This may be more than you want but it is from UptoDate which is a fee based resource we docs use for the real deal information.
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ALOPECIA AREATA TREATMENT Not all people with alopecia areata require treatment; many patients with limited disease will experience spontaneous hair regrowth.
For patients who use treatments, there are several options. However, alopecia areata cannot be "cured." As noted above, most patients experience future episodes of hair loss.
Corticosteroids Corticosteroids, commonly called steroids, are antiinflammatory medications that are used to treat alopecia areata. They can be taken by injection, applied topically (as a cream or lotion), or taken by mouth.
Injected corticosteroids This method of treatment is often recommended for adults with isolated patches of hair loss. The medication is injected directly into the affected area to stimulate hair regrowth. It may take around six to eight weeks to notice new hair growth; injections are repeated every four to six weeks until regrowth is complete. If needed, the affected area can be pretreated with a prescription topical anesthetic cream to reduce the pain associated with injections.
Topical corticosteroids Topical corticosteroids are sometimes prescribed as an alternative to injected corticosteroids for children or adults who cannot tolerate injections. Topical corticosteroids are usually applied to affected areas on a daily basis.
Like injected corticosteroids, this treatment is used for patients with isolated patches of hair loss. Topical corticosteroids are unlikely to be beneficial for people with extensive hair loss.
Topical minoxidil Available over-the-counter, topical
minoxidil (eg, Rogaine) promotes hair growth by lengthening the growth phase of hair follicles and causing more follicles to produce hair [
3].
Minoxidil is approved to treat androgenetic alopecia (male pattern hair loss); it may also be useful in patients with mild alopecia areata. The solution is typically applied twice a day to the area of hair loss, and can be used alone or in combination with other therapies. When treatment is successful, new hair growth is seen in about 12 weeks. Minoxidil is not effective in patients with severe alopecia areata or total loss of scalp hair.
Anthralin Anthralin is a treatment that was originally developed for the treatment of another skin condition, psoriasis, but was later found to regrow hair in some people with mild alopecia. It must be used with care because it irritates the skin and eyes and can stain fabrics. Hair regrowth may be seen within three to four months.
Topical immunotherapy Topical immunotherapy is probably the most effective treatment for patients with extensive or recurrent scalp involvement. This technique involves applying a substance known to cause an allergic reaction to the area of hair loss. The resulting itching, scaling, and irritation often induce hair growth for reasons that are not completely understood.
Topical immunotherapy is not widely available in the United States. Patients who are interested in trying it should see a dermatologist (clinician specializing in the skin) who is experienced with this treatment.
Photochemotherapy In photochemotherapy, the person is given a light-sensitive drug (either applied to the skin or taken by mouth) and then exposed to an ultraviolet light source. Studies have shown conflicting results. However, a trial of photochemotherapy may be reasonable in people with extensive alopecia areata if topical immunotherapy is not available. Treatment is usually continued for four to six months.
Investigational treatments New therapies for alopecia areata may emerge in the future. The preliminary results from drugs known as Janus kinase (JAK) inhibitors (tofacitinib and
ruxolitinib) look promising, but additional study is necessary to evaluate the efficacy and safety of JAK inhibitors for alopecia areata. Oral JAK inhibitors are expensive, may carry significant risks, and are not yet recommended for routine treatment of alopecia areata. There is ongoing research on topical and oral JAK inhibitors and other therapies, giving hope that better treatments for alopecia areata will become available.
COSMETIC APPROACHES TO ALOPECIA AREATA Female patients with extensive alopecia areata usually opt to purchase a wig or hairpiece. An attractive wig is important for many women and children, although high-quality wigs can be expensive. Wigs can be cut and styled according to an individual's preference and may be attached to the head with double-sided tape or a suction cap.
Men frequently opt to shave their scalp; wigs and hairpieces are generally less acceptable. Temporary tattooing can be helpful for the loss of eyebrows. False eyelashes are an option for patients with hair loss involving the eyelashes.
WHERE TO GET MORE INFORMATION Your healthcare provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our website (
www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.
Patient level information UpToDate offers two types of patient education materials.
The Basics The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
Patient education: Hair loss in men and women (The Basics)Beyond the Basics Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Professional level information Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Clinical manifestations and diagnosis of alopecia areataManagement of alopecia areataThe following organizations also provide reliable health information.
National Alopecia Areata Foundation
(
www.naaf.org)
National Library of Medicine
(
www.nlm.nih.gov/medlineplus/healthtopics.html)
Alopecia UK
(
www.alopeciaonline.org.uk)
American Academy of Dermatology
(
www.aad.org)