Treatment of Alopecia Areata With Squaric Acid Dibutylester

Fourteen out of 18 patients with extensive alopecia areata completed weekly treatments with squaric acid dibutylester in acetone. The concentration was adjusted to maintain moderate dermatitis. Only one area was treated until significant hair growth occurred, then the rest of the scalp was treated. Four patients (28.5%) experienced complete hair regrowth, though one had recurrent alopecia after stopping treatment. Ten patients (71.4%) were treatment failures, with seven showing initial regrowth but recurrent alopecia, one failing to maintain dermatitis, and two not growing hair despite dermatitis. Successful outcomes were linked to having alopecia for less than two years, developing dermatitis within three weeks, persistent hair growth within two months, and being 16 years or older.