Interventions for Alopecia Areata

In a review from April 16, 2008, seventeen randomized controlled trials with a total of 540 participants were analyzed to assess the effectiveness of various interventions for alopecia areata, alopecia totalis, and alopecia universalis. The interventions studied included topical and oral corticosteroids, topical ciclosporin, photodynamic therapy, and topical minoxidil. The trials ranged from 6 to 85 participants each and failed to show significant treatment benefits in terms of hair growth when compared to placebo. No studies were found where participants self-assessed their hair growth or quality of life. Common treatments such as diphencyprone, dinitrochlorobenzene, intralesional corticosteroids, or dithranol were not evaluated in randomized controlled trials (RCTs), despite their frequent use. While topical steroids and minoxidil are widely prescribed and appear to be safe, there is no convincing evidence of their long-term benefits. The trials were poorly reported and too small to conclusively determine any significant clinical benefits. The review highlighted the urgent need for large, well-conducted studies that evaluate the long-term effects of therapies on quality of life and suggested that, considering the potential for spontaneous remission, not undergoing treatment or wearing a wig may be viable alternatives for dealing with the condition.