Higher Concentrations of Dithranol Appear to Induce Hair Growth Even in Severe Alopecia Areata

The study retrospectively analyzed 102 patients with alopecia areata (AA) who had not responded to ultra-potent topical steroids and were treated with dithranol up to 3%. Using the severity of alopecia areata tool, patients were categorized into mild, moderate, and severe groups. Results showed that any hair regrowth and at least 50% regrowth occurred in all groups, with 72% and 61.5% in mild, 68% and 48.4% in moderate, and 50% and 37.5% in severe AA, respectively, over a median treatment duration of 12 months. Complete regrowth was achieved in 28.4% of patients, with no significant difference in proportions across severity groups, though the time to discharge varied significantly. The findings suggested that higher concentrations of dithranol might be a viable treatment option for AA patients unresponsive to potent steroids, and recommended further randomized trials with less staining formulations.