Topical and Intralesional Therapies for Alopecia Areata

The document reviewed treatments for alopecia areata (AA), indicating that while there are various options, none are curative or preventive. Topical corticosteroids have limited efficacy and potential side effects like skin atrophy. Intralesional corticosteroids are effective for patchy AA but should be limited to 20 mg per session to avoid side effects. Minoxidil is dose-responsive but not fully understood and can cause contact dermatitis. Anthralin is effective but can cause irritation and staining, while DPCP has a 50-60% success rate but risks severe dermatitis. Latanoprost showed a 45% response rate for eyelash AA, and bimatoprost helped those with less extensive loss. Phototherapy is not favored due to cancer risks, though the 308-nm excimer laser showed a 41.5% regrowth rate. Bexarotene and capsaicin ointment are promising but need more research. Topical tacrolimus, pimecrolimus, imiquimod, and photodynamic therapy were ineffective. The document recommends topical and intralesional corticosteroids for localized AA and contact immunotherapy for extensive cases.