Treatments for Alopecia Areata

In many cases of alopecia areata, some or all of the hair will grow back on its own. Treatments for this type of hair loss are also very effective.

Treatment for alopecia areata depends on two things, the age of the patient and the extent of the hair loss. Children usually receive treatments that consist of minoxidil, a topical corticosteroid or an ointment called anthralin. Adults are subject to more aggressive treatments.

If the hair loss is mild, or less than 50% lost, the most common treatment includes local corticosteroid injections. The steroid is usually triamcinolone acetonide or kenalog, with between 3mL - 5 mL locally injected into the bald patches, just below the epidermis. Hair growth is usually apparent after four weeks, with the treatment repeated every four to six weeks. Side effects are rare, but could include weight gain, reddening and rounding of the face and neck and irritation or pain around the site of the injection. Topical corticosteroids are usually not as effective, and oral corticosteroids are seldom used because of the adverse side effects.

Another treatment that is offered to those with mild alopecia areata is a twice-daily topical application of 5% minoxidil solution. According to one study, this treatment gave results to 40% of patients who lost 25 - 99% of their scalp hair.

If there is more than 50% of hair lost, the physician might recommend topical contact sensitization therapy. This is a trio of chemicals that block the autoimmune reaction thought to cause the hair loss from alopecia areata. These are dinitrochlorobenzene (DNCB), squaric acid dibutyl ester (SADBE) and diphenylcyclopropene (DPCP). These chemicals are irritants that activate an allergic reaction when applied to the scalp. This reaction causes the immune system cells to withdraw from the hair follicles, hopefully activating hair growth.

A solution is applied onto the scalp, usually once a week, by the physician, and is left on for several hours to a few days. If the treatment is successful, cosmetically acceptable hair will appear in about 6 months.

Also used to treat alopecia areata is a tarlike ointment called Anthralin. This treatment works by restraining cell division and preventing the overproduction of skin cells covering the scalp. Coming in a 0.1, 0.25, 0.5 and 1% cream, Anthralin is applied on the scalp, left on for a period of time, and then rinsed and washed off. About 25% of patients have cosmetically acceptable results within 6 months.

Another type of treatment is called PUVA (Psoralens and Ultraviolet Light). PUVA is known as phototherapy, where the patient ingests or topical applies a light-sensitive drug, and is exposed to ultraviolet light for a short period of time (about 3 - 5 minutes). The treatments are given over a three to six week time period, where it is administered two to three times a week for six months, until hair regrows. PUVA works by suppressing the immune system and has an overall success rate of 40 - 60 %.

Unfortunately, if you suffer from alopecia totalis or alopecia universalis, the chances for reversal are low.