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What employers need to know about alopecia areata – Benefits Canada

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“It was a really difficult transition going from someone who was a redhead . . . to having no hair, no eyebrows, no eyelashes and staring [in the mirror] at someone I just didn’t know,” recalled Krahn, now the owner of Image Evolution by Freedom Wigs, during Benefits Canada’s 2023 Chronic Disease at Work conference in early February. “It was devastating and it really took me out and made me a shell of my current self.”

Read: Webinar coverage: How can alopecia areata affect benefits plan members?

Alopecia areata is an autoimmune disease caused by the body’s immune system attacking the hair follicles. Affecting roughly two per cent of people globally, the disease is typically chronic in nature and can start at any age, said Jeff Donovan, dermatologist at Donovan Hair Clinic, also speaking during the session, which was supported by Pfizer Canada Inc.

There are three types of alopecia: areata, which involves small or medium patches of hair loss that eventually grow back on their own or with treatment; totalis, which means complete hair loss on the head; and universalis, which is when someone experiences complete hair loss all over their body. Roughly five to 10 per cent of patients progress to total hair loss.

People who have one autoimmune condition are more likely to also experience others, something that’s true for those living with alopecia, said Donovan, noting many alopecia patients also have autoimmune thyroid disease. Eczema or atopic dermatitis, rheumatoid arthritis and pernicious anemia also occur in smaller numbers of patients.

Alopecia can be treated with cortisone creams or injections to reduce inflammation around the hair follicles, minoxidil to stimulate hair growth and, in cases of significant hair loss, immunosuppressive medications that are also used for other autoimmune conditions like rheumatoid arthritis or inflammatory bowel disease. 

Read: A primer for plan sponsors on autoimmune conditions

But Donovan noted that, while small patches of hair loss may respond well to treatment, it’s often much harder to treat significant hair loss. “We have a long way to go to improve the outcomes that we are able to achieve, but certainly new medications are on the horizon.” 

Indeed, he noted no Health Canada-approved treatments for alopecia currently exist, but treatment is key for many patients because it helps to reduce some of the psychological impacts associated with the disease. Given the profound emotional impact of hair loss, people living with alopecia face an increased risk of developing anxiety and depression.

A 2020 study in the Journal of Investigative Dermatology found 62 per cent of alopecia areata patients made “major life decisions” about their relationships, education and/or career due to their disease. Some studies have suggested more than 75 per cent have experienced a change in their quality of life after developing alopecia. And the impact is more severe for younger patients, women and patients who lose their eyebrows and eyelashes.

Alopecia may also prompt employees to take more time off work, according to multiple studies of alopecia in the workplace. One study of 5,000 adults with the disease found they also experienced an up to 12 per cent reduction in productivity while at work.

“The more feelings of self-consciousness, embarrassment, sadness or frustration [a person with alopecia reported], the more they had impairment in their productivity at work,” said Donovan, noting some studies have found alopecia patients make career decisions specifically to take on roles with less public visibility.

Read: Panel: Should drug coverage for certain conditions still be optional?

Krahn encouraged plan sponsors to support employees with alopecia through their benefits plans by covering the cost of wigs or hair pieces — which can range from $1,000 to $10,000 — and existing and future treatments for the condition. Some workplace benefits plans may consider hairpieces cosmetic rather than medical, she said, but argued that was the wrong approach.

“Hair is part of our identity . . . and it’s very much attached to our mental health, though you don’t realize that until it’s going and you’re experiencing all the feelings associated with that loss. Just to treat it as aesthetic would be incorrect. If we realized that, I think we’d be making [strides] and there’d be so many more people who would be [comfortable] working in the workplace.”

For Krahn, finally finding a good hair piece allowed her to feel confident again and to feel comfortable returning to her teaching career. “It’s been a difficult process to go through, but it’s been rewarding at the same time to get to the other side of that loss.”

Read more coverage of the 2023 Chronic Disease at Work conference.

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

The Canadian Press. All rights reserved.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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