Alopecia Areata Treatments

Alopecia reata affects about 2% of the world's population. Most people with alopecia areata develop a small circular area of hair loss. The hair often grows back spontaneously. Hair growth can be helped with several different treatments.

AA is an autoimmune disease. Normally, our immune system is designed to attack bacteria and viruses as our main line of defence from the outside world. Our immune system also kills some types of cancer cells. The immune system is complex and has dozens of other roles too. However, when a patient has an autoimmune disease, the immune system also targets a specific part of the patient's own body. In the case of alopecia areata, the immune system is targetting the patient's hair follicles. Inflammation develops around the hairs and this causes the hair to fall out. Inflammation develops at the very bottom of the hair follicle - around a region called the 'bulb.' Cortisone medications and cortisone injections help to "chase away" the inflammation around the bulb and help to get the hairs back in a growing mode.

INTRALESIONAL CORTICOSTEROID INJECTIONS

This method of treatment — the most common and best studied form of treatment for alopecia areata — uses corticosteroids that are injected into bare patches of skin with a tiny needle. These injections are repeated about every four to six weeks and are usually given by a skin specialist.

Benefits

If new hair growth occurs from corticosteroid injections it is usually visible within four weeks. There are few known side effects related to this kind of treatment.

Drawbacks

Corticosteroid injections, like all treatments for alopecia areata, do not prevent new hair loss from developing. While there are few reported side effects related to this kind of treatment, temporary depressions (called “dells”) in the skin may result from the injections. However, these usually improve with time. People may experience slight discomfort from the needle pricks and tingling from the medication, but usually, there is no other pain or discomfort after leaving the skin specialist’s office.

TOPICAL CORTICOSTEROIDS

In alopecia areata, corticosteroids are thought to decrease the inflammation around the hair follicle. Topical steroids can come in different brands, strengths and preparations, such as solutions, lotions, foams, creams, or ointments.

Benefits

Studies have shown that there is a reduction in hair loss when using topical steroids. In addition, improved regrowth of approximately 25% has been observed with the use of highly potent topical corticosteroids. They can be good adjunct medications, especially when treating children with alopecia areata.

Drawbacks

The effectiveness of topical corticosteroids is limited by their absorption in the scalp.

TOPICAL MINOXIDIL

With this form of treatment, a 5% topical minoxidil solution is applied once or twice a day to help stimulate hair on the scalp, eyebrows and beard to regrow. Two and 5% topical minoxidil solutions are available but aren’t usually effective for alopecia areata when used alone, but when applied in combination with topical corticosteroid medications, some people see improved results.

Benefits

If a person’s hair grows back completely with topical minoxidil, treatment can be stopped. This medication is considered easy to use and has minimal side effects.

Drawbacks

Topical minoxidil is not considered effective on its own in treating patients with extensive hair loss.

ANTHRALIN CREAM OR OINTMENT

This synthetic, tar-like substance — also widely used for psoriasis — is a common form of treatment for alopecia areata. Anthralin is applied to the hairless patches once a day and then washed off typically after a short time (usually 30-60 minutes later) or in some cases, after several hours.

Benefits

If new hair growth from anthralin application happens, it is usually visible within eight to 12 weeks.

Drawbacks

This form of medication may irritate the skin and cause a temporary, brownish discoloration of the skin that’s been treated. However, some patients can reduce these side effects by using anthralin for shorter periods of time, without decreasing the treatment’s effectiveness.