Advances in the Management of Alopecia Areata

The 2011 document reviews the management of alopecia areata (AA), indicating that while up to 80% of patients with limited patchy AA may see spontaneous remission within a year, more severe cases like alopecia totalis/universalis (AT/AU) often do not improve and have high treatment failure rates. It outlines various treatments, including contact immunotherapy, corticosteroid therapies, antihistamines, photochemotherapy, and minoxidil, with high-dose corticosteroid therapy showing 67% of patients with recent-onset multifocal AA achieving over 50% hair regrowth. The Japanese guideline is introduced, offering treatment plans based on age and disease extent, and recommending different approaches for patients under and over 15 years old. The document emphasizes the importance of proper diagnosis and that treatment decisions should consider the patient's age, hair loss type, disease course, and personal preferences. It also notes the lack of robust trials for some therapies used in Japan, such as cryotherapy and carpronium chloride hydrate, despite the latter showing significant effects in a placebo-controlled randomized trial.