Our Microbiome Paper is Now Published
It’s a great joy to share our new paper exploring the gut microbiome and whether it should currently be considered part of an evidence-based treatment plan for patients with alopecia areata. The paper is available Open Access in the International Journal of Dermatology.
There has been growing interest in the “gut–skin axis” and whether gut dysbiosis may contribute to alopecia areata by influencing immune regulation, inflammation, and T-regulatory cell function. Patients are increasingly asking about probiotics, gut microbiome testing, dietary changes, and even fecal microbiota transplantation (FMT) as possible treatment strategies.
Is it worth adding these evaluations and treatments?
In this paper, we examined the available evidence surrounding microbiome-directed therapies in alopecia areata. While some small studies have identified potential bacterial biomarkers and very isolated reports have described hair regrowth following FMT, the overall evidence remains limited and inconsistent. A recent randomized trial of probiotics didn’t show a significant benefit.
We are grateful to Wiley and the International Journal of Dermatology for publishing this Viewpoint paper. At present, the science is simply not strong enough to support routine microbiome testing or microbiome-targeted therapies as standard care for alopecia areata. Probiotics, dietary interventions, and FMT remain interesting areas of investigation—but not yet part of the evidence-based treatment plan.
More rigorous longitudinal studies and stronger clinical trials are needed before these approaches can move from exciting theory to everyday clinical practice. Someday, we’ll better understand the link – and be able to better target therapies!
I’ve enjoyed working with our group on this subject. Congratulations to first author Dr Eric McMullen from the University of Toronto for leading the way and for all our great discussions on this topic. And thanks to all our colleagues for their wonderful insights and hard work!
Reference
McMullen E, Abdel Hafeez D, Pai N, et al. The gut microbiome as a therapeutic target in alopecia areata: not yet part of the patient treatment plan. Int J Dermatol.
