All posts by Hair Loss Team

We frequently have to tell women that there is no cure for Alopecia Areata – and that is still the case. But there is finally a treatment which has some prospect of success in reducing its worst effects.

Litfulo

A new drug called Litfulo is now available from Pfizer and was approved in November 2023 for use in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) for severe alopecia areata in patients 12 years and older. It has also recently been approved by the US and Canadian health authorities.

It’s the trade name of a drug with the tongue-twisting pharmaceutical name ritlecitinib, and is a type of drug known as enzyme inhibitors – it essentially reduces the activity of two types of enzymes which cause inflammation in the hair follicles.

It may not work for everyone, although it has shown promise in clinical studies – in Pfizer’s study of 718 people, 31% of those who had at least 50% hair loss improved to only 20% hair loss after taking the drug for five and a half months.

Drawbacks and side-effects

However before you get your hopes up too much there are some drawbacks.

  • Firstly it is very expensive – the cost in the US is expected to be an eye-watering $49,000 for a years supply. There is no word yet whether it will ever be offered on the NHS, but at that price it seems unlikely.
  • Secondly it appears that if you stop taking it the likelihood is that the alopecia will return, so it’s not a cure and the cost is not a one-off expense.
  • Thirdly there are some side-effects – increased risk of contracting infections, including upper respiratory infections and tuberculosis, headaches, dizziness, diarrhoea, and folliculitis.

However it is at least a first step towards an effective treatment – and that’s something we haven’t had before now – so there is hope for the future.

The problems of hair loss due to alopecia were highlighted last year by an unfortunate joke told at the Oscar ceremonies.  That triggered actor Will Smith to slap the comedian who told it – Smith felt it was pointed at his wife, Jada Pinkett Smith, who suffers from the condition. The video of this was soon being shown all round the world and produced considerable discussion on social media.

There are a number of different types of alopecia and this article explains what they are and the differences between them.

Alopecia areata

Francesca before intralaceThis is one of the most commonly reported types of hair loss, referring to bald patches or spots on the scalp.(areata simply mean patchy)

It is considered to be an auto-immune disorder and can appear at any age, although there seems to be a bias towards younger people. Stress and emotional trauma, such as a bereavement, are commonly reported as triggers.

There seems to be some tendancy towards a genetic connection – if one of your parents had it there’s a slightly greater chance that you may get it – but it’s not considered a major factor.

The progress of AA can be very unpredictable – sometimes the hair grows back and the problem goes away, but it can just as easily recur without warning or fresh patches appear in different places. Some people can suffer a recurring cycle of loss and regrowth for many years. Medical treatments are similarly unpredictable – what works for one person may not work for another.

Read more information and examples of our approach to disguising it.

Alopecia totalis

alopecia totalisThis version of alopecia affects the whole of the head, often including eyelashes and eyebrows.

It’s a more advanced stage of alopecia areata, which progresses to totalis and universalis in around 1 – 2 per cent of cases.

Alopecia universalis

This term relates to hair loss all over the body, meaning that the entire epidermis is free from hair. It is the most severe form of alopecia areata, and  is therefore quite rare, occurring only in around 1 in 100,000 people. It came to public attention in the 1980s when Olympic swimming gold medallist Duncan Goodhew revealed he suffered from it.

Androgenetic Alopecia

Commonly know as Pattern Hair Loss there are male and female versions which are different in appearance. The male pattern normally recedes from the front or the temples, leaving a bald area in its wake, whereas the female patttern is much more diffuse – showing as thinnning over the head in general. More information on Female Pattern Hair Loss.

Frontal Fibrosing Alopecia

frontal fibrosing alopeciaAlso known as Scarring Alopecia or Cicatricial Alopecia, it was only identified as recently as 1994 but seems to be becoming more common.

As with the related condition Lichen Planopilaris, this type of hair loss is permanent due to the scar tissue generated by the inflammation that causes it.  The hair follicles are destroyed and cannot grow back.

It is characterised by a receding of the hairline at the front and sides of the scalp. More information on FFA.

Traction Alopecia

This is where hair falls out due to physical stress on the follicles – usually caused by overly-tight hair styles such as severe ponytails, tight buns or cornrows, or by badly-fitted and/or too heavy extensions or weaves. If the cause is discontinued the hair may return to normal but if it has been going on for too long their may be permanent damage.

There are No Cures…

While there are various creams and medicines which can help some of these conditions in some cases, for instance corticosteroid immunosuppressants are sometimes prescribed for the autoimmune types, there are no definite cures, and some of the treatments have side-effects or are only suitable for men. Such treatments should only be used under medical advice and we do not offer them. However we do recommend that medical advice is sought at the onset of sudden hair loss in case it is an indicator of another disease or condition.

…but there are ways to look good

Francesca
The lady in the first photograph above looks like this with her Intralace System

We can disguise female hair loss very effectively with a variety of hair systems which we have developed and pioneered over the last four decades. These include the Intralace System options and ultra-fine hair extensions called Medi Connections.

 

If you’d like to explore those options then come and talk to us and we can asses the best approach for you. In the UK we have six studios across the country, with a new studio in Newcastle due to open in summer 2023.

Contact details and/or enquiry forms are on the following pages:

Manchester was the second hair loss specialist studio we opened in the UK away back in 2009 and it’s been a great success. So much so that in the years since then we’ve often had to run waiting lists due to the demand for our services, and have looked a various options for expansion.

We’re delighted to say that we’ve now secured the floor above our current premises and work is starting on fitting it out. So we’ll now be able to provide more immediate appointments with no delays, and all without having to move from our present central position.

We’re planning on opening it up for use around the end of June 2023 and we’ll post photos of the new space and further details of the opening date as we get nearer the time.

Why we make our studios as luxurious and pampering as we can

While the vast majority of our clients are delighted by our services, we are occasionally criticised on forums for being too expensive and for spending money on fancy facilities rather than trying to keep the cost of our systems as low as possible, so I’d like to explain the reasons why we adopt the approach that we do.

Experiencing hair styling

with normal hair

Most women who have never experienced hair loss will regularly visit hairdressers to have their hair styled and taken care of – they usually enjoy the experience, look forward to going, and appreciate the results and the lift it gives them. The stylists are used to working with normal full hair and having plenty of options to offer their customers.

with hair loss

However the experience of those with hair loss is very different. If you have Alopecia for instance then you may be trying to cover up patches of skin which may be empty of hair. If you’ve suffered from Trichotillomania from teenage years then you may have been too embarrassed to visit a normal hairdresser for most of your life – the thought of admitting that you have sparse areas or overall thinning – and that you did it to yourself – is unthinkable. Even if you were brave enough the stylists will probably have little understanding of what they could do to help you and may even be scared to try because it’s outside their experience and training.

Again and again we hear these sorts of stories from the women who come to us – they’ve felt cut off from support and unable to even access the sort of normal hairdressing service that others take for granted.

Fortunately having once experienced our approach they are almost invariably enthusiastic about what we do.

The importance of being relaxed and comfortable…

Our idea is that you need to make managing hair loss an enjoyable experience – because the misery and depression that often accompanies female hair problems runs deep, and needs to be tackled along with the physical issues in order for many of these women to recapture their confidence and vitality.

Some hair loss “clinics” are rather cold and medically-oriented – the emphasis is on treating a disease – but does that do anything for the client’s psychological needs; their anxieties and their often long-established feelings of lack of confidence and reduced femininity?

… and of feeling safe and understood

So we try to make our studios somewhere that our clients will enjoy spending the day in – after all if they are having a complete system fitted then it is an all-day process. Comfortable furniture and surroundings, a warm and welcoming environment with little luxuries to make your day a positive experience, plenty to read or watch, tea and coffee, or wine or soft drinks if desired – all these help you feel valued and relaxed and ready to look and feel your best.

Just as important we recruit our staff not just for their skills with hair and the ability to create natural-looking results with our systems, but also for their empathy and ability to take good care of their clients – and to enjoy doing so! A recurring theme is how fulfilling they find the work they do.

We believe this approach works, and from the feedback we receive our clients seem to agree with us. Watching their glowing expressions with their new hair confirms it too.

It can’t be done on the cheap

Now we’d love to be able to offer the same service to everyone who needs it, whatever their circumstances, but unfortunately good materials and good quality hair costs money. If we used cheaper materials then the results wouldn’t be as convincing and they wouldn’t last as long. If we didn’t spend the time and attention to detail that we do then again the results would be poorer: the benefits wouldn’t be anything like as positive as they are. Our clients wouldn’t get the often life-changing boost that we are able to give them.

Sometimes a little luxury is the only way to get the right result!

Hair replacement systems for women versus Human hair wigs

Deciding what the best solution is for your hair loss is a very personal process which can depend on a number of factors, for instance:

  • The type of hair loss you have
    Is it patchy, overall, thinning, or receding?
  • The extent of your hair loss
    It can be mild thinning to complete baldness
  • Whether your hair is growing back or not
  • Your age
  • What type of activities you like to take part in
    Are you a sporty person, an outdoor enthusiast, or are you engaged in a regular round of social events?
  • Whether you have a partner or not and want to look your best for them all the time
  • Whether you want a 24/7 solution or are happy with a temporary one

FrancescaAll these factors and more may be relevant to your choice and it’s important to understand how the different methods of attachment and different approaches to wearing the various types of wigs and hair systems can be accommodated into your lifestyle and daily routines.

The choice is often confused by perceptions that may be out of date or skewed by images of men’s wigs and hair pieces – which seem to be more prevalent in the media than women’s ones – or by cheap “glamour” wigs.

Cover up or disguise?

Fundamentally there are two approaches:

  • To cover up the hair loss completely – which is basically what full wigs do – by hiding the existing hair (if any) completely.
  • To disguise the problem by adding new hair to the existing hair and blending the two types together.

Of course it’s not entirely black and white, and there are examples of partial coverage from both sides of the spectrum, but this can be a good way to think about them initially.

Activity types – matching your hair to what you like doing

If you are the sort of person who regularly goes running, or swimming, or plays a lot of sports then that may be a major factor in your choice. If you want something that will be secure and easily washable and will allow you to look good at the same time then a hair system is likely to be the best choice, unless you are happy to be seen removing a wig before taking part and replacing it later.

Alternatively if you are more of a social person and regularly attend functions or meet friends and want to swap looks and styles easily, then a wig or selection of wigs may give you a flexibility that suits your lifestyle more than a system.

24/7 or temporary?

JoeleneFor some women what matters is looking and feeling good in specific circumstances while for others it’s an overall feeling of confidence that’s the key consideration. If you are happy to remove a wig when you get home or go to bed then that may suit you best, but if you want to be able to forget about your hair loss and get back to a full-time normal feeling then it’s likely that a hair system will be a far better solution.

Many women, particularly with partners, feel very self-conscious removing a wig as it makes them feel less attractive and “incomplete”, so having a hair system that doesn’t need to be removed in a day-to-day setting helps them to feel fully themselves all the time.

Connecting to your hair

How your chosen solution attaches to your existing hair can also greatly affect your final choice. It’s common to see images of men’s toupees being glued or taped into place on a bald head, but unless you have complete hair loss – Alopecia Totalis – it’s much less common for a woman to have to use such a method. That’s because women usually have some remaining hair, and that can usually be used as a base; although sometimes a much smaller section of hair may be fixed by an adhesive method to cover a receding hairline in a case such as Lichen Planopilaris.

With partial wigs or toppers it is more common in women to use clips to help secure them to your remaining hair, and that method can also be used with clip-in extensions for volume. While with hair systems it is more common to have a method of integrating the new hair into your own hair. That can be by using a mesh system as with our Intralace Systems or by gluing extensions to existing hair as we do with our Medi Connections.

The main question here is what feels secure and comfortable for you. Clips sometimes need adjusting and tape and glues on the scalp can lose their adhesion or sometimes cause irritation. If that is a concern for you then you may well feel better with a system that has more durable connections to your own hair.

Maintenance of your hair choice

Another consideration that may affect your decision is maintenance. Both wigs and hair systems require looking after, but with wigs it’s down to you to keep them clean and well conditioned, whereas with a hair system they can normally be washed as a normal part of your daily routine, while there are other aspects of keeping them well maintained that the salon will do for you at regular visits. In the case of systems that are connected to your own hair these will need adjustment as your hair grows – otherwise the system will gradually become loose.

Both wigs and hair system will wear out in time, and generally speaking the more you pay for them the longer they will last.

Costs

Good hair systems and regular maintenance are not cheap – although compared to regular trips to the hairdressers they may not be too much more. Wigs have improved in quality and appearance in the last couple of decades but good ones are also not cheap, and if you want to have more than one for changing styles then they soon add up. So overall costs may be quite similar and it will ultimately depend on what you think is acceptable in terms of appearance and realism.

The final decision

Now we have to declare that we’re biased. We don’t make conventional wigs, although our Intralace Freewear systems are perhaps closer to wigs than to systems in some ways. We think our systems, along with their associated hair partings and fringes, which we’ve developed and refined over four decades (and which are even patented in the US) are often the most suitable solutions for the many women who come to us for help.

However we’re fully aware that there is no universal solution that suits everyone and we’ll always try to advise our clients on what best for them – not for us. We won’t ever pressure you into something that you don’t feel is right for your situation. The final choice is yours after you’ve explored all the options. Come and talk to us and let’s explore those options together.

Tel: 0208 741 8224 or use any of our UK contact forms for:
London
Manchester
Edinburgh
Midlands (Solihul)
Bristol
Southampton