Alopecia Areata: Treatment of Today and Tomorrow

June 2003 in “ Journal of Investigative Dermatology Symposium Proceedings ”

Pia Freyschmidt‐Paul, Rudolf Happle, Kevin J. McElwee, Rolf Hoffmann

alopecia areata contact sensitizers diphenylcyclopropenone squaric acid dibutylester topical corticosteroids systemic corticosteroids immunosuppressive strategies immunomodulatory strategies autoimmune hair follicles inflammation AA DCP SADBE

TLDR Contact sensitizers like DCP and SADBE are the most effective treatments for alopecia areata.

The document reviewed treatments for alopecia areata (AA) as of 2003, concluding that contact sensitizers like diphenylcyclopropenone (DCP) and squaric acid dibutylester (SADBE) were the only effective treatments based on evidence-based criteria, with a median response rate of 51% and initial regrowth visible after 8-12 weeks. Topical corticosteroids were ineffective due to poor penetration, while intralesional corticosteroids were useful for small patches but had side effects. Systemic corticosteroids and PUVA treatments showed mixed results and required further controlled studies. Minoxidil lacked evidence-based support for AA treatment. Future therapies were suggested to focus on immunosuppressive or immunomodulatory approaches targeting the autoimmune nature of AA.

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Research cited in this study

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research Intralesional Treatment of Alopecia Areata with Triamcinolone Acetonide by Jet Injector

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Triamcinolone acetonide injections help hair regrow quickly in mild alopecia but not in severe cases.

research Evidence-Based Treatment of Alopecia Areata

12 citations , October 2001 in “Journal of the American Academy of Dermatology”

Topical 5% minoxidil lacks strong evidence for treating alopecia areata.

research Current and Potential Agents for the Treatment of Alopecia Areata

41 citations , February 2001 in “Current pharmaceutical design”

Current and future treatments for alopecia areata focus on immunosuppression, immunomodulation, and protecting hair follicles.

research Role of Cytotoxic T Cells in Chronic Alopecia Areata

127 citations , January 2000 in “Journal of Investigative Dermatology”

Cytotoxic T cells cause hair loss in chronic alopecia areata.

research Treatment of Widespread Alopecia Areata in Young Patients with Monthly Oral Corticosteroid Pulse

48 citations , July 1998 in “Pediatric Dermatology”

Monthly oral corticosteroid pulses effectively treat widespread alopecia areata in young patients.

research Topical Liposome Delivery of Molecules to Hair Follicles in Mice

60 citations , February 1997 in “Journal of Dermatological Science”

Liposomes can safely and effectively deliver substances to mouse hair follicles, potentially useful for human hair treatments.

research Pulsed Administration of Corticosteroids in the Treatment of Alopecia Areata

117 citations , February 1996 in “International Journal of Dermatology”

A 300 mg monthly pulse of prednisolone effectively and safely treats widespread alopecia areata.

research PUVA Treatment of Alopecia Areata Partialis, Totalis, and Universalis: Audit of 10 Years' Experience at St John's Institute of Dermatology

105 citations , December 1995 in “British journal of dermatology/British journal of dermatology, Supplement”

PUVA treatment is generally ineffective for alopecia areata.

research Stimulation of Hair Growth by Topical Application of FK506, a Potent Immunosuppressive Agent

54 citations , February 1994 in “Journal of Investigative Dermatology”

research Topical Minoxidil in Alopecia Areata: No Effect on the Perifollicular Lymphoid Infiltration

33 citations , July 1992 in “Journal of Investigative Dermatology”

Minoxidil doesn't affect perifollicular lymphoid infiltration in alopecia areata patients.

research Alopecia Areata in Children: Response to Treatment with Diphencyprone

84 citations , August 1991 in “British Journal of Dermatology”

Most children treated with diphencyprone regrew some or all of their hair.

research Extensive Alopecia Areata: Results of Treatment with 3% Topical Minoxidil

36 citations , March 1989 in “Cleveland Clinic Journal of Medicine”

3% topical minoxidil effectively treats extensive alopecia areata.

research 3 Percent Topical Minoxidil Compared With Placebo for the Treatment of Chronic Severe Alopecia Areata

26 citations , June 1988 in “PubMed”

3% topical minoxidil is ineffective for severe chronic alopecia areata.

research Treatment of Alopecia Areata With Squaric Acid Dibutylester

42 citations , August 1987 in “Archives of Dermatology”

Squaric acid dibutylester led to complete hair regrowth in 28.5% of patients with alopecia areata.

research Double-Blind, Placebo-Controlled Evaluation of Topical Minoxidil in Extensive Alopecia Areata

104 citations , March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil helps hair growth in 63.6% of alopecia patients, with 27.3% having excellent results.

research Topical Minoxidil (3%) in Extensive Alopecia Areata, Including Long-Term Efficacy

54 citations , March 1987 in “Journal of The American Academy of Dermatology”

3% topical minoxidil effectively treats extensive alopecia areata with few side effects.

research A Trial of 1% Minoxidil Used Topically for Severe Alopecia Areata

37 citations , March 1986 in “Acta Dermato Venereologica”

1% minoxidil didn't improve hair growth in severe alopecia areata.

research Topical Minoxidil Dose-Response Effect in Alopecia Areata

54 citations , February 1986 in “Archives of Dermatology”

Higher minoxidil concentration (5%) works better for severe hair loss, with most patients seeing regrowth in 48-60 weeks.

research A Trial of 1% Minoxidil Used Topically for Severe Alopecia Areata

27 citations , January 1986 in “PubMed”

1% minoxidil didn't improve hair growth for severe alopecia areata.

research Topical Photochemotherapy for Alopecia Areata

63 citations , April 1985 in “Journal of the American Academy of Dermatology”

Topical PUVA can cause temporary hair regrowth in some alopecia areata patients but doesn't change the long-term outcome.

research Topical Minoxidil for Extended Alopecia Areata

17 citations , March 1985 in “Acta Dermato Venereologica”

1% topical minoxidil helped some hair regrow, but only one person had noticeable results.

research Topical Minoxidil for Hair Regrowth

80 citations , September 1984 in “Journal of The American Academy of Dermatology”

5% minoxidil helps hair regrowth in androgenic alopecia.

research Alopecia Areata Treated With Topical Minoxidil

78 citations , April 1984 in “Archives of Dermatology”

Minoxidil can help regrow hair in alopecia areata patients.

research Topical Minoxidil in the Treatment of Alopecia Areata

18 citations , March 1984 in “BMJ”

Minoxidil helps hair regrowth in alopecia, but more research needed.

research Topical Treatment of Extended Alopecia

17 citations , January 1977 in “Dermatology”

Ultraviolet light helped hair growth more effectively than triamcinolone acetonide.

research Large Doses of Glucocorticoid in the Treatment of Alopecia Areata

80 citations , November 1975 in “Acta dermato-venereologica”

Large doses of glucocorticoids are not suitable for general use in treating severe alopecia areata due to inconsistent results and risks.

research Treatment of Alopecia Areata With Steroid Solution

30 citations , December 1972 in “Archives of dermatology”

The steroid solution can regrow hair but often causes skin issues and doesn't work long-term.

Alopecia Areata: Treatment of Today and Tomorrow

Research cited in this study

research Intralesional Treatment of Alopecia Areata with Triamcinolone Acetonide by Jet Injector

research Evidence-Based Treatment of Alopecia Areata

research Current and Potential Agents for the Treatment of Alopecia Areata

research Role of Cytotoxic T Cells in Chronic Alopecia Areata

research Treatment of Widespread Alopecia Areata in Young Patients with Monthly Oral Corticosteroid Pulse

research Topical Liposome Delivery of Molecules to Hair Follicles in Mice

research Pulsed Administration of Corticosteroids in the Treatment of Alopecia Areata

research PUVA Treatment of Alopecia Areata Partialis, Totalis, and Universalis: Audit of 10 Years' Experience at St John's Institute of Dermatology

research Stimulation of Hair Growth by Topical Application of FK506, a Potent Immunosuppressive Agent

research Topical Minoxidil in Alopecia Areata: No Effect on the Perifollicular Lymphoid Infiltration

research Alopecia Areata in Children: Response to Treatment with Diphencyprone

research Extensive Alopecia Areata: Results of Treatment with 3% Topical Minoxidil

research 3 Percent Topical Minoxidil Compared With Placebo for the Treatment of Chronic Severe Alopecia Areata

research Treatment of Alopecia Areata With Squaric Acid Dibutylester

research Double-Blind, Placebo-Controlled Evaluation of Topical Minoxidil in Extensive Alopecia Areata

research Topical Minoxidil (3%) in Extensive Alopecia Areata, Including Long-Term Efficacy

research A Trial of 1% Minoxidil Used Topically for Severe Alopecia Areata

research Topical Minoxidil Dose-Response Effect in Alopecia Areata

research A Trial of 1% Minoxidil Used Topically for Severe Alopecia Areata

research Topical Photochemotherapy for Alopecia Areata

research Topical Minoxidil for Extended Alopecia Areata

research Topical Minoxidil for Hair Regrowth

research Alopecia Areata Treated With Topical Minoxidil

research Topical Minoxidil in the Treatment of Alopecia Areata

research Topical Treatment of Extended Alopecia

research Large Doses of Glucocorticoid in the Treatment of Alopecia Areata

research Treatment of Alopecia Areata With Steroid Solution

research A Comparison of Intralesional Triamcinolone Hexacetonide and Triamcinolone Acetonide in Alopecia Areata

research Local Injection of Steroids and Hair Regrowth in Alopecias

research Growing of Hair in Alopecia Areata and Maligna After Intracutaneous Hydrocortisone Injection