Topical Photochemotherapy for Alopecia Areata

    Andrew J. Mitchell, Margaret Douglass
    TLDR Topical PUVA can cause temporary hair regrowth in some alopecia areata patients but doesn't change the long-term outcome.
    Twenty-two patients with alopecia areata were treated with a combination of topical 0.1% 8-methoxypsoralen and UVA (PUVA). Of these, 8 patients (36.3%) experienced excellent regrowth, and 2 patients (9.1%) showed good regrowth. The mean total UVA exposure and number of treatments for responders were 171.7 joules/cm² and 47.4 treatments, respectively. However, 8 of the 9 responders available for follow-up experienced some degree of relapse within an average of 8.3 months after treatment discontinuation. Despite the lack of long-term efficacy, combining PUVA with other treatments might prolong its beneficial effects, potentially due to an immunomodulatory mechanism.
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