Treatment Modalities for Lymphocytic and Neutrophilic Scarring Alopecia

    Ogechi Ezemma, Shivali Devjani, Kristen J. Kelley, Maryanne M. Senna
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    TLDR Early treatment is key for permanent hair loss disorders, with options ranging from medications and phototherapy to immunomodulators and antibiotics, depending on severity and type.
    The document discusses the treatment of primary cicatricial alopecia (PCA), a group of disorders causing permanent hair loss. Early intervention is crucial and aims to reduce symptoms, slow disease progression, and improve hair density. Treatments for mild lymphocytic PCA include topical and intralesional medications, hydroxychloroquine, and phototherapy. Severe cases may require mycophenolate mofetil, methotrexate, cyclosporine, pioglitazone, dutasteride, and Janus kinase inhibitors. For neutrophilic PCA, treatments aim to reduce inflammation and bacterial load, with first-line treatments including benzoyl peroxide wash, topical steroids, steroid scalp injections, and oral antibiotics. Other treatments mentioned include oral prednisone, isotretinoin, systemic immunomodulators like dapsone, adalimumab, infliximab, and topical metformin for hair regrowth. The document does not provide the number of patients involved in the studies of these treatments.
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