In this feature video, Dr Atanaskova-Mesinkovska shares what she’ll be covering during her session, “What You Need To Know NOW About Alopecia Areata,” to be presented at the 2023 Fall Clinical Dermatology Conference.

Natasha Atanaskova Mesinkovska, MD, PhD, is an associate professor and vice chair for clinical research in the department of dermatology at the University of California in Irvine, CA.

Transcript:

What major points do you hope attendees can take away from your session?

Natasha Atanaskova Mesinkovska: So much is happening in alopecia areata. There are so many treatments. I think hair loss is going to be one of those things that we all feared and were worried and scared of because we didn't have too many tools. But now, there are medications. There are two newly approved medications, and we will discuss what to pick and when. Then if those medications don't suit somebody, what are some of the other options that people can use that are either not immunosuppressive or adjunct stuff such as minoxidil? So just a lot of exciting stuff when it comes to treatments.

What are the latest updates in treating alopecia areata?

Natasha Atanaskova Mesinkovska:  I think the biggest thing that has happened in the past year is the approval of two medications, both JAK inhibitors, one for adults and one for 12 and above, so including adolescents. Both of the medications, baricitinib and ritlecitinib, have really changed the way we approach the patients. But they are serious medications. They are medications that do need some monitoring. There is a boxed warning by the FDA for both. So I think as we approach treatment with these medications, we all need to learn couple of pointers, and I hope to bring some of those pearls from my experience and share others' thoughts as well.

What best practices should physicians implement in their practice when treating alopecia areata?

Natasha Atanaskova Mesinkovska:  I think the thing that we all are learning more and more and trying to understand is just the impact that alopecia has on our patients. Whether it's alopecia areata or androgenetic alopecia or any of the scarring alopecias that we're just learning more and more about every day, we know the impact and we see the impact, and we need to understand that when we approach the patient, because it's tough. The perception, our physical perception, is still one of the driving forces as to how we get embraced by society and how we do our daily lives.

The thing is, the medications are coming along and especially the strong ones. Some are going to be prescribed on label. Some are going to be prescribed off-label. But one of the initial things we have to discuss, I think, with patients is going to be what is their commitment, for us not to assume that this is what they want, and for also to discuss the chronicity and the longevity of the medications that we may be offering. Because a lot of the things that are out there right now, although exciting, do require longterm treatments. What does this mean when discussing hair loss with a woman who is about to get married and may have kids? These are things you have to ask. Maybe they are not the most PC questions that you can ask during an interview, but this is something you have to find out from your patients. So just the way we approach things, the discussions that we have about the longevity of the available therapies are things that I think are important.

Are there any tips or insights you’d like to share with your dermatologist colleagues regarding your session to be presented at Fall Clinical 2023?

Natasha Atanaskova Mesinkovska:  I think Fall Clinical is one of my favorite meetings because it's super clinical. I like things going to the point. I like things that are practical, boom, boom, boom, boom. So I think the way that my talk is going to be is going to be very informal. That's just my style. I am not a verbose person. We are going to literally be practical with tips, and I will tell you who to prescribe, what to prescribe, how to take it, what you can take, how long, what are people going to see, what are things we have to talk about, what labs to check, just things that are on daily practice clinical things.