Treatment Options for Alopecia: An Update, Looking to the Future

In 2012, the document provided an update on treatment options for alopecia, with a focus on androgenetic alopecia (AGA), alopecia areata (AA), and scarring alopecias. For AGA, approved treatments included topical minoxidil and oral finasteride, with dutasteride being an alternative in Korea. Finasteride was linked to sexual dysfunction and potential risks of high-grade prostate cancer and male breast cancer. Higher doses of finasteride combined with oral contraceptives showed some success in women. Other treatments mentioned were the HairMax® LaserComb, prostaglandin inhibitors, and platelet-rich plasma (PRP) therapy. AA treatments were mostly off-label, with topical steroids, steroid injections, topical immunotherapy, and anthralin being used. Methotrexate and oral ciclosporin showed varying success rates, and systemic steroids were effective in 59.4% of recent-onset AA patients. For trichotillomania, N-acetylcysteine improved symptoms in a 12-week study. Cicatricial alopecias were treated with anti-inflammatory approaches, and DLE was managed with photoprotection, steroids, and antimalarials. The document also discussed the potential of genomic studies for new treatments, the exploration of drugs for other autoimmune diseases, and the development of biological drugs and cell-based therapies. It emphasized the need for continued research and evidence-based treatments for alopecia.