a dermatologist will repeat that process on the first appointment to get a baseline. This test measures common electrolytes in the blood as well as other compounds such as calcium, glucose, sodium, potassium, carbon dioxide, chloride, blood urea nitrogen, and creatinine 

Blood tests should all be covered under Medicare. 

2. Does This Follow the Australian Consensus for Treatment Plan?

Prior to this study, there were no evidence-based treatment guidelines for systemic therapy of AA. This study developed an evidence-based consensus for treatment, specifically in regard to systemic treatment. 

We recommend you take this study to your appointments and use it to help make decisions regarding when to begin treatment, how to monitor and assess treatment, and appropriate cessation of therapy.

3. What Are the Risks? Is It Safe to Fall Pregnant? 

It is important to always consult with your doctor about any potential risks in your chosen treatment. You can reduce any risks by knowing what they are and how to minimise them. 

Remember that in many cases, receiving treatment requires that you watch your lifestyle closely to ensure you’re not hindering the positive effects of treatment. Make sure to ask your doctor about any changes you should make to your diet, physical movement, and emotional condition to ensure you get the most of your treatment while reducing any potential risks. 

If you are planning on falling pregnant soon, it is best to discuss this with your doctor to ensure that the treatment plan you pursue supports you and your baby. 

4. What Are the Long-Term Side Effects?

The long-term side effects of any treatment are unique to the individual, the type of treatment they pursue, and the stage of hair loss they’re at. As such, the potential long-term side effects of any treatment are out of the scope of this blog post.

The good news is that AAAF have a wealth of this type of information on our website. Be sure to check out our treatments section for more information on various treatment options and their potential long-term effects. 

5. How long will it take to work? 

There is no cure for alopecia areata. However, there are treatments that have had positive results. Each individual case varies and there is no timeline for experiencing positive results with any form of treatment, and results will vary from individual to individual. Read about different treatment options here. 

Any regrowth can take a minimum of 6 to 12 months according to Harvard Medical School. When you understand the phases of hair growth, it is easier to understand the results. You can read more about this here. 

6. What Happens If I Don’t Do Anything?

As there is no guaranteed result for any treatment plan, you may choose not to pursue treatment at all and that’s okay too.  

There are absolutely no risks to your general health if you choose not to pursue treatment now. However, some individuals will experience psychological impacts if their hair loss continues. You should know that AAAF is here to support you through the process and connect you with many people who are living well with their hair loss.

7. What Happens If Treatment Doesn’t Work?

Ask your doctor what will happen if the proposed treatment doesn’t work. Ask how long you will wait for results before deciding it has or hasn’t worked. You should also ask if you can pursue a different course of treatment and what that might look like.

Feel comfortable asking your physician any and all of the questions you can think of until you are completely satisfied and feel supported.

8. How long will I need to be on treatment? 

Each treatment and person are unique, but you will find it is generally recommended you stay on your chosen treatment from anywhere from a few weeks to a few months. Ask your doctor what is best for you. 

9.  How often will I need to see you? 

Depending on your treatment plan and unique needs, your doctor will request regular check-ups that may be monthly or every few months. These may also vary in frequency at different stages of your treatment.

10. What do I do if I get a new patch? 

If you get a new patch and are using a topical treatment, your doctor may recommend you apply the treatment to the new patch. Make sure you are kind to yourself and try not to worry if a new patch appears. 

11. Are there any natural treatments or diets that I can start?

As there is no known cause on what triggers the onset of Alopecia Areata, it is impossible to state with certainty that a change in diet or a natural treatment will help or not.  As Alopecia Areata is known to be an autoimmune disease, anything that promotes increasing the immunity can be seen as an option. 

12. What Are the Rates of Relapse and Remission?

According to this study, results have shown that  40% of people with a hair loss patch will not develop another patch of hair loss and will achieve spontaneous and complete durable remission within 6 months. An additional 27% will develop an additional patch of hair loss but will still achieve complete durable remission within one year. 33% of individuals will develop chronic alopecia areata, which is defined as alopecia areata that lasts longer than 1 year. 

The course of alopecia areata is unpredictable and your doctor will not be able to tell you where you fit into these statistics. However, it’s important to note that without systemic treatment 55% of those individuals with chronic AA will experience patches of hair loss regularly with some regrowth. 

13. What Are the Costs?

Costs will relate to the type of treatment you’re taking and how often you have to visit the doctor. Be sure to ask your doctor for the cost of your treatment & visits.

What you have to pay out of pocket to cover those costs is unique to your private health insurance, the state in which you live, and your specific needs or medications. Some medications may be covered by your private or state health insurance, whilst others may not be. The same can be said for the costs of wigs.

It is recognised that alopecia doesn’t receive the same financial support from government bodies or private foundations that other conditions, such as cancer does. It’s for this reason that we’ve put together a sponsorship program to alleviate some of the financial burden of alopecia areata treatments. Learn more about our sponsorship program here.

An example of costs might be: 

Visit to the GP for a referral and initial consultation: 

Depending on what your GP charges, if they bulk bill or whether you belong to a health co-op or have a health care card, the normal Medicare rebate is $36.30 (as of 29.4.2021). 

It is better to have a referral for specialist appointments because then you can claim a Medicare subsidy), otherwise if you do not have a referral then you don’t get that amount covered.

Initial dermatologist visit: 

Up to $300 for an initial visit according to Melbourne Skin & Dermatology.  The normal Medicare rebate is around $75.05 and you may be able to claim this on your private health insurance.   Should you wish to travel to a major city to see a dermatologist, you will need to consider your travel costs. 

Blood work: This may be bulk billed and covered by Medicare. Consult to see what Medicare covers for your unique treatment plan. 

Treatment: The cost of your treatment will depend on the treatment you pursue. Options include but are not limited to: Corticosteroids, Topical sensitizers, Minoxidil, Anthralin, Platelet-Rich Plasma (PRP), Immunomodulators, Trichology, Scalp Micro Pigmentation, Hair Growth Based Vitamin Products.  Some drugs, such as tofacitinib, that are used to treat AA are also used to treat other illness and disease and are on the Pharmaceutical Benefit Scheme (PBS), you can consult the PBS here. 

Some PBS drugs have a specified condition for which you can claim the PBS subsidy price – Alopecia Areata is often not recognised. It means you have to pay the full price for that drug because it isn’t a recognised drug to treat AA by the PBS. 

14. What Other Types of Support is Out There?

Whether or not you are pursuing treatment, hair loss can have deep psychological impacts on the individuals who experience it. It’s helpful to connect with people who have gone through similar experiences. 

Ask your doctor if they have any information about support groups in your area. Or, check out these AAAF support groups to connect with others who can provide support, advice, and friendship.

15. If I wear a wig/hat will it stop the treatment working? 

No, there is no evidence to suggest that headcovers change the efficacy of any treatment. You can wear as many hats, scarves or wigs as you like! 

16. Any tips on how to manage my existing hair?

You can manage existing hair in many ways. You do not need to shave your hair when you have alopecia areata. You may choose to, but you do not have to. You get to decide what best suits you.  Some people prefer to use bandanas, hats, toppers, wigs, or to shave.

17. When new hair grows what can I expect?

Your hair may grow back the same as it was before, or it may be slightly different. There is no way to know until it does. Some people find that to start the hair grows back white before taking on a colour. You may wonder if you can colour the hair. Colouring may weaken the hair, but it doesn’t affect the hair root. If you decide to colour it is more likely to snap and not grow to full length, but it doesn’t prevent the hair from regeneration.