In this feature video, Dr Benjamin Ungar discussed his Mount Sinai Symposium session's focus on the epidemiology of alopecia areata (AA), which covered its frequency, risk factors, and populations most affected.

Benjamin Ungar, MD, is an assistant professor of dermatology; director, Rosacea & Seborrheic Dermatitis Clinic, Mount Sinai, New York City, NY.

Transcript:

Can you go over what your session will cover regarding the epidemiology of AA?
Dr Benjamin Ungar: Before I answer that question, I'll just, note that, you know, my session, my talk is part of a bigger symposium meeting about alopecia areata. Looking at various different aspects of the disease, you know, the pathogenesis, the treatments. Importantly, there are, sessions where we hear from patients who are suffering from the condition both in terms of, the disease itself, the treatments, and so on. So, you know, that in many respects is the most impactful, most important part of it. However, you know, it certainly, it's important to understand, you know, who suffers from this disease, who is likely to get it, and so on. And so, the epidemiology of that is very important.

So, my session regarding the epidemiology of alopecia areata is going to discuss, you know, I mean, essentially, the epidemiology. So, you know, how frequent it is, how often people, develop the condition, you know, what the basis for our understanding of what that is because, you know, epidemiology often can be very difficult to study. Different populations, different countries, can, different method methodologies. So, there are many ways to look at it, and, you know, part of the goal of my session is to paint an overview and kind of put together all the data in a way that gives us an approximation and understanding of how common this is, what age groups are affected, you know, whether there are different demographics that are more affected than others, and then as well as that the other kinds of, medical conditions and diseases that are more common or potentially less common, with alopecia areata as well.

What risk factors are associated with AA that you'll be covering?
Dr Benjamin Ungar: I'm going to be discussing risk factors associated with AA and then, you know, medical conditions that are associated with it. And sometimes there are, what we call bidirectional associations where one condition makes AA more likely, and having AA makes other conditions more likely. And so, the number 1 condition that goes with, alopecia areata, and this is a bidirectional association as well is atopic dermatitis. So atopic dermatitis, eczema, is the most common condition that go hand in hand with alopecia areata. More broadly, other atopic conditions, are also very common. So, asthma, seasonal allergies, and so on, all have a strong relationship with alopecia areata as well.

There are other risk factors such as, you know, having a family history of alopecia areata that will increase the odds of someone having, alopecia areata as well. That go hand in hand are still being uncovered and under, understood more broadly speaking, but I would say those are probably the 2 most important ones. And then on kind of the flip side, you know, having alopecia areata also increases the risk of other conditions like thyroid disease, other autoimmune conditions as well. And, you know, depending on the study, these kinds of, the percentages and how common these are, can vary a bit. However, though those are pretty well established as conditions that have an increased risk in in patients with alopecia areata.

In your experience, what are the challenges and considerations when managing patients with alopecia areata, and its comorbidities?
Dr Benjamin Ungar: Alopecia areata for a long time, and I think, unfortunately, you know, from some perspectives, it has been and still is considered a quote-unquote cosmetic condition. You know, people will say something like it's only hair. And the reality is that alopecia areata is a very serious condition that has a tremendous negative, impact on patients who suffer from it. And so one of the challenges is making sure that, it's treated with the appropriate, significance, and kind of the appropriate, gravity that it deserves. You know, that's not a that's not a challenge, you know, from my perspective in terms of the way I approach it, and it's not a challenge from the patient's perspective in terms of how they are experiencing it, but it is a challenge Just kind of big picture, to make sure that people understand that.

And then beyond that the part of the challenge and considerations comes, in mind with other conditions that go along with it. You know? So, whether that is making sure that the patient's also not suffering from, thyroid disease, making sure that the treatments are appropriately addressing their eczema, asthma, and so on. One of the things that has happened very commonly in my experience is that people with alopecia areata, have such an impact on them that they focus on that condition. I don't want to say to the exclusion of other things, but with such a, you know, a serious focus that they're not always considering the other conditions that they may be dealing with as well.

And so, one of the important things is that we treat the alopecia areata as effectively as possible while also treating the patient holistically in terms of others that they may be dealing with this as well.

What else would you like to share with your colleagues regarding your session at Mount Sinai Symposium?
Dr Benjamin Ungar: I think that the symposium, it really is an excellent opportunity to learn about alopecia areata from all sorts of different perspectives. From the academic sort of medical perspective, it's the epidemiology, comorbidities, disease, pathogenesis, treatments, and so on. So, you know, treatment approaches. So, all of that's very important. And then I think perhaps most importantly is to hear from patients themselves who, who are suffering from alopecia areata. There's going to be, an opportunity to hear from the patients. And, you know, it's really, really hard to over overstate how impactful hearing from the patients, really can be.

You know, I treat many patients with alopecia areata and have them in the office, and we discuss, you know hopefully, the best approaches to have a nice clinical response to re grow their hair and so on. But even for me, hearing from the patients in these sessions Always has a, you know, an incredible impact to really understand just how significant this is to people who are, suffering from alopecia areata.

And I know in speaking with my colleagues that, essentially, everyone who listens to another session, has the same experience where they leave it, you know, kind of a with a new appreciation for just how big a deal this is for patients. And so, if there's really one thing that I can kind of, share and emphasize is really hearing from the patients.