Dr. Diane M. Hoss, MD discusses Alopecia Areata Treatment. See more at http://www.dermnet.com PLEASE RATE AND
COMMENT!!!
The treatment of alopecia areata depends on the amount of hair loss, location of hair loss and age of the patient being
treated. It is important to stress to the patient and family that treatment will not alter the course of the condition; it
can not cure the condition, and it can't prevent new areas of alopecia from occurring and the treatment does not speed up
regrowth. Localized areas of alopecia areata can be treated with several modalities. Some patients may opt not to treat
small localized inconspicuous areas of alopecia, this is acceptable. These areas will probably spontaneously regrow over
several months to two years.
If the patient desires treatment of localized areas to speed regrowth, several options
can be considered. In a child, a mid-potency topical steroid used once daily for 3 months is an easy first line of therapy.
The patient is seen in follow up in 3 months, if there is no regrowth, the treatment is unlikely to be effective. Topical
short-contact anthralin therapy (SCAT) or topical 5% minoxidil can then be tried. In an older child (greater than 10 to 12
years of age), intralesional steroids can be used. An adult with localized alopecia areata is usually treated with
intralesional steroids (triamcinolone at a concentration of 3 to5 mg/ml).
Adults with an aversion to needles can also
be treated with topical SCAT or 5% minoxidil. Adults and children with alopecia totalis or universalis must be counseled on
the low efficacy of therapy. Support must be given including referrals to local support groups and referrals to reputable
makers and fitters of full cranial prostheses. If an adult or adolescent with totalis or universalis desires a trial of
therapy, topical immunotherapy probably has the highest efficacy. Diphenylcylopropenone (DPCP) is the most commonly used
sensitizer. Up to 25% of patients with totalis or universalis will respond to this therapy.
