Treatment Strategies for Alopecia

The document from April 1, 2009, reviews treatment strategies for androgenetic alopecia (AGA), alopecia areata (AA), and cicatricial alopecias, concluding that while treatments like topical minoxidil and oral finasteride are effective for AGA, there is a lack of high-quality studies for AA and cicatricial alopecias. For AGA, minoxidil increases hair count and thickness, and finasteride prevents disease progression in 91% of patients, with hair transplantation being an option for severe cases. AA treatments, which do not cure but aim to induce regrowth, include topical and intralesional steroids with variable success, and other treatments like systemic steroids, methotrexate, topical immunotherapy, and photochemotherapy have shown some efficacy but lack long-term results or sufficient control groups. Cicatricial alopecias, which lead to follicular destruction, are treated with antistaphylococcal oral antibiotics, dapsone, and isotretinoin, among others, but with common relapses and no consistent successful treatment. The document emphasizes the need for better clinical trials, objective evaluation methods, and a strong doctor-patient relationship due to the complexity of treatment and the lack of universally effective therapies. The document does not specify the number of participants in the studies it references.