Current and Future Pharmacotherapy for Alopecia Areata

March 2015 in “ Expert opinion on orphan drugs ”

Norma Elizabeth Vázquez-Herrera, Antonella Tosti

alopecia areata hair loss immune privilege inflammatory attacks hair follicles steroids immunotherapy psychological support JAK inhibitors abatacept IL-2 anti-IFN-y PRP platelet-rich plasma stem cell therapy ezetimibe simvastatin tianeptine

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Platelet-Rich Plasma →

growth factors taken from your blood and injected into your scalp to stimulate hair

Studysummary This review discusses recent advances in the treatment of alopecia areata, highlighting new potential therapies like JAK inhibitors and PRP, and reports no new clinical results.

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

The 2015 document reviews the state of pharmacotherapy for alopecia areata, a condition causing hair loss, and explores both current and potential future treatments. It details the disease's genetic and immunological underpinnings, including the loss of immune privilege and inflammatory attacks on hair follicles. Current treatments, such as steroids, immunotherapy, and psychological support, are discussed alongside their efficacy and limitations. The document also introduces future therapies like JAK inhibitors, abatacept, IL-2, anti-IFN-y, PRP, stem cell therapy, ezetimibe/simvastatin, and tianeptine, which have shown promise in preliminary studies but require more extensive clinical trials to confirm their safety and effectiveness. It emphasizes the need for new treatments based on a deeper understanding of the disease's pathogenesis, with JAK inhibitors being particularly promising, though further research is necessary to establish reliable pharmacotherapy options for alopecia areata.

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Research cited in this study

48 / 48 results

research Alopecia Universalis Successfully Treated With Adalimumab

37 citations , October 2014 in “JAMA dermatology”

This case report describes a woman with alopecia universalis, resistant to multiple treatments, who experienced successful hair regrowth with adalimumab, suggesting potential mechanisms for future investigation.

Mycophenolate Antagonizes IFN-γ-Induced Catagen-Like Changes via β-Catenin Activation in Human Dermal Papilla Cells and Hair Follicles

research Mycophenolate Antagonizes IFN-γ-Induced Catagen-Like Changes via β-Catenin Activation in Human Dermal Papilla Cells and Hair Follicles

11 citations , September 2014 in “International Journal of Molecular Sciences”

This study found that mycophenolate may stabilize β-catenin and counteract interferon-γ-induced catagen changes in human dermal papilla cells, which could promote hair growth.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , June 2014 in “Journal of Investigative Dermatology”

This case report describes complete hair regrowth in a patient with alopecia universalis and improved psoriasis after treatment with the oral Janus kinase inhibitor, tofacitinib.

research Lack of Response to Laser Comb in Spontaneous and Graft-Induced Alopecia Areata in C3H/HeJ Mice

13 citations , January 2014 in “Journal of Investigative Dermatology”

The laser comb did not improve hair regrowth in mice with alopecia areata.

research Excimer Laser: A Module of the Alopecia Areata Common Protocol

17 citations , December 2013 in “Journal of Investigative Dermatology Symposium Proceedings”

The excimer laser may help hair regrow in alopecia areata patients.

research Current Treatment of Alopecia Areata

71 citations , December 2013 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

This review discusses various treatments for alopecia areata, highlighting their limitations and individualized approach, and reports no new clinical results.

research Clobetasol Propionate, 0.05%, vs Hydrocortisone, 1%, for Alopecia Areata in Children

49 citations , November 2013 in “JAMA dermatology”

This study found that topical clobetasol propionate cream was more effective than hydrocortisone cream in reducing hair loss surface area in children with patchy alopecia areata over 24 weeks, with no serious adverse effects.

research Targeted Photochemotherapy in Alopecia Areata

3 citations , October 2013 in “Photodermatology Photoimmunology & Photomedicine”

This study observed that combining targeted UVA phototherapy with topical 8-methoxypsoralen showed cosmetically acceptable hair regrowth in patients with patchy alopecia areata.

research Serum Granulysin as a Possible Key Marker of the Activity of Alopecia Areata

26 citations , September 2013 in “Journal of Dermatological Science”

In this study, researchers found that serum granulysin levels might serve as a novel marker for disease activity in acute alopecia areata, being significantly associated with broader bald skin areas, poorer prognosis, and co-existing allergic disorders.

A Randomized, Double-Blind, Placebo- and Active-Controlled, Half-Head Study to Evaluate the Effects of Platelet-Rich Plasma on Alopecia Areata

research A Randomized, Double-Blind, Placebo- and Active-Controlled, Half-Head Study to Evaluate the Effects of Platelet-Rich Plasma on Alopecia Areata

205 citations , April 2013 in “British Journal of Dermatology”

In this study, platelet-rich plasma significantly increased hair regrowth and reduced symptoms of alopecia areata compared to triamcinolone acetonide or placebo, with no observed side effects.

research Pulse Corticosteroid Therapy for Alopecia Areata in Children: A Retrospective Study

38 citations , January 2013 in “Dermatology”

This study found that intravenous high-dose pulse corticosteroids resulted in a complete response in 38% of children with alopecia areata, but the majority of responders relapsed within a year.

research British Association of Dermatologists’ Guidelines for the Management of Alopecia Areata 2012

218 citations , April 2012 in “British Journal of Dermatology”

This updated guideline from the British Association of Dermatologists discusses current recommendations for managing alopecia areata but reports no new clinical research findings.

research Alopecia Areata: An Autoimmune Disease Causing Hair Loss

421 citations , April 2012 in “The New England Journal of Medicine”

Alopecia Areata is an autoimmune condition causing hair loss with no cure and treatments that often don't work well.

research Hair and Scalp Dermatoscopy

245 citations , March 2012 in “Journal of The American Academy of Dermatology”

This review discusses the dermoscopic features of common hair and scalp disorders and reports no new clinical results, aiming to assist dermatologists in diagnosing conditions like tinea capitis and alopecia areata.

research Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

39 citations , January 2012 in “Dermatology”

In this study, the combination of pulse intravenous corticosteroids and methotrexate was associated with positive hair regrowth in severe alopecia areata patients, with half achieving total regrowth.

research Narrowband Ultraviolet B Phototherapy for Alopecia Areata

37 citations , November 2011 in “Photodermatology Photoimmunology & Photomedicine”

This study found that narrowband UVB phototherapy alone is not very effective for severe alopecia areata, with improved responses noted primarily in patients also receiving corticosteroid injections.

research Effects of the Lexington LaserComb on Hair Regrowth in the C3H/HeJ Mouse Model of Alopecia Areata

81 citations , July 2011 in “Lasers in Medical Science”

This study found that using a low-level laser comb led to hair regrowth in a mouse model of alopecia areata, while sham-treated mice showed no hair regrowth.

research The Genetics of Alopecia Areata: What's New and How Will It Help Our Patients?

43 citations , May 2011 in “Dermatologic therapy”

This study identified at least eight genetic regions associated with alopecia areata, which may lead to the development of new targeted therapies based on these findings.

research Efficacy and Tolerability of Methotrexate in Severe Childhood Alopecia Areata

70 citations , April 2011 in “British journal of dermatology/British journal of dermatology, Supplement”

This retrospective study found that methotrexate had variable efficacy in treating severe alopecia areata in children, with successful hair regrowth observed in five out of thirteen assessable cases.

research Type 1 Interferon Signature in the Scalp Lesions of Alopecia Areata

52 citations , March 2010 in “British Journal of Dermatology”

This study demonstrated the expression of type 1 interferon-related proteins in inflammatory lesions of alopecia areata, showing a distinct distribution pattern compared to cicatricial alopecia.

research Alopecia Areata Update

244 citations , January 2010 in “Journal of the American Academy of Dermatology”

This review discusses treatment options for alopecia areata and suggests tailored treatment plans, noting the challenges posed by spontaneous remission and limited high-quality clinical trials.

research Medium-Dose Prednisolone Pulse Therapy in Alopecia Areata

17 citations , November 2009 in “Dermato-endocrinology”

This study found that a series of three monthly courses of medium-dose prednisolone pulse therapy was effective and well tolerated in most patients with active, multifocal alopecia areata but not in those with totalis/universalis.

research Alefacept for Severe Alopecia Areata: A Multicenter, Double-Blind, Randomized, Placebo-Controlled Clinical Trial

43 citations , November 2009 in “Archives of dermatology”

This study found that alefacept showed no significant improvement in treating severe alopecia areata compared to placebo over a 24-week period.

Lack of Efficacy of Topical Latanoprost and Bimatoprost Ophthalmic Solutions in Promoting Eyelash Growth in Patients with Alopecia Areata

research Lack of Efficacy of Topical Latanoprost and Bimatoprost Ophthalmic Solutions in Promoting Eyelash Growth in Patients with Alopecia Areata

55 citations , March 2009 in “Journal of The American Academy of Dermatology”

This study found that latanoprost and bimatoprost, when applied cutaneously to the eyelids, did not induce appreciable eyelash regrowth in patients with alopecia areata over 16 weeks.

research Treatment of Persistent Alopecia Areata with Sulfasalazine

45 citations , July 2008 in “International Journal of Dermatology”

This study found that oral sulfasalazine led to varying hair regrowth outcomes in patients with persistent alopecia areata, with 56.3% showing moderate to good responses.

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 The Importance of Myeloid-Derived Suppressor Cells in Regulating Autoimmune Effector Cells in Chronic Contact Eczema

84 citations , October 2007 in “The Journal of Immunology”

This study found that chronic eczema supports the expansion of myeloid suppressor cells, which contribute to silencing autoreactive T cells and partially promote hair regrowth in alopecia areata.

research Alopecia Areata: Overview and Treatment Options

151 citations , February 2007 in “International Journal of Dermatology”

This review explores the causes and mechanisms of alopecia areata and discusses current treatments, reporting no new clinical findings.

research Efficacy And Safety Of A New Clobetasol Propionate 0.05% Foam In Alopecia Areata: A Randomized, Double-Blind Placebo-Controlled Trial

114 citations , October 2006 in “Journal of the European Academy of Dermatology and Venereology”

In this study, clobetasol propionate foam demonstrated effectiveness and good patient compliance as a safe topical treatment for moderate to severe alopecia areata, with significant hair regrowth compared to placebo.

research A Comparison of the Efficacy, Relapse Rate, and Side Effects Among Three Modalities of Systemic Corticosteroid Therapy for Alopecia Areata

97 citations , January 2006 in “Dermatology”

This study found that intramuscular triamcinolone acetonide or pulse therapy effectively treats alopecia areata with manageable side effects, but further strategies are needed to reduce relapse rates.

research Alefacept for Alopecia Areata

33 citations , December 2005 in “Archives of dermatology”

This study presents case reports of four patients with alopecia areata or alopecia universalis, highlighting varied responses to treatments like prednisone, intralesional triamcinolone, and squaric acid dibutyl ester.

research Treatment of Alopecia Areata with Anti-Interferon-Gamma Antibodies

16 citations , November 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This study found that intramuscular anti-IFN-γ significantly stabilized and promoted hair regrowth in alopecia areata patients with patchy, progressive hair loss, whereas those with total baldness showed more limited improvement.

research Human Hair Follicles Display a Functional Equivalent of the Hypothalamic-Pituitary-Adrenal (HPA) Axis and Synthesize Cortisol

489 citations , June 2005 in “The FASEB Journal”

This study found that human scalp hair follicles can respond to corticotropin releasing hormone stimulation similarly to the classical HPA axis, including up-regulating cortisol production and activating neuroendocrine feedback loops.

research Recurrence of Alopecia Areata in a Patient Receiving Etanercept Injections

75 citations , June 2005 in “Archives of Dermatology”

In this case report, a patient experienced a recurrence of alopecia areata while undergoing etanercept treatment, suggesting the drug may not effectively prevent this condition's return.

research Placebo-Controlled Oral Pulse Prednisolone Therapy in Alopecia Areata

141 citations , February 2005 in “Journal of the American Academy of Dermatology”

In this study, oral prednisolone pulse therapy led to significant hair regrowth in some patients with extensive alopecia areata, whereas no improvement was seen in the placebo group.

research 308-Nm Excimer Laser Therapy in Alopecia Areata

85 citations , November 2004 in “Journal of the American Academy of Dermatology”

The 308-nm excimer laser helps hair regrowth in some alopecia areata cases but not all.

research Restoration of Hair Growth in Mice with an Alopecia Areata-Like Disease Using Topical Anthralin

29 citations , January 2004 in “Experimental Dermatology”

In this study, anthralin treatment led to hair regrowth in alopecia areata-like affected C3H/HeJ mice, suggesting it may be an effective therapy for this condition.

Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

research Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

66 citations , July 2003 in “International Journal of Dermatology”

This study found that betamethasone valerate foam was more effective and well-tolerated than betamethasone dipropionate lotion in treating mild-to-moderate alopecia areata, with higher hair regrowth rates observed.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations , July 2003 in “Journal of the American Academy of Dermatology”

In this study, clobetasol propionate 0.05% ointment was found to induce hair regrowth in 28.5% of patients with severe alopecia areata under occlusive conditions, though long-term benefit was limited to 17.8%.

research PUVA Treatment of Alopecia Areata Totalis and Universalis: A Retrospective Study

39 citations , April 2003 in “Australasian journal of dermatology”

This study found that PUVA treatment resulted in complete hair regrowth in over half of patients with alopecia areata totalis or universalis, despite a higher treatment failure rate in those with a family history of the condition.

research Cutaneous Latanoprost in the Treatment of Alopecia Areata

22 citations , April 2003 in “Eye”

Applying latanoprost on skin can stimulate hair growth with minimal side effects.

research Sulfasalazine for Alopecia Areata

62 citations , April 2002 in “Journal of the American Academy of Dermatology”

In this study, sulfasalazine treatment resulted in cosmetically acceptable hair regrowth in 23% of patients with severe alopecia areata in whom a response could be determined.

research Alopecia Due to Psychotropic Medications

37 citations , May 1999 in “Annals of pharmacotherapy/The annals of pharmacotherapy”

This review describes psychotropic drug-related hair loss as a possible but uncommon side effect, with resolution typically achieved by discontinuing the medication, and emphasizes clinician-patient discussions for managing the condition.