Practical Approach for Treatment Lines of Alopecia Areata: Review Article

July 2023 in “ The Egyptian Journal of Hospital Medicine ”

Samia Ibrahim, Mohamed El-Ghareeb, Aya Mohamed, Abd Elhamed

alopecia areata autoimmune disease hair loss topical corticosteroids intralesional corticosteroids systemic medications AA corticosteroids

TLDR The conclusion is that emotional support and a variety of treatments are important for alopecia areata, but more research is needed.

The document reviews the treatment approaches for alopecia areata (AA), an autoimmune disease causing unpredictable hair loss. The literature search spanned from September 2001 to April 2021, excluding non-English documents and unpublished works. The conclusion emphasizes the importance of emotional support for AA patients and the variability in treatment response. Few well-designed clinical trials exist, but treatments include topical, intralesional, and systemic medications, as well as devices. Patchy AA is commonly treated initially with intralesional or topical corticosteroids, although evidence for the effectiveness of various treatments is limited but promising.

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Research cited in this study

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Tofacitinib is safe and effective for severe alopecia areata, but hair loss may return 2 months after stopping treatment.

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A user did not respond to finasteride, dutasteride, and oral minoxidil for hair loss after four years of treatment and is considering scalp micropigmentation (SMP). Other users suggest the hair loss pattern may indicate alopecia areata and recommend seeing a dermatologist.

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A 19-year-old is distressed about his 17-year-old autistic brother's hair loss, projecting his own insecurities despite being on finasteride and dutasteride. Replies suggest the brother might not care about balding, and the poster should address his own issues.

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