Monotherapy for Alopecia Areata: A Systematic Review and Network Meta-Analysis

January 2019 in “ Skin appendage disorders ”

Aditya K. Gupta, Jessie Carviel, Kelly A. Foley, Neil H. Shear, Bianca Maria Piraccini, Vincent Piguet, Antonella Tosti

alopecia areata intralesional corticosteroids diphenylcyclopropenone topical corticosteroids prostaglandin analogs topical minoxidil laser therapy oral tofacitinib DPCP minoxidil tofacitinib

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Tofacitinib →

a JAK inhibitor for alopecia areata and other autoimmune conditions

Studysummary This study used a network meta-analysis to compare alopecia areata treatments, finding that intralesional corticosteroids are most effective for mild cases, while diphenylcyclopropenone ranks highest for moderate to severe cases; further research on oral tofacitinib is needed.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This systematic review and network meta-analysis compared the efficacy of various treatments for alopecia areata, finding that intralesional corticosteroids were most effective for mild disease (78.9% response rate), while diphenylcyclopropenone (DPCP) was most effective for moderate to severe disease (87.9% response rate). Other treatments for mild disease included topical corticosteroids, prostaglandin analogs, and topical minoxidil, whereas for moderate to severe disease, laser therapy, topical minoxidil, and topical corticosteroids were also effective. The study highlighted the need for further controlled trials to evaluate the efficacy of oral tofacitinib.

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Research cited in this study

13 / 13 results

research Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study

66 citations , December 2018 in “Dermatology”

This study found that oral JAK inhibitors, ruxolitinib and tofacitinib, are effective and well-tolerated for treating severe alopecia areata, with a similar degree of hair regrowth and relapse rates, but ruxolitinib induced faster initial hair regrowth.

research Treatment of Alopecia Universalis with Topical Janus Kinase Inhibitors – A Double Blind, Placebo, and Active Controlled Pilot Study

49 citations , August 2018 in “International Journal of Dermatology”

In this phase I study, partial hair regrowth was observed in patients with alopecia universalis using topical JAK inhibitors, though more research is needed to confirm potential as a treatment alternative to clobetasol.

research Alopecia Areata: Treatment Options and Efficacy

182 citations , December 2017 in “Journal of the American Academy of Dermatology”

This article reviews current and emerging treatments for alopecia areata, including Janus kinase inhibitors, highlighting variability in clinical outcomes and the lack of sustained remission.

research Efficacy of Tofacitinib in Treatment of Alopecia Universalis in Two Patients

51 citations , June 2016 in “Journal of the European Academy of Dermatology and Venereology”

In this study, tofacitinib treatment was associated with significant hair regrowth in two patients with alopecia universalis over eight months, with minimal adverse effects reported.

research Familial Aggregation of Alopecia Areata

295 citations , May 2016 in “Journal of the American Academy of Dermatology”

This review examines the immunological aspects of alopecia areata, focusing on genetic, neuroimmunological, and immune privilege factors, but does not report new clinical findings.

research The Genetics Of Alopecia Areata: New Approaches, New Findings, New Treatments

62 citations , January 2015 in “Journal of Dermatological Science”

This review summarizes the current genetic research on alopecia areata, including potential new therapeutic strategies, but reports no new clinical findings.

research Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients

14 citations , August 2014 in “Journal of the American Academy of Dermatology”

This study found that topical diphenylcyclopropenone is an effective treatment for extensive alopecia areata, with significant hair regrowth reported in most patients, though effectiveness varied with disease characteristics.

Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

research Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

48 citations , January 2011 in “International journal of trichology”

This study found that intralesional triamcinolone acetonide was most effective for hair regrowth in localized alopecia areata, with betamethasone valerate foam also being beneficial, while tacrolimus ointment showed no significant effect.

research Interventions for Alopecia Areata

164 citations , April 2008 in “Cochrane library”

This review of interventions for alopecia areata found no significant treatment benefits for hair growth compared to placebo, indicating a need for larger, well-conducted studies.

research Probing the Effects of Stress Mediators on the Human Hair Follicle

159 citations , November 2007 in “American Journal of Pathology”

In this study, researchers found that substance P triggered premature catagen development and immune changes in human scalp hair follicles, providing a possible biological link between stress and hair loss conditions like telogen effluvium and alopecia areata.

research Alopecia Areata: A Tissue-Specific Autoimmune Disease of the Hair Follicle

185 citations , August 2005 in “Autoimmunity Reviews”

This review discusses alopecia areata as a model for studying tissue-directed autoimmune diseases and reports no new clinical findings.

research Topical Immunomodulators in Dermatology

28 citations , January 2005 in “PubMed”

This review discusses the use, mechanism, and side effects of topical immunomodulators in treating immune-mediated skin disorders and reports no new clinical results, urging further research on experimental agents.

research Alopecia Areata in Korea (1982–1994)

46 citations , November 1995 in “The Journal of Dermatology”

This study found that immunotherapy with DNCB or DPCP showed better therapeutic effects than intralesional triamcinolone acetonide for patients with bald areas greater than 50 cm², including alopecia totalis and universalis.