Direct and Hidden Costs with Alopecia: Support and Resources.

Alopecia areata is an autoimmune disease that causes patchy hair loss. Most cases develop before the age of 30, and many begin during childhood or adolescence, but onset can occur at any time during your life.

An autoimmune disease happens when your immune system mistakes healthy cells for intruders and attacks them. In the case of alopecia areata, your immune system targets your hair follicles. Autoimmune diseases are not contagious.

Hair loss from alopecia areata can be unpredictable. Sometimes, hair grows back without treatment and never falls out again. In other cases, hair loss and regrowth repeatedly occur after initially successful treatment.

For some, hair loss can be upsetting and difficult to cope with. Finding a cost-effective treatment that works can make a positive difference in your life.

Read on for information about alopecia areata treatment options and their costs.

Treatment costs

There are a few alopecia areata treatments to choose from, with a range of costs.

Treatment may not be covered by insurance for a couple of reasons:

• Many insurance providers consider alopecia areata treatments to be cosmetic rather than medically necessary.
• Most treatments are used “off-label” because prior to June 2022, no treatments were approved by the Food and Drug Administration (FDA) for alopecia areata.

Still, it’s worth checking with your insurance provider just to make sure.

According to the National Alopecia Areata Foundation (NAAF), about 40% of appeals for denied insurance claims are successful, so if your insurance company initially refuses to cover the cost of treatment, it’s worth the effort to submit an appeal.

Topical treatments

Applying a topical prescription corticosteroid to bald areas once or twice a day is an effective treatment for some people. For children with alopecia areata, this may be the only treatment they need.

Minoxidil (brand name Rogaine) can maintain hair regrowth after you finish corticosteroid treatment.

Anthralin is another topical medication your dermatologist might suggest. You may achieve better results if you use it with minoxidil.

Topical treatments can range in cost from $40 to $1,000, depending on how much treatment you need and where you buy it. Minoxidil is available at most drugstores and online.

Oral treatments

Immunomodulators like Janus kinase (JAK) inhibitors block the immune system response that causes hair loss in alopecia areata. They’re also used to treat other conditions like rheumatoid arthritis and certain blood disorders.

Tofacitinib (brand name Xeljanz) is a JAK inhibitor that may improve the effectiveness of corticosteroids, according to a 2022 study.

However, a 2022 review found the insurance coverage denial rate to be 97%, with the most common reason being that tofacitinib is not FDA-approved to treat alopecia areata. The costs can range widely from $80 to $4,700, depending on factors like insurance coverage and dose requirements.

On June 13, 2022, the FDA approved the first systemic treatment for severe alopecia areata: the oral tablet baricitinib (Olumiant). Without insurance coverage, baricitinib costs around $2,500 and $5,000 per month for 2-mg or 4-mg tablets, respectively.

Injections

Your dermatologist may suggest corticosteroids delivered through injections. This is a common treatment because it can more locally address hair loss.

For this treatment, you’ll have to visit your dermatologist’s office every 4 to 6 weeks. Corticosteroid injection treatment can cost $200 to $1,000 or more.

Platelet-rich plasma (PRP) therapy is another injectable treatment option. This procedure involves drawing your own blood platelets and injecting them into your scalp, where the increased blood supply can stimulate cell reproduction.

PRP costs about $500 to $2,500 per injection. Treatment usually consists of three or four injections 4 to 6 weeks apart, with maintenance injections every 4 to 6 months.

Mesotherapy involves injecting bioactive compounds, like vitamins and plant extracts, into the affected area. Depending on clinician preference, this treatment may occur weekly at first, then less frequently during the maintenance phase.

Mesotherapy typically costs $250 to $600 per session and may not be covered by insurance.

Laser and light therapy

Laser and light therapies are other treatment options for alopecia areata. Devices used to conduct these therapies include:

• excimer laser/lamp
• ultraviolet laser
• low-level laser
• thulium laser
• erbium-glass laser
• carbon dioxide laser

A 2020 review of studies found that excimer laser/light therapy produced favorable therapeutic results in people experiencing hair loss from alopecia areata. This therapy suppresses your immune system response by inducing cell death in certain immune cells.

Laser and light therapy may not be as effective if your hair loss is severe, so make sure to discuss this option with your doctor before purchasing a cap.

Depending on the number and grade of lasers and LEDs, the cost of light therapy caps can range from $550 to $2,500.

Hair transplant

Hair transplant surgery is a procedure where a surgeon moves hair from one area of your head to another. There are two types:

• Follicular unit transplantation (FUT): This involves the removal of a strip of scalp followed by follicle separation and transplantation.
• Follicular unit extraction (FUE): This involves the extraction and transplantation of individual hair follicles.

Hair transplants cost anywhere from $4,000 to $15,000. Insurance companies typically consider hair transplants cosmetic and may not provide coverage.

Wigs and other head coverings

Wigs are an effective way to camouflage hair loss. Synthetic wigs are more durable than human hair wigs but take longer to dry. Human hair wigs look more natural than their synthetic counterparts but may fade in sunlight.

Depending on the type of wig construction you select, the price can range from around $75 to $500. Here are the price ranges for several options:

• Basic wig cap: $75 to $150
• Lace front: $150 to $200
• Monofilament: $200 to $300
• Hand-tied cap: $300 to $500

You can also choose from a range of head coverings like scarves, caps, and comfort liners designed to fit under any type of hat. NAAF’s alopecia areata marketplace provides links to retailers selling these products.

Beauty treatments and grooming products

There are also personal grooming options you can try to manage hair loss, including:

• scalp scrubs
• soaps
• massagers
• hair clippers
• root touch-up sprays or concealers

The prices of these products may range from $10 to $200, depending on the brand you purchase.

If you’ve experienced alopecia-related eyelash loss, your dermatologist may suggest solutions to protect your eyes, including:

• glasses: $15 and up
• false eyelashes: $20 to $350
• medication for lash regrowth (such as bimatoprost): about $53 per ml on average

Injectable corticosteroids followed by minoxidil may help treat eyebrow loss. To cover up eyebrow loss, stick-on eyebrows cost $5 and up, while microblading and semi-permanent tattoos for eyebrows typically cost around $600.

Finding financial assistance

NAAF has a helpful resources page that can connect you to support and offer advice about insurance reimbursement.

NAAF’s Ascot Fund offers financial assistance up to $300 toward the purchase of a hairpiece to applicants who meet eligibility requirements.

Needy Meds is another resource that offers a directory of diagnosis-based alopecia areata assistance programs.

The takeaway

If alopecia areata is affecting your self-esteem and daily functioning, it’s worth it to make treatment a priority.

There are many options to treat or cover areas of hair loss. However, most insurance providers consider these treatments to be cosmetic and don’t provide coverage.

It’s always a good idea to check with your insurance provider though, rather than assuming there’s no financial assistance available.

If you’re looking for a dermatologist to treat alopecia areata, try using the American Academy of Dermatology Association’s search tool. For a pediatric dermatologist, try the Society for Pediatric Dermatology.