To Treat or Not to Treat: Two Roads Traveled With Alopecia Areata

Alopecia areata (AA) can be a uniquely devastating disease with a profound psychosocial impact due to societal norms of human appearance and beauty. Empathetic physician-patient relationships have always been crucial to the management of AA, but given the new medical interventions now available, the "art of medicine" and understanding the whole patient may be even more important. In this essay, C.G., a dermatologist with AA, illustrates the personal decision to embrace baldness despite professional expertise in hair loss, while emphasizing patient-centered care and the importance of offering all available therapeutic options. Conversely, C.S.T., a medical student, shares her story of growing up with extensive AA, showcasing the transformative efficacy of Janus kinase (JAK) inhibitors in achieving hair regrowth and building self-identity. Together, these narratives underscore the complexity of managing AA, demonstrating how the option to treat or not to treat, driven by individual patient choice and evolving therapeutic advancements, can impact disease course, quality of life, and, ultimately, the trajectory of the AA patient's life.