Treatment of Alopecia Totalis

In a letter to the editor, the author argued that the dosages recommended by Dr. Orentreich for treating alopecia were inadequate. The author suggested starting treatment with at least 30 mg of prednisone per day, tapering to 10-15 mg/day over a month, and adjusting as needed. Additionally, intralesional steroids should be used to minimize systemic treatment, with 3 ml of a 3.33-mg/ml solution of triamcinolone acetonide administered every 2-3 weeks. The author reported successful treatment of two patients with alopecia totalis and subsequently treated a total of ten patients, eight of whom responded positively.