Treatment-Resistant Alopecia Areata: Response to Combination Therapy with Minoxidil Plus Anthralin

Combination therapy with 5% minoxidil plus 0.5% anthralin was used to treat 51 patients with severe treatment-resistant alopecia areata. Most patients had previously not responded well to either drug used alone. The therapy was generally well tolerated, with only one patient experiencing a severe irritant reaction. Mild to moderate irritant dermatitis was seen in the remaining patients. Out of the 45 patients who completed the 6-month study, 5 (11%) showed a cosmetic response. Among those who continued treatment for up to 84 weeks, 4 (80%) maintained their cosmetic response. All responders showed evidence of hair regrowth by week 12, and the combination therapy resulted in faster and more extensive hair regrowth compared to using either drug alone. The study also found enhanced systemic minoxidil absorption, likely due to the irritant dermatitis, but no clinical evidence of systemic minoxidil effects. These findings suggest that combination therapy with drugs that have different mechanisms of action may have a synergistic effect in treating alopecia areata.