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!

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The NHS estimates that 8 million women in the UK suffer from some form of hair loss and The Washington Post reports that the figure for genetically inherited fining alone is 30 million women across the United States. Experts believe the true numbers of women dealing with hair loss are much higher however, because of the shame and despair felt by the hidden millions struggling to cope with the condition.

Research has proven that women with severe hair loss can experience deep psychological distress and intense emotional suffering. Hair loss for whatever reason – genetically inherited female-pattern baldness, the most common form of hair loss; age-related fining; alopecia in all its forms; or as a result of chemotherapy, surgery, accidents, scarring or the self-harm of hair-pulling – can result in behavioural changes and social withdrawal that give rise to personal and work-related problems.

Emotional trauma as a hair loss trigger

Emotional shocks are also believed to lead to actual hair loss, although the link is not clinically proven. But if you lose your hair in reaction to a bereavement or other grievous life or financial event this creates a vicious circle of being depressed about the follicles rapidly shedding, and potentially causing further thinning.

TV personality Ranvir Singh first lost her hair in patches at the tender age of eight when her father unexpectedly died. She admits that she suffers from ongoing insecurities because of it and has been frank about how she continues to manage outbreaks of alopecia at the age of 44.

“I feel dreadful,” Ranvir told the Lorraine show earlier this year. “I’ve always had a fringe. I’ve found ways to cover it. I use coloured sprays and things. I’ve got a patch in the middle, I’ve got a patch at the back.”

Ignorant criticism and abuse doesn’t help

Nothing more dramatically illustrates the abuse women can face over hair loss than beautiful actress Jada Pinkett Smith, dignified in a gorgeous green gown and rocking her shaved head, being publicly mocked in front of a global audience of millions over her alopecia, an autoimmune condition she can do nothing to alter, at the 2022 Oscars ceremony.

The taunt and the furious, punchy reaction of her husband Will Smith did have a positive outcome, however, in sparking worldwide debate about how hair loss impacts the female psyche.

Healing is needed, not judgement

Healing is the essence of what women seeking help for hair loss dream of achieving. Hair can, and sometimes does, grow back, but alopecia in particular is very fickle and there is no guarantee your hair won’t fall out again at some stage in reaction to illness or emotional stress.

Regrettably the world judges women – and men, too, but not as fiercely – on the state of their hair. How healthy, thick, glossy, styled, curled, straight, shaved it is, the colour and the texture, and how healthy and glossy and tempting it looks. Or not.

In an ageist society, any sign of baldness reminds us of our frailty and mortality, especially as modern medicine has yet to find a cure. Losing your hair gives rise to feelings of powerlessness as it shows our bodies are beyond our control.

Far more important than mere vanity

Laura showing her alopecia
Client Laura showing the effects of her alopecia

When our hair goes wrong for any reason, women are hesitant to trouble their GP about their follicular health, fearing that their concerns may be dismissed and well aware that hair loss is not fatal or dangerous, like cancer or heart trouble. Opinions aired about Jada later – including “why can’t she just wear a wig like everyone else” – proved that many people see female hair loss as a trivial issue and that women should just put up and shut up.

Losing your hair isn’t a death sentence, agreed, but for women the result is definitely life-limiting, in the most literal way. A woman can be scared their scalp may be exposed by a sudden gust of wind, a raindrop, or with a hat or beanie removed without the aid of a mirror. She will dread participation in sports, rainy or windy-day walks, or in activities such as cycling – what if the helmet lifts my hair afterwards to show hidden bald patches?

Perhaps the most damaging aspect is in a woman’s perception of herself as feminine – our concepts of not just beauty but the essence of femaleness itself is closely connected to hair and its flowing, silky appearance. Take that away and you remove an essential component of who you are.

Even professionals don’t always offer support

Imogen before and after
Client Imogen had complete hair loss before getting our Freewear System.

Women even hesitate to take the problem to a salon for professional advice. There is that icy fear of seeing a horrified reaction, or of hearing nothing can be done about it. Analysis by trained professionals of such a deeply personal problem needs to be empathetically and kindly delivered, and at times, depending on who they are or what they are privately struggling with, that is not available. All these variables make most women extremely cautious about taking anyone into their confidence.

As for getting romantic and your other half wanting to run their fingers through your hair – well, perish the thought.

It is actually quite astonishing that something that can affect so many women at some stage of our lives is still considered so shameful and embarrassing.

However, while we may not be able to reverse hair loss with medicines, nutrition or therapies – yet – there is hope.

Solutions – and a sympathetic ear

Modern medical hairdressing solutions such as the extensive suite of treatments offered by the Lucinda Ellery Consultancy, each individually and carefully tailored to the person in the salon chair, are a lifeline for women dealing with all forms of hair loss challenges.

Every single woman who visits any one of the Consultancy salons found across the UK and the USA will receive warm and supportive care. You will receive expert advice on a personalised hair system that can be cut and coloured in any way to suit you and your lifestyle. You will be shown how to look after and maintain and manage your beautiful new hair. Ongoing aftercare support is also available to all who desire it.

Science has some catching up to do in the field of hair loss but, with the help of Lucinda Ellery, you can feel and look good again with the appearance of a naturally healthy full head of hair.

Your beautiful new hair will lift you back up mentally and physically. The true, unquantifiable benefit of being thus restored in your own eyes, however – and in those of the people who matter – is the return to being the best version of you that you really are.

– – – – –

If you’d like to speak to us about hair loss issues then either call us on 0208 741 8224 or use one of our Contact forms on the main website for whichever studio is closest to you.
London – Manchester – Edinburgh – Midlands (Solihull) – Bristol – Southampton

How Lucinda Ellery has helped me overcome a lifetime of hair-pulling.

By Anna Bruning

The day, 20 years ago, I decided to finally request a meeting to discuss my hair loss at the Lucinda Ellery Consultancy ranks among one of the most important in my life.

It had taken me years to get up the courage to make that call to ask for the help with my hair I desperately needed – and to override that little voice within that told me no one and nothing would be able to undo the lifetime’s damage I had done to my follicles. And that I didn’t deserve it. So there!

I had been living with the secretive and ruinous desire to pull out my own hair since the age of 13. I craved that rush of serotonin release in response to a childhood of beatings, vicious putdowns and bullying both at home and in school. But of course the pulling that gives relief from emotional pain also creates it anew, with each fresh cycle of destruction. After all, hair is literally a woman’s crowning glory and there I was, turning mine into a patchy, scraggy mess. Desirable me just when I should be dating? Not exactly.

It is impossible to say what hurt more, the pulling or the realisation that I had just freshly re-sabotaged my brave, struggling follicles under constant attack.

Each time something upset me – and, like for most of us, things do, almost daily – my busy little fingers went cotton-picking straight up into my roots for that sharp nerve twinge, followed by sweet release.

By the time I made that call to the Lucinda Ellery Consultancy there was very little hair left on my head. It had become impossible to hide the large bald patches, even behind the permanent up-do that was my calling card. My partner said he loved me, but I didn’t love myself.

My hair issues hurt my confidence – and my career

My hair story definitely hurt my professional life. Rival colleagues sensed my secret vulnerability. People used to sneak up behind my desk and try to swiftly undo my hairclips.

“Go on, Anna, let your hair down,” was the bullying ‘joke’, fully aware that something was stopping me. For my birthday one year my office designed a collage card featuring my face topped with allegedly witty hairstyles – from Marie Antoinette-like tall-ship wigs to punk Mohicans, from Jennifer Aniston’s iconic ‘Rachel’ style to cornrows, an Afro, dreadlocks and more. Very amusing. Not. Needless to say, it all added to me feeling super unconfident. I never even considered putting my naked head above the parapet for promotion.

Now, after 30 years of unstoppable self-harm – giving in to the overwhelming craving for warm release after the pain of pulling, then knowing I had yet again destroyed weeks’ or months’ worth of hopeful regrowth – I was on the cusp of transformation.

Nervous ahead of the first consultation

I was shaking when I drove to meet the Lucinda Ellery team for the first time, unsure they could help me. Jumpy, I scraped the entire length of my brand new Mercedes. The car proved more expensive to fix than my hair has ever been!

The minute I was buzzed into the Consultancy all that fear dropped away. The salon is gorgeous: a bright, beautiful, safe, warm and welcoming space. I was greeted with genuine care. No one was judging. Everyone was there to help. Privacy and discretion guaranteed.

Best of all, I was told with sincerity and warmth that mine was not the worst case Lucinda Ellery had seen. In fact, I had plenty of natural hair on my head for them to work with.

I also heard for the first time that hair-pulling is surprisingly common. I had researched my condition and had come across the term Trichotillomania. Have to say, still not thrilled with the ‘mania’ element of the term that is cobbled together from various Greek medical words. And I had no idea how many women might suffer from this destructive impulse. I was pretty sure I was the only one. Back in the day, that sort of information simply wasn’t out there.

The salon had the reassurance. Although just under 2% of us worldwide have the condition, more commonly known as TTM, they explained that it is more prevalent among females. You just feel alone because we don’t exactly see TTM women power-posing their way across the planet, gleaming scalps signalling our sexual allure and feminine mojo. And I wasn’t mad. I was merely one of those (mainly starting in childhood, in response to events we cannot control) who find release in hurting their own largest and nearest vital organ, their skin – by worrying at it and its variations. Girls and boys skin-pick, nail-bite, hair-pull, cut, ink, score and pierce their skin. Taking it out on ourselves provides relief from circumstances we cannot alter.

Lucinda Ellery explained the various practical hair solutions the salon offers. It was made clear it was entirely my choice as to which system might best serve me.

I decided on the Intralace, where a fine mesh is placed over your own hair which is then lifted through it and attached to it. Hair is then added in any colour you desire. You can stick with your own shade or have your hair tinted to match what you’ve selected instead. The result is then styled very naturally in the shape and length you desire.

Normal everyday activities will not disturb the integrity of the Intralace, because it is attached to your own existing hair base. It will never fly off in wind, rain, gales, during sport, or while you’re getting romantic. Moreover, the system prevents you pulling or scratching your own hair underneath, giving your follicles a chance to heal and regenerate.

I could participate in daily life again without worrying that the Intralace would desert my head at the hint of a breeze or that scalp would show through come the teeniest drop of rain. No one would ever know, unless I chose to tell.

My dream hair

In contrast to previous salons where stylists had been hoity about being asked for a hot look – sorry (so not sorry!), your thin, miserable strands won’t achieve that, fnarr fnarr! – here I had been encouraged to bring in photos of what I dreamed of.

I wanted to go back to the long blonde hair of my early teens (before I started pulling). It is now me. I always ask for dark roots, to indicate healthy regrowth. My own hair continues to grow strongly, if inevitably patchily, underneath.

My first day back at work there were plenty of comments – mostly genuinely complimentary, but with the less civilised colleagues (every office has ’em) wondering out loud why I looked so different.  As time went on, any unusual interest in my appearance died down. I didn’t stand out for all the wrong reasons. The more confident new me finally had the courage to aim for – and attain – a senior professional role.

It’s your hair, you paid for it

After leaving the salon with your new hair, you will need to adjust. As I headed home wearing my first Intralace, that nagging inner voice told me my lovely blonde locks looked obviously fake. My new hair felt too thick, too blonde, too obviously added on. It didn’t feel like me. I was used to doing without.

I was warned the system initially might feel too closely fitted – but of course your own hair, which anchors it, continues to grow out, millimetre by millimetre, day by day. In just days that tightness definitely eases.

In fact, I enjoyed the Intralace being so deeply entwined with my own hair. I knew it wouldn’t come off unless I went back to the salon to beg them to remove it, and that was never going to happen.

It took me just one evening to get over any lingering doubts. By the next morning my Intralace felt as if it was entirely my own, as if I’d never been without it. With my mind basking under a flatteringly full head of hair, it reset to an entirely more positive view of myself and the world.

Best of all, no one would ever know. Unless I choose to tell, as I am telling you now.

© Anna Bruning

Anna Bruning is a former Sunday Times journalist. She has been a client of the Lucinda Ellery Consultancy for 20+ years

If you’d like to speak to us about hair pulling please call one of our studios or use our Trichotillomania Contact form.