Alopecia Areata: Clinical Treatment

September 2019

Norma Elizabeth Vázquez‐Herrera, Antonellá Tosti

alopecia areata immunosuppressive treatments immunomodulating treatments steroids corticosteroid-sparing agents disease-modifying antirheumatic drugs JAK inhibitors minoxidil prostaglandin F2a analogs topical tofacitinib Vitamin D3 ezetimibe simvastatin platelet-rich plasma antihistamines aromatherapy Rogaine PRP

TLDR Alopecia areata treatments should be personalized, using options like steroids, JAK inhibitors, and other therapies based on individual needs.

The document reviewed therapeutic strategies for alopecia areata, focusing on immunosuppressive and immunomodulating treatments such as steroids, corticosteroid-sparing agents, and disease-modifying antirheumatic drugs. JAK inhibitors were highlighted for severe cases. Treatments for eyelashes and eyebrows included steroids, minoxidil, prostaglandin F2a analogs, and topical tofacitinib. Adjuvant therapies like Vitamin D3, ezetimibe/simvastatin, platelet-rich plasma, antihistamines, and aromatherapy were also discussed. The document stressed an evidence-based approach tailored to individual patient needs, considering factors like age and disease severity.

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Research cited in this study

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research Topical Tofacitinib Solution for the Treatment of Alopecia Areata Affecting Eyelashes

24 citations , October 2018 in “JAAD Case Reports”

A woman's eyelash regrowth was successful using tofacitinib solution for alopecia areata.

research Intralesional Betamethasone as a Therapeutic Option for Alopecia Areata

11 citations , March 2018 in “Anais Brasileiros de Dermatologia”

Betamethasone can effectively treat alopecia areata.

An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis

research An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis

130 citations , February 2018 in “Journal of Investigative Dermatology”

Tofacitinib may help treat severe hair loss, but more research is needed.

research Vitamin D Deficiency in Patients With Alopecia Areata: A Systematic Review and Meta-Analysis

32 citations , December 2017 in “Journal of the American Academy of Dermatology”

Alopecia areata patients often have low vitamin D levels.

research Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

48 citations , November 2017 in “Journal of the American Academy of Dermatology”

Tofacitinib 2% ointment helped hair regrow in 3 out of 10 patients with alopecia areata, but caused side effects like scalp irritation and raised cholesterol in some.

research UVA-1 in the Treatment of Alopecia Areata

3 citations , August 2017 in “Dermatologic therapy”

UVA-1 phototherapy might help treat alopecia areata.

research Topical Janus Kinase Inhibitors for the Treatment of Pediatric Alopecia Areata

83 citations , June 2017 in “Journal of the American Academy of Dermatology”

Topical JAK inhibitors may help children with alopecia areata regrow hair.

research The Role of Micronutrients in Alopecia Areata: A Review

63 citations , May 2017 in “American Journal of Clinical Dermatology”

People with alopecia areata often have lower levels of vitamin D, zinc, and folate, but more research is needed to understand if supplements can help treat it.

research Oral Ruxolitinib Induces Hair Regrowth in Patients with Moderate-to-Severe Alopecia Areata

196 citations , September 2016 in “JCI insight”

Ruxolitinib effectively regrows hair in most patients with severe hair loss.

research Successful Hair Regrowth in an Acute Diffuse Form of Alopecia Areata During Oral Tacrolimus Treatment in a Patient With Rheumatoid Arthritis

8 citations , August 2016 in “Journal of the European Academy of Dermatology and Venereology”

Oral tacrolimus helped a rheumatoid arthritis patient regrow hair lost due to alopecia areata.

research A Novel Therapeutic Paradigm for Patients with Extensive Alopecia Areata

30 citations , May 2016 in “Expert Opinion on Biological Therapy”

New treatments targeting immune pathways show promise for severe hair loss but need more research for safety and effectiveness.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations , February 2015 in “EBioMedicine”

A patient with Alopecia Areata had complete hair regrowth after using the drug baricitinib.

research Clinical Response to Combined Therapy of Cyclosporine and Prednisone

10 citations , December 2013 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

Combined prednisone and cyclosporine therapy led to excellent hair regrowth and improved well-being.

research Excimer Laser: A Module of the Alopecia Areata Common Protocol

17 citations , December 2013 in “Journal of Investigative Dermatology Symposium Proceedings”

The excimer laser may help hair regrow in alopecia areata patients.

research Advances in the Management of Alopecia Areata

51 citations , December 2011 in “The Journal of Dermatology”

New treatments for severe hair loss often fail, but some patients see hair regrowth with specific therapies, and treatment should be tailored to the individual's situation.

research Narrowband Ultraviolet B Phototherapy for Alopecia Areata

37 citations , November 2011 in “Photodermatology Photoimmunology & Photomedicine”

Narrowband UVB phototherapy alone is not very effective for treating alopecia areata.

research Experimental Evaluation of Ebastine, a Second-Generation Antihistamine, as a Supportive Medication for Alopecia Areata

35 citations , March 2010 in “Journal of Dermatological Science”

Ebastine may help regrow hair in alopecia areata patients.

research Topical Immunotherapy in Alopecia Areata

45 citations , January 2010 in “International journal of trichology”

Topical immunotherapy, especially with DPCP, is effective for treating severe alopecia areata.

research Treatment of Severe Alopecia Areata with Intralesional Steroid Injections

60 citations , October 2009 in “PubMed”

Intralesional steroid injections are safe and effective for treating severe alopecia areata.

research 308-nm Excimer Laser for the Treatment of Alopecia Areata in Children

79 citations , September 2009 in “Pediatric dermatology”

The 308-nm Excimer laser is effective and safe for treating patchy alopecia areata in children.

research Treatment of Persistent Alopecia Areata with Sulfasalazine

45 citations , July 2008 in “International Journal of Dermatology”

Sulfasalazine may help treat persistent alopecia areata.

research Efficacy And Safety Of A New Clobetasol Propionate 0.05% Foam In Alopecia Areata: A Randomized, Double-Blind Placebo-Controlled Trial

114 citations , October 2006 in “Journal of the European Academy of Dermatology and Venereology”

The new clobetasol propionate foam is effective and safe for treating alopecia areata.

research Use of the Pulsed Infrared Diode Laser (904 nm) in the Treatment of Alopecia Areata

63 citations , January 2006 in “Journal of cosmetic and laser therapy”

The pulsed infrared diode laser is effective for treating hair loss in alopecia areata.

research 308-Nm Excimer Laser Therapy in Alopecia Areata

85 citations , November 2004 in “Journal of the American Academy of Dermatology”

The 308-nm excimer laser helps hair regrowth in some alopecia areata cases but not all.