Childhood Alopecia Areata: What Treatment Works Best?

    James Haynes, Robert K. Persons, Barbara Jamieson
    TLDR Topical immunotherapy with SADBE and DPCP is most effective for short-term hair regrowth in children with severe alopecia areata.
    The document reviewed treatments for childhood alopecia areata (AA) and found that topical immunotherapy using squaric acid dibutylester (SADBE) and diphenylcyclopropenone (DPCP) induced the most significant short-term hair regrowth in children with severe AA, based on 4 small individual cohort studies and 1 moderately sized retrospective case review. Intralesional steroids were effective in inducing hair regrowth greater than 50% in children with limited AA, according to 1 retrospective cohort study. However, other treatments such as topical and oral corticosteroids, topical cyclosporine, photodynamic therapy, and topical minoxidil showed no benefit over placebo, as evidenced by 14 randomized controlled trials and 3 within-patient studies.
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