Review of Treatment for Alopecia Totalis and Alopecia Universalis

April 2017 in “ International Journal of Dermatology ”

Sama Kassira, Dorota Z. Korta, Lance W. Chapman, Francis Dann

TLDR No treatment is completely effective for alopecia totalis and alopecia universalis.

The review examined treatments for alopecia totalis (AT) and alopecia universalis (AU), focusing on evidence from 40 studies retrieved from PubMed between 2000 and 2016. Treatments included topical immunotherapy, steroids, photodynamic therapy, immunosuppressive agents, TNFα inhibitors, and other therapies like sulfasalazine, bexarotene, JAK inhibitors, and simvastatin/ezetimibe. While some treatments showed significant hair regrowth, none were completely effective. The most promising therapies were diphenylcyclopropenone, squaric acid dibutylester, photodynamic therapy, steroids, and cyclosporine with methylprednisolone. The review highlighted the need for high-quality randomized-controlled trials with large sample sizes and unified outcome guidelines to better compare future studies.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Cited in this study

25 / 25 results

research Treatment of an Alopecia Areata Patient with Tofacitinib Results in Regrowth of Hair and Changes in Serum and Skin Biomarkers

70 citations , July 2016 in “Experimental Dermatology”

A patient with alopecia areata regrew hair after taking tofacitinib and showed changes in certain blood and skin markers.

research Topical Ruxolitinib for the Treatment of Alopecia Universalis

96 citations , April 2016 in “JAMA dermatology”

research Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients

41 citations , November 2015 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

Diphenylcyclopropenone (DPCP) can help regrow hair in many alopecia areata patients but may cause side effects and relapses.

research Combined Oral Pulse and Topical Corticosteroid Therapy for Severe Alopecia Areata in Children: A Long-Term Follow-Up Study

28 citations , July 2015 in “Dermatologic therapy”

The combined therapy was effective and safe for children with severe alopecia areata.

research Efficacy and Safety of Diphenylcyclopropenone Alone or in Combination with Anthralin in the Treatment of Chronic Extensive Alopecia Areata: A Retrospective Case Series

44 citations , April 2015 in “Journal of the American Academy of Dermatology”

Combining diphenylcyclopropenone with anthralin is more effective for hair regrowth in alopecia areata than using diphenylcyclopropenone alone, but may cause more side effects.

research Combination Therapy with Zinc Gluconate and PUVA for Alopecia Areata Totalis: An Adjunctive but Crucial Role of Zinc Supplementation

16 citations , March 2015 in “Dermatologic therapy”

Zinc supplementation may be an important part of treating severe hair loss.

research The Autoimmune Basis of Alopecia Areata: A Comprehensive Review

162 citations , February 2015 in “Autoimmunity reviews”

Alopecia areata is caused by the immune system attacking hair follicles.

research Intravenous Methylprednisolone Pulse Therapy in Severe Alopecia Areata

14 citations , January 2015 in “Indian journal of dermatology, venereology, and leprology”

Methylprednisolone infusions can help some people with severe alopecia regrow hair.

research Alopecia Universalis Successfully Treated With Adalimumab

37 citations , December 2014 in “JAMA dermatology”

A woman with severe hair loss was successfully treated with the drug adalimumab.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , December 2014 in “Journal of Investigative Dermatology”

A man with severe hair loss and skin disease regrew his hair with no side effects after taking tofacitinib.

research Efficacy and Safety of Methotrexate in Alopecia Areata

44 citations , September 2014 in “Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia”

Methotrexate is a promising and safe treatment for severe alopecia areata, with better results when combined with corticosteroids.

research New Aspects of the Treatment of Alopecia Areata

18 citations , January 2014 in “Postępy Dermatologii i Alergologii”

Personalized treatment plans are important for people with alopecia areata.

research The Effect of Oral Cyclosporine in the Treatment of Severe Alopecia Areata

33 citations , October 2013 in “Cutaneous and ocular toxicology”

Oral cyclosporine can help regrow hair in severe alopecia areata cases.

research Alopecia Areata Update

85 citations , January 2013 in “Dermatologic Clinics”

Alopecia Areata is an autoimmune condition often starting before age 20, with varied treatment success and a need for personalized treatment plans.

research Pulse Corticosteroid Therapy for Alopecia Areata in Children: A Retrospective Study

38 citations , January 2013 in “Dermatology”

Careful patient selection is key for effective pulse corticosteroid treatment in children with alopecia areata.

research Multivariate Analysis of Prognostic Factors in Patients With Rapidly Progressive Alopecia Areata

26 citations , December 2012 in “Journal of The American Academy of Dermatology”

Patients with rapidly progressive alopecia areata often have a better outlook and shorter disease duration, with regrown fine hairs and no past alopecia being positive signs.

research Extensive Alopecia Areata: Not Necessarily Recalcitrant to Therapy

14 citations , January 2011 in “International Journal of Trichology”

Some people with severe, long-lasting baldness responded well to a specific combination treatment.

research Turban PUVASOL: An Effective Treatment in Alopecia Totalis

5 citations , January 2010 in “International journal of trichology”

PUVASOL might effectively treat complete scalp baldness.

research Phase I/II Randomized Bilateral Half-Head Comparison of Topical Bexarotene 1% Gel for Alopecia Areata

44 citations , October 2009 in “Journal of the American Academy of Dermatology”

Topical bexarotene 1% gel might help regrow hair in alopecia areata and is generally safe.

research Combination Therapy With Oral PUVA and Corticosteroid for Recalcitrant Alopecia Areata

24 citations , March 2009 in “Archives of dermatological research”

The combination of oral PUVA and corticosteroids helps regrow hair in severe alopecia areata.

research Acute Diffuse And Total Alopecia: A New Subtype Of Alopecia Areata With A Favorable Prognosis

64 citations , January 2009 in “Journal of The American Academy of Dermatology”

A new type of rapid hair loss called ADTA usually gets better on its own within 6 months.

research Treatment of Persistent Alopecia Areata with Sulfasalazine

45 citations , July 2008 in “International Journal of Dermatology”

Sulfasalazine may help treat persistent alopecia areata.

research Topical Immunotherapy of Severe Alopecia Areata with Diphenylcyclopropenone: Experience in an Iranian Population

36 citations , May 2005 in “BMC dermatology”

DPCP is effective for treating severe alopecia areata, but relapse is common.

research Guidelines for the Management of Alopecia Areata

182 citations , October 2003 in “British Journal of Dermatology”

The 2003 guidelines suggest that while some treatments can regrow hair in alopecia areata, none alter the disease's progression, and wigs may be the best option for extensive hair loss.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations , July 2003 in “Journal of the American Academy of Dermatology”

Clobetasol propionate ointment can help some people with total hair loss regrow hair.

3 / 3 results

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations , March 2019 in “Journal of autoimmunity”

Alopecia areata is an autoimmune disease causing patchy hair loss, often with other autoimmune disorders, but its exact causes are unknown.

research Linear Alopecia Areata

4 citations , November 2018 in “JAAD case reports”

Alopecia areata can sometimes appear as a straight line of hair loss instead of round patches.

research Treating Resistant Cases of Alopecia Universalis

May 2018 in “Journal of cosmetology & trichology”

Combining platelet-rich plasma therapy with prostaglandin-F eye drops can significantly regrow hair in alopecia universalis.