Early Treatment to prevent Alopecia Areata Progression (E-TAAP) Alopecia UK funds invested: £4350 When: March 2018 Start date: September 2020 Project type: Feasibility work to optimise study design Project Lead: Dr Matthew Harries Length of project: 18 months – 2 years Research Institute: Salford Royal NHS Foundation Trust Condition of interest: Children and adults with first episode patchy scalp alopecia areata (AA) Funds being used for: whole feasibility study including focus groups, statistical support, study team costs, specialist IT support for development of surveys and data management, and printing costs. Research question: Can progression of alopecia areata be prevented by early diagnosis and treatment? Justification for research project: There is no robust evidence that any treatment improves the long-term outcomes in AA. The British Association of Dermatologists guidelines currently recommend conservative management as an option for limited patchy AA. However, further episodes of hair loss are common in AA and progression to more extensive disease (from which spontaneous re-growth is unlikely) is well recognised, particularly in those with more extensive or longstanding alopecia at presentation. This study hypothesises that the early identification and treatment of AA at first presentation will increase hair regrowth rates and reduce the risk of relapse and disease progression in the longer term. This pilot work will help inform study design and strengthen a bid for a larger, prospective, multi-centre RCT in AA. If early treatment does improve longer term outcomes this will lead to a paradigm shift in AA management in the UK, with early effective therapy being instituted in primary care and reducing onward referrals to secondary care. Lower numbers of patients progressing to extensive alopecia areata will not only reduce the overall psychological impact of the disease, but will lower treatment costs and diminish wig provision requirements, with significant cost benefit to the NHS. Who is leading the project: The project is being run by Dr Matthew Harries who is a Consultant Dermatologist and Honorary Senior Lecturer in Manchester. The majority of his research experience has been with translational hair loss clinical studies during his PhD (awarded in 2011) and in various studies since. Dr Harries was the co-champion and clinical lead for the hair loss and alopecia areata priority setting partnerships (PSP) run in conjunction with the James Lind Alliance and Alopecia UK. He runs a regional specialist hair loss service with a large AA cohort. Dr Harries will be working alongside a team of people including clinicians, researchers and patient representatives.