Topical and Intralesional Therapies for Alopecia Areata

    January 2012 in “ ˜The œYear book of dermatology
    G.K. Kim, J.Q. Del Rosso
    From the encyclopedia
    Alopecia Areata →

    autoimmune disorder causing patchy hair loss

    Minoxidil →

    An essential vasodilator with some anti-androgenic effects

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    Studysummary This study found that women with late onset acne have fewer comedones and acne lesions compared to those with early onset, despite no differences in P. acnes density or sebum secretion.
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    The document reviews various treatments for alopecia areata (AA), a common, unpredictable inflammatory nonscarring alopecia affecting both children and adults, which can also be associated with nail changes and autoimmune diseases. The efficacy of intralesional corticosteroid (ILC) injections for AA is not supported by randomized controlled trials, and the response to topical minoxidil is inconsistent. Anthralin, although messy and skin-discoloring, can be used as short contact therapy. Phototherapy with psoralen plus UVA light, topical tacrolimus, pimecrolimus, and photodynamic therapy have not shown encouraging results in treating AA. The authors recommend no routine testing for AA patients and suggest treatment should consider the patient's age and disease extent. For patients under 10 years, a combination of minoxidil 5% with a midpotency topical corticosteroid is recommended as first-line treatment. For those over 10 years, ILC is suggested along with 5% minoxidil and topical corticosteroid therapy as adjuncts. For extensive disease in patients over 10 years, topical therapy with diphenylcyclopropenone may be used, expecting allergic contact dermatitis. Topical corticosteroid therapy and ILC are preferred for localized disease.
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