For the average balding person reading your manuscript -Combination therapy with zinc gluconate and PUVA for alopecia areata totalis: an adjunctive but crucial role of zinc supplementation-, what would you say is the key point they should know from your experience and report?

To consult a dermatologist if they suffer from alopecia areata, to take zinc alone or with local treatment if alopecia areata is recent, and zinc in combination with an immunosuppressive treatment if alopecia areata is totalis.

Do you test all your hair loss patients for zinc levels?

Quite all my patients are tested. In most patients, the zinc levels, if normal, are in the lowest quartile, or indicate marginal zinc deficiency. I also check vitamin D, as vitamin D deficiency limits zinc absorption.

Once you start zinc therapy, do you re-check levels, and how often?

I re-check zinc levels every 6 months if the patient is given 30 mg zinc per day, and every year if the patient is given 15 mg per day ( RDA )

Would a scalp biopsy and measuring zinc levels in tissue be of any help?

It would be interesting, but I don’t know in which laboratory it could be measured.

Do you always recommend minoxidil or other adjustments to your hair loss patients?

In alopecia areata, it depends of the patient. In androgenetic alopecia, yes I do.

What do you think will be the next big break through in hair loss and/or hair transplants?

The next big break through in alopecia areata may be development in genetic epidemiology to better understand the disease.

Do you plan a follow up report and/or study?

I hope so, including more patients and with contribution of other dermatologists.

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