Alopecia Areata: An Overview of Treatments and Efficacy

June 2014

Rodney Sinclair

alopecia areata autoimmune disease nonscarring hair loss intralesional corticosteroids topical immunotherapy PUVA therapy anthralin topical minoxidil cryosurgery systemic corticosteroids methotrexate azathioprine topical corticosteroids Rogaine

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Studysummary This review examines current treatment options for alopecia areata and highlights the challenges due to limited evidence-based data and unpredictability in disease progression.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The 2014 document on alopecia areata describes it as an autoimmune, often familial disease causing nonscarring hair loss, with a lifetime incidence of 1.7%. Treatments vary in effectiveness and side effects, with intralesional corticosteroids and topical immunotherapy being more common options. PUVA therapy and anthralin have low success rates, while topical minoxidil and cryosurgery have mixed results. Systemic corticosteroids and other systemic treatments like methotrexate and azathioprine are not well-supported due to high relapse rates and potential toxicity. A study on 28 children showed that 84% had hair regrowth with topical immunotherapy, although side effects were common. The document concludes that no treatment changes the natural course of the disease and that efficacy varies, with some treatments like topical corticosteroids potentially being more effective in children.

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27 / 27 results

research Efficacy and Tolerability of Methotrexate in Severe Childhood Alopecia Areata

70 citations , April 2011 in “British journal of dermatology/British journal of dermatology, Supplement”

This retrospective study found that methotrexate had variable efficacy in treating severe alopecia areata in children, with successful hair regrowth observed in five out of thirteen assessable cases.

Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

research Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

48 citations , January 2011 in “International journal of trichology”

This study found that intralesional triamcinolone acetonide was most effective for hair regrowth in localized alopecia areata, with betamethasone valerate foam also being beneficial, while tacrolimus ointment showed no significant effect.

research Treatment of Persistent Alopecia Areata with Sulfasalazine

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

This study found that oral sulfasalazine led to varying hair regrowth outcomes in patients with persistent alopecia areata, with 56.3% showing moderate to good responses.

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”

In this study, clobetasol propionate foam demonstrated effectiveness and good patient compliance as a safe topical treatment for moderate to severe alopecia areata, with significant hair regrowth compared to placebo.

research Intralesional Treatment of Alopecia Areata with Triamcinolone Acetonide by Jet Injector

100 citations , July 2006 in “British Journal of Dermatology”

This study found that intralesional triamcinolone acetonide injections using a needleless injector led to rapid hair regrowth in patients with limited alopecia areata, while lasting growth was rare in alopecia totalis.

research Placebo-Controlled Oral Pulse Prednisolone Therapy in Alopecia Areata

141 citations , February 2005 in “Journal of the American Academy of Dermatology”

In this study, oral prednisolone pulse therapy led to significant hair regrowth in some patients with extensive alopecia areata, whereas no improvement was seen in the placebo group.

Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

research Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

66 citations , July 2003 in “International Journal of Dermatology”

This study found that betamethasone valerate foam was more effective and well-tolerated than betamethasone dipropionate lotion in treating mild-to-moderate alopecia areata, with higher hair regrowth rates observed.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations , July 2003 in “Journal of the American Academy of Dermatology”

In this study, clobetasol propionate 0.05% ointment was found to induce hair regrowth in 28.5% of patients with severe alopecia areata under occlusive conditions, though long-term benefit was limited to 17.8%.

research Safety of Topical Minoxidil Solution: A One-Year, Prospective, Observational Study

26 citations , July 2003 in “Journal of Cutaneous Medicine and Surgery”

This study found that topical minoxidil solution is a safe treatment for androgenetic alopecia, with no increase in cardiovascular events or adverse pregnancy outcomes observed.

research Alopecia Areata: Gene Expression in Skin Samples from Patients

23 citations , March 2001 in “Clinics in dermatology”

This study found that 363 genes were differentially expressed in alopecia areata skin compared to non-lesional skin, suggesting T-cell mediated immune responses and distinct gene profiles related to the disease's stage.

research Efficacy of Topical Sensitizers in the Treatment of Alopecia Areata

132 citations , November 1998 in “Journal of the American Academy of Dermatology”

This review evaluates the efficacy and safety of topical sensitizers in treating alopecia areata but reports no new clinical findings.

research Randomized Trial of Aromatherapy for Alopecia Areata

122 citations , November 1998 in “Archives of Dermatology”

This study found that aromatherapy involving essential oils significantly improved symptoms of alopecia areata compared to carrier oils alone in a randomized controlled trial.

research Topical Tretinoin as an Adjunctive Therapy with Intralesional Triamcinolone Acetonide for Alopecia Areata: Clinical Experience in Northern Saudi Arabia

11 citations , April 1997 in “International Journal of Dermatology”

This article discusses using topical tretinoin with intralesional triamcinolone acetonide for alopecia areata in northern Saudi Arabia, but it reports no new clinical findings.

research Pulsed Administration of Corticosteroids in the Treatment of Alopecia Areata

117 citations , February 1996 in “International Journal of Dermatology”

This study found that monthly oral prednisolone pulses of 300 mg were effective and safe for treating widespread alopecia areata, with 58.3% of patients achieving cosmetically acceptable hair growth.

research PUVA Treatment of Alopecia Areata Partialis, Totalis, and Universalis: Audit of 10 Years' Experience at St John's Institute of Dermatology

105 citations , December 1995 in “British journal of dermatology/British journal of dermatology, Supplement”

This retrospective study concluded that PUVA treatment is generally ineffective for alopecia areata, with low effective success rates for partialis, totalis, and universalis types.

Treatment of Chronic Severe Alopecia Areata with Topical Diphenylcyclopropenone and 5% Minoxidil: A Clinical and Immunopathologic Evaluation

research Treatment of Chronic Severe Alopecia Areata with Topical Diphenylcyclopropenone and 5% Minoxidil: A Clinical and Immunopathologic Evaluation

41 citations , November 1993 in “Journal of The American Academy of Dermatology”

This study found that DPCP treatment led to cosmetically acceptable hair regrowth in 38% of patients with chronic severe alopecia areata, while adding 5% minoxidil showed no significant clinical benefit.

research Evaluation of Anthralin in the Treatment of Alopecia Areata

109 citations , November 1987 in “Archives of dermatology”

In this study, 0.5%-1.0% anthralin cream led to a cosmetic response in 25% of patients with severe alopecia areata, despite common side effects like pruritus and erythema.

research Topical Minoxidil Solution (1% and 5%) in the Treatment of Alopecia Areata

101 citations , March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil solution helps hair regrowth in alopecia areata, with 5% being more effective.

research Double-Blind, Placebo-Controlled Evaluation of Topical Minoxidil in Extensive Alopecia Areata

104 citations , March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil helps hair growth in 63.6% of alopecia patients, with 27.3% having excellent results.

research A Trial of 1% Minoxidil Used Topically for Severe Alopecia Areata

37 citations , March 1986 in “Acta Dermato Venereologica”

In this study, there was no significant difference in hair growth between patients with extensive alopecia areata treated with 1% minoxidil and those receiving a placebo.

research Topical Minoxidil Dose-Response Effect in Alopecia Areata

54 citations , February 1986 in “Archives of Dermatology”

This study found that 5% topical minoxidil solution led to greater hair regrowth in severe alopecia areata patients compared to 1% minoxidil, although most regrowth was not cosmetically acceptable.

research Topical Photochemotherapy for Alopecia Areata

63 citations , April 1985 in “Journal of the American Academy of Dermatology”

This study observed that topical PUVA treatment led to excellent or good hair regrowth in 45.4% of patients with alopecia areata, though many experienced relapse after treatment stopped.

research Topical Minoxidil for Hair Regrowth

80 citations , September 1984 in “Journal of The American Academy of Dermatology”

In this study, 5% topical minoxidil was observed to promote hair regrowth in some patients with androgenic alopecia, while no regrowth was noted in patients with alopecia areata.

research Alopecia Areata Treated With Topical Minoxidil

78 citations , April 1984 in “Archives of Dermatology”

This study found that 1% minoxidil topical solution led to terminal hair regrowth in some patients with alopecia areata, though it was only cosmetically acceptable in less than half of those cases.

research Topical Treatment of Alopecia Areata

50 citations , July 1981 in “Archives of Dermatology”

This study found that applying dinitrochlorobenzene (DNCB), a contact allergen, led to hair regrowth in patients with alopecia areata, while croton oil did not have the same effect.

research Corticosteroids in the Treatment of Alopecia Totalis

28 citations , October 1978 in “Archives of dermatology”

This study found that combined topical, intralesional, and oral corticosteroids led to significant hair regrowth in some patients with alopecia totalis or universalis, allowing eventual cessation of oral corticosteroids in several cases.

research A Comparison of Intralesional Triamcinolone Hexacetonide and Triamcinolone Acetonide in Alopecia Areata

75 citations , September 1971 in “British Journal of Dermatology”

This study found that both intralesional triamcinolone acetonide and triamcinolone hexacetonide promote continuous hair growth in alopecia areata, with effects lasting at least 9 months after a single injection.