TLDR No systemic treatment for alopecia areata has strong evidence of effectiveness.
This systematic review evaluated the evidence for systemic treatments for alopecia areata, alopecia totalis, and alopecia universalis by analyzing 16 randomized controlled trials (RCTs) with a total of 768 participants. The review found significant variability in treatment success definitions and noted that no study assessed the impact of treatments on quality of life using comprehensive quantitative instruments. Oral prednisolone pulse therapy and oral inosiplex showed some efficacy, while oral zinc sulfate, alefacept, and efalizumab were not supported by evidence. Adverse events were mostly corticosteroid-related but generally well tolerated. The review concluded that no specific systemic therapy had robust evidence from RCTs, and future studies should have clear clinical response endpoints to facilitate meta-analyses.
128 citations,
February 2016 in “British Journal of Dermatology” Alopecia areata significantly lowers the quality of life, especially in emotional and mental health aspects.
20 citations,
January 2013 in “Evidence-based complementary and alternative medicine” TGPC plus CGT is effective and safe for treating severe alopecia areata in children.
18 citations,
August 2012 in “Chinese journal of integrative medicine/Chinese Journal of Integrative Medicine” Both treatments for alopecia areata are equally effective and safe.
43 citations,
November 2009 in “Archives of dermatology” Alefacept does not effectively treat severe alopecia areata.
97 citations,
January 2006 in “Dermatology” imTA and pulse therapy are effective for alopecia areata with manageable side effects, but relapse rates need improvement.
1 citations,
August 2023 in “Acta dermato-venereologica” Corticosteroids are the most common treatment for alopecia areata, but many patients need better options.
6 citations,
November 2022 in “Journal of autoimmunity” JAK inhibitors like tofacitinib may effectively treat Alopecia Areata.
October 2022 in “Journal of Armed Forces Medical College, Bangladesh” Tofacitinib is effective and safe for treating alopecia areata.
39 citations,
April 2016 in “Case Reports in Dermatology” Tofacitinib temporarily regrew hair in a man with alopecia, but its effects didn't last.
5 citations,
June 2015 in “Veterinary dermatology” A dog with complete hair loss regrew most hair after treatment, with no relapse after stopping treatment.
39 citations,
April 2003 in “Australasian journal of dermatology” PUVA treatment led to significant hair regrowth in over half of the patients with alopecia areata totalis and universalis.
