Treatment of Alopecia Areata

In 1996, various treatments for alopecia areata were discussed, including intralesional steroids for patchy hair loss, topical steroids like 0.05% betamethasone dipropionate cream, systemic steroids for extensive hair loss, anthralin for patients with less than 75% scalp hair loss, and topical and oral minoxidil. While some treatments showed efficacy, such as a cosmetic response in a subset of patients using 5% minoxidil, the effectiveness varied, and long-term use was often necessary without altering the disease's course. Side effects were a concern, with one patient discontinuing treatment due to dermatitis, but no systemic effects from minoxidil were noted. The document recommended practical management strategies, including treating the entire scalp, waiting at least 3 months before changing treatments, and considering maintenance therapy. It also suggested that atopic patients with seasonal hair loss might benefit from antihistamines or mast cell stabilizers. Despite the variability in treatment response, the importance of seeking safe and effective long-term treatments was emphasized.