Approximately 6.7 million people suffer from Alopecia Areata in the United States, and up till now there has been little in the way of treatment and no sign at all of a cure. That has improved slightly with the news of the approval of a new drug by the Food and Drug Administration.

Litfulo from Pfizer was approved for use in the US in June 2023, and has since been approved in the UK in November and in Canada in December, as being suitable for use in patients age 12 and over with severe symptoms.

The pharmaceutical name, if you can get your tongue around it, is ritlecitinib, and its an enzyme inhibitor which targets what is known as the JAK pathway – which is the part of the immune system which causes the hair follicles to stop growing.

Litfulo may not work for everyone, although it has shown considerable promise in clinical studies so far – 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. However it will only be after more people have taken the drug and the data from that is assessed, that its true potential will become clear.

Expensive, and there are side-effects

The bad news is that the drug is expected to cost around $49,000 for a years supply. What that will translate to will depend on your health insurance and whether it is covered by it. There are also some side-effects to be aware of: increased risk of contracting infections, including upper respiratory infections and tuberculosis, and the possibility of headaches, dizziness, diarrhoea, and folliculitis.

It should also be noted that the alopecia is likely to return if you stop taking the drug. So it isn’t a cure and whatever the cost turns out to be it may need to be an on-going one for as long as your immune system remains in overdrive.

It is however a promising step towards a time when further research and development may give us a better way of controlling this distressing condition.

Until then our techniques for disguising Alopecia remain one of the few methods of helping women who suffer from it. If you’d like to read more about those techniques then please visit our Alopecia Areata page.

Why we make our US 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; both visually and for the psychological lift it gives them. The stylists are used to working with normal full hair and having plenty of options such as colors and styles to offer their customers.

with hair loss

However the experience of those with hair loss is often 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 your teenage years then you may have been too embarrassed to visit a normal hair salon 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. With these and other hair loss conditions even doctors may not be able to offer support.

We hear these sorts of stories from the women who come to us all the time – they’ve felt cut off from support, cannot find anyone who understands their worries, and unable to even access the sort of normal hairdressing service that others take for granted.

This is where we try to provide an environment and a level of encouragement and assistance that helps our clients to feel normal while we make their hair look good.

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 and visual 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, and, particularly in the US, clients may be travelling long distances to reach us.

Comfortable soft furnishings 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. And to feel that you deserve it!

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.

– – – – –

If you’d like to speak to us about hair loss issues then either call us at one of our two US studios or use one of the contact forms, where you’ll also find details of our lcations, opening hours, and services.

Los Angeles contact form – – phone 310-288-0788

New York contact form – – phone 212-359-1641

If you’re outside the US then contact our London head office via our UK website.

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.

UK 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.

Indeed Lucinda Ellery herself lost her hair at 9 years old after the death of her father.

Stress and Illness too

Stress and illness are also major factors – Kristin Davis and Tyra Banks have both spoken about having alopecia caused by their hectic and stressful schedules, while Alyssa Milano and Khloé Kardashian both lost substantial amounts of hair after suffering from Covid-19.

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

Client Laura showing the typical patches of Alopecia
Client Laura showing the typical patches of Alopecia

When our hair goes wrong for any reason, women are hesitant to trouble their doctor 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

Client Imogen had complete hair loss
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 please either call us or fill in one of our contact forms:

New York:    212-359-1641contact form

Los Angeles:    310-288-0788contact form

 

The problem of hair loss due to alopecia has recently been highlighted by the rather ill-judged joke told at the Oscar ceremonies which was followed by Will Smith’s slap of the comedian who he felt told it against Smith’s wife, Jada Pinkett Smith, who suffers from it.

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

Alopecia areata

This is one of the most commonly reported types of hair loss, referring to bald patches or spots on the scalp. It is considered to be an auto-immune disorder and can be very unpredictable – sometimes the hair grows back – but it can recur without warning or fresh patches appear in different places. More information and examples of our approach to disguising it.

Alopecia totalis

Sarah showing alopecia totalisThis is hair loss affecting the whole of the head, including eyelashes and eyebrows. It is 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 as such is quite rare, occurring only in around 1 in 100,000 people.

Androgenetic Alopecia

Known as Pattern Hair Loss there are male and female versions. The male pattern normally recedes from the front or the temples, whereas the female patttern is much more diffuse – thinnning over the head in general. More information on FPHL.

Frontal Fibrosing Alopecia

Melanie showing the effects of FFAAlso known as Scarring Alopecia or Cicatricial Alopecia, it was only identified as recently as 1994. 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 a severe ponytail, or by badly-fitted and/or too heavy extensions.

There are No Cures

While there are various creams and lotions which can help some of these conditions there are no cures, and most 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 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 and ultra-fine extensions called Medi Connections.

If you’d like to explore those otions then come and talk to us and we can asses the best approach for you. In the US we have studios at

9022 Burton Way
Beverly Hills
Tel: 310-288-0788
Inquiry form

and

Suite 607, 37 East 28th Street
New York City
Tel: 212-359-1641
Inquiry form

while if you are in the UK we have studios in London, Manchester, Edinburgh, Midlands (Solihull), Bristol, and Southampton. You can contact us there via our UK website.

Deciding on the best solution 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
  • The climate in your area – in the hotter states a wig may simply be too warm!

Francesca with IntralaceAll 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 blended 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’re 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’re happy to be seen removing a wig before taking part and replacing it later, which most women would baulk at.

Alternatively if you’re 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?

Joelene with IntralaceFor 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’re 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 far 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 important 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’ll probably 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 your 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 very 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 of course 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 here 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’s 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.

9022 Burton Way
Beverly Hills
Tel: 310-288-0788
Inquiry form

Or

Suite 607, 37 East 28th Street
New York
Tel: 212-359-1641
Inquiry form

After Covid-related delays we’re hoping to resume our US expansion plans this year with new studios in Chicago and Boston, so watch out for those or ask us to notify you when there’s more news.

The effects of the coronavirus on the mind and body are continually being discovered; recently, it’s come to light that many survivors are suffering from stress-related hair loss, a medical condition known as telogen effluvium.

Rather than being a symptom of Covid, doctors say that it is actually a side-effect of the virus.  It impacts the percentage of natural hair shedding (telogen) by as much as 50 percent. The devastating emotional impact leaves women confused, as telogen effluvium has a delayed start. It typically doesn’t occur until two to three months following the cause. In this case, Covid survivors and those who have suffered extreme stress and anxiety from the onset of the pandemic are experiencing greater hair loss now than when the outbreak began.

The Cause of Covid Stress Hair Loss

While many doctors report seeing increased cases of telogen effluvium among Covid survivors, there are also many who have been impacted without falling ill. The increased stress from living through a global health crisis can increase the body’s production of stress hormones, which worsen hair shedding and cause a variety of other symptoms including gastrointestinal problems, migraines, anxiety attacks and depression.

Dermatologist Dr. Shilpi Khetarpal spoke to the Cleveland Clinic about how stress can cause covid telogen effluvium. “At any given time, about 90% of our hair is growing, about 5% is resting and 5% is shedding,” she explained. “But when you have a major stress event or shock, up to 50% of hairs can be pushed into the shedding phase.”

Dr. Khetarpal also mentions that people who have a thyroid condition or Vitamin D deficiency are also more likely to experience excessive hair shedding. Balding from the coronavirus can also occur in serious cases; women who already suffer from trichotillomania or alopecia areata can experience worse symptoms due to higher levels of stress.

For those who have survived the virus, the long-term effects of covid on the immune system vary but include, among telogen effluvium:

  • Heart inflammation
  • Lung problems
  • Chronic fatigue
  • Insomnia and sleep disturbances
  • Loss of smell
  • Breathlessness and breathing difficulties
  • Headaches & dizziness
  • Difficulty concentrating

Every patient is different, and whether you are in recovery from the virus or trying to manage stress and anxiety caused by the pandemic, self-care is tremendously important.

What are the risk factors?

People who already experience hair loss, including thinning or balding, are more likely to experience excessive shedding as a result of high stress. Dr. Khetarpal also listed nutrition as a major influence. She explained that deficiencies of essential vitamins and minerals can cause the body to essentially “discard” hair to preserve its red blood cells.

She explained that people with low iron stores are more likely to suffer from anemia and hair loss. “If you have high iron stores, your body is going be able to support the hair more than, say, if you’re anemic and have other issues going on. The body doesn’t see the hair as essential, so if you have low iron stores, it’s going to shift that to make your red blood cells. It’s not going to focus on making hair. It’s just going to say, ‘Well, let the hair shed. We don’t need that.”

Does this mean taking iron supplements can help with hair loss and shedding? Possibly, but it’s only one solution that should first be discussed with a doctor.

How to Treat Telogen Effluvium

In cases unrelated to other hair loss conditions, coronavirus telogen effluvium can resolve on its own within six to nine months. You should continue your normal hair washing routine, but you may want to introduce a hair strengthening shampoo and conditioner to preserve the quality of your hair that’s still intact.

In addition to eating a healthy diet with plenty of fresh produce, you should also check in with your mental health. Mental health screening tools can help you monitor your stress and anxiety levels to manage them more effectively. Virtual therapy can put you in touch with a real therapist who can help you become more accepting of the current uncertainty and fear surrounding the pandemic.

Although you cannot control hair loss or its causes, taking the best possible care of yourself and reaching out for help when needed is your best line of defense.

Additional Resources:

What is telogen effluvium? – Harvard Health
https://www.health.harvard.edu/a_to_z/telogen-effluvium-a-to-z

COVID Stress Syndrome: What It Is and Why It Matters  Psychology Today
https://www.psychologytoday.com/us/blog/experimentations/202007/covid-stress-syndrome-what-it-is-and-why-it-matters

Telogen Effluvium: What Is It and What Can I Do? Healthline
https://www.healthline.com/health/telogen-effluvium