VIDEO: No data to support non-pharmacologic treatment options for alopecia areata

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So, when we think about the treatment of alopecia areata, it is really natural for us to wonder, can I make this better with diet? Can I make this better with some behavioral change? Can I make this better with an antidepressant or an anxiolytic? Because we have been told for decades that alopecia areata is caused by stress, and there is actually a little bit of data, a little bit of investigation into this idea of using an antidepressant or an anxiolytic for treatment. I don’t think that there’s any data to support that those things are beneficial. Then when we think about diet, exercise, the role of vitamin D in autoimmune disease gets a lot of play. And here again, there’s no data to support that any dietary manipulation, any vitamin or other supplement is going to change the course of alopecia areata. Now, that’s not to say that if somebody is profoundly vitamin D deficient that they shouldn’t get treatment for vitamin D deficiency. It’s just a leap that’s unsupported by evidence that treating that vitamin D deficiency is going to make their alopecia areata better. And so really, when we think about what I like to call reliably effective treatment of alopecia areata, we’re really reaching for medicines like intralesional corticosteroids, even oral minoxidil or medicine that has been around for quite some time, and for which there’s data to support its use in alopecia areata. And then like I said, the role of JAK inhibitors, oral JAK inhibitors in particular.