Treating scarring alopecia is hard work. The patient knows his or her hair the best and so has an incredibly valuable role in deciding whether a scarring alopecia is responding to treatment. A patient should not arrive a the appointment and say “I am here for my appointment. Tell me what you think, doctor!” That might be how it works when a patient arrives at the eye doctor for evaluating some sort of eye disease or at the kidney doctor for evaluating some type of kidney disease – but that’s not how it works for scarring hair loss.
Patients need to come to the appointment with their side of the story ready to share. If there were scalp symptoms at the last appointment, have they improved ? What treatment seems to help symptoms the best? Has hair shedding improved? What treatment has made the most impact? Have their been any new areas of scalp hair loss? What about eyebrow or eyelash or body hair loss? Photos should ideally be taken by the patient or his or her family at home every few months. This is time consuming, I know, but incredibly helpful.
Treatment of scarring alopecia is best viewed as a team effort. The patient’s role must not be underestimated. A doctor who looks at the scalp and says “Everything looks pretty quiet to me” must never stop there.
Well, treating scarring alopecia is much more about “we” than about “me.”
The doctor must turn to the patient and say “do we as a team think this disease has stopped? Let’s compare your photos from today’s visit to past visits or the one’s you have been taking at home.”
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