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A new study explores the values and attitudes of physicians when helping patients choose an alopecia areata treatment. It may reveal the complexities of decision-making, potential communication barriers, and the possible role of shared decision-making tools.

  • Alopecia areata treatment decision-making involves considering a variety of treatment factors and patient characteristics.
  • Physicians express the need for improved communication tools to share information about alopecia areata treatment options.
  • Shared decision-making tools could help, provided they are balanced, efficient, and customizable for individual patients.

Alopecia areata (AA) is an autoimmune condition that leads to hair loss. The decision-making process regarding AA treatment is complex, often marked by uncertainty and frustration due to the multitude of treatment options and limited research data. According to a recent study published in JAAD International, physicians are a key player in this process, guiding patients in choosing treatments that align with their individual needs and preferences.

Assessing Factors in AA Treatment Decisions

In the study, dermatologists were interviewed to understand their approach when assisting patients in choosing AA treatments. Important considerations included treatment efficacy, safety, accessibility, and convenience. Patient characteristics such as demographics, disease severity, ability to adhere to medication, psychosocial burden, and personality traits were also factored in.

Interestingly, dermatologists preferred that patients gain information about AA treatments from professional dermatological organizations and physicians themselves. However, they recognized the role of patient testimonials and internet resources in patient education, highlighting the need for credible, professionally backed resources.

Exploring the Utility of a Shared Decision-Making Aid

Dermatologists indicated the potential benefits of a shared decision-making (SDM) tool in improving patient care and communication. This tool could help patients understand treatments better, simplify complex information, and provide a structured decision-making process. However, concerns were expressed about the tool’s potential lack of individualization, possible information overload, and the risk of patients prematurely anchoring on decisions without physician guidance.

Implications for Clinical Practice and Further Research

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The process of AA treatment decision-making is intricate and multi-faceted, involving the consideration of a multitude of variables. Barriers to effective communication and the complexity of decision-making suggest a potential role for an SDM tool.

For healthcare providers, understanding the challenges and nuances of this process can lead to more effective patient–physician interactions and higher-quality decisions that align with patient values and preferences. The possible implementation of an SDM tool in practice could be an area of further exploration, with future research required to gauge patient values when choosing an AA treatment.


Han, J. J., Manjaly, P., Lee, K., Kassamali, B., Kus, K. J., Perez-Chada, L. M., LaChance, A. H., Li, S. A., Senna, M. M., Huang, K. P., & Mostaghimi, A. (2022). Physician values in alopecia areata treatment decision-making: A qualitative assessment. JAAD International, 11, 14–23. https://doi.org/10.1016/j.jdin.2022.11.010