Treatment-Resistant Alopecia Areata: Combination Therapy with Minoxidil and Anthralin

In a 1990 study, 51 patients with severe treatment-resistant alopecia areata were treated with a combination of 5% minoxidil and 0.5% anthralin. Most patients had previously shown inadequate responses to these drugs when used individually. The combination therapy was generally well tolerated, though all patients experienced mild to moderate irritant dermatitis, and one patient had to drop out due to a severe reaction. After 6 months, 5 out of 45 patients (11%) who completed the study showed a cosmetic response, with 4 of these 5 maintaining hair regrowth for up to 84 weeks. Hair regrowth was observed by week 12 in all responders, and the combination therapy proved more effective than either drug alone. Despite increased systemic absorption of minoxidil, no systemic effects were noted. The study suggested that using drugs with different mechanisms of action together might have a synergistic effect in treating alopecia areata.