Treatments for Alopecia Areata: A Systematic Review and Network Meta-Analysis

February 2021 in “ Dermatologic therapy ”

Takeshi Fukumoto, Rie Fukumoto, Elizabeth Magno, Masahiro Oka, Chikako Nishigori, Nobuyuki Horita

alopecia areata pentoxifylline topical corticosteroids topical calcipotriol NBUVB intralesional corticosteroids SADBE IFNA contact immunotherapy TCPC.sys CGT.sys Chinese herbal medicines AA PTX corticosteroids calcipotriol narrowband UVB interferon alpha immunotherapy

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Calcipotriene →

Studysummary This study found that pentoxifylline plus topical corticosteroids had the highest treatment success rate for alopecia areata compared to no treatment, but the best overall treatment remains uncertain due to varying data.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This systematic review and network meta-analysis included 54 randomized controlled trials with 3,209 patients, evaluating 49 different treatments for alopecia areata (AA). The study found that pentoxifylline (PTX) plus topical corticosteroids had the highest treatment success rate compared to "no treatment," with other treatments like PTX alone, topical calcipotriol plus NBUVB, and intralesional corticosteroids also showing high success rates. SADBE plus IFNA was the most effective in the contact immunotherapy loop, and TCPC.sys plus CGT.sys was the best among Chinese herbal medicines. Despite these findings, no single best treatment for AA was identified due to independent loops and wide confidence intervals, highlighting the need for further head-to-head comparisons among effective treatments.

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Research cited in this study

18 / 18 results

research Topical Calcipotriol vs Narrowband Ultraviolet B in Treatment of Alopecia Areata: A Randomized-Controlled Trial

9 citations , June 2019 in “Archives of Dermatological Research”

This study found that both topical calcipotriol and narrow band ultraviolet B phototherapy improved hair regrowth and vitamin D3 levels in alopecia areata patients.

research Cyclosporine for Moderate-to-Severe Alopecia Areata: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety

44 citations , April 2019 in “Journal of the American Academy of Dermatology”

This study observed that cyclosporine showed a trend toward improving alopecia areata symptoms compared to placebo, but the difference was not statistically significant.

research The Efficacy of Topical Minoxidil for Non-Scarring Alopecia: A Systematic Review

1 citations , February 2019 in “PubMed”

This source reports that topical minoxidil effectively treats hair loss in androgenetic alopecia, varying efficacy by ethnic groups, and when combined with other therapies, shows increased effectiveness for conditions like alopecia areata and congenital hair disorders.

research Monotherapy for Alopecia Areata: A Systematic Review and Network Meta-Analysis

16 citations , January 2019 in “Skin appendage disorders”

This study used a network meta-analysis to compare alopecia areata treatments, finding that intralesional corticosteroids are most effective for mild cases, while diphenylcyclopropenone ranks highest for moderate to severe cases; further research on oral tofacitinib is needed.

A Randomized Placebo-Controlled Single-Center Pilot Study of the Safety and Efficacy of Apremilast in Subjects with Moderate-to-Severe Alopecia Areata

research A Randomized Placebo-Controlled Single-Center Pilot Study of the Safety and Efficacy of Apremilast in Subjects with Moderate-to-Severe Alopecia Areata

42 citations , November 2018 in “Archives of dermatological research”

Apremilast was not effective in treating moderate-to-severe alopecia areata.

research Intralesional Pentoxifylline Injection in Localized Alopecia Areata

3 citations , October 2018 in “Journal of cosmetic dermatology”

This study found that intralesional pentoxifylline injections were effective for localized alopecia areata, with the best results observed when combined with triamcinolone acetonide.

research Systemic Treatments for Alopecia Areata: A Systematic Review

41 citations , September 2018 in “Australasian journal of dermatology”

This review suggests that oral prednisolone pulse therapy and oral inosiplex may be effective for alopecia areata, but robust evidence from randomized controlled trials is lacking, highlighting the need for better-designed future studies.

research A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

23 citations , April 2018 in “PubMed”

This review finds preliminary evidence suggesting that topical finasteride may significantly reduce hair loss and increase hair counts in treating androgenetic alopecia, with a promising safety profile.

research Platelet-Rich Plasma Versus Minoxidil 5% in Treatment of Alopecia Areata: A Trichoscopic Evaluation

62 citations , October 2016 in “Dermatologic Therapy”

This study found that platelet-rich plasma was more effective for treating alopecia areata than topical 5% minoxidil, leading to earlier hair regrowth and reduction in hair abnormalities.

research Alopecia Areata: What’s New in Epidemiology, Pathogenesis, Diagnosis, and Therapeutic Options?

56 citations , October 2016 in “Journal of dermatological science”

This review explores multidisciplinary advances in understanding alopecia areata, including epidemiology, pathogenesis, and innovative treatments, but reports no new research results.

research Clobetasol Propionate, 0.05%, vs Hydrocortisone, 1%, for Alopecia Areata in Children

49 citations , November 2013 in “JAMA dermatology”

This study found that topical clobetasol propionate cream was more effective than hydrocortisone cream in reducing hair loss surface area in children with patchy alopecia areata over 24 weeks, with no serious adverse effects.

research British Association of Dermatologists’ Guidelines for the Management of Alopecia Areata 2012

218 citations , April 2012 in “British Journal of Dermatology”

This updated guideline from the British Association of Dermatologists discusses current recommendations for managing alopecia areata but reports no new clinical research findings.

research The Randomized Double-Blind Placebo-Controlled Trial of Intralesional Botulinum Toxin A Injection for Recalcitrant Alopecia Totalis and Alopecia Universalis

1 citations , March 2012 in “Journal of the American Academy of Dermatology”

Botulinum toxin A injections may help treat difficult cases of total hair loss.

research Advances in the Management of Alopecia Areata

51 citations , December 2011 in “The Journal of Dermatology”

This review discusses updated treatment guidelines for alopecia areata in Japan, highlighting new options like corticosteroid pulse therapy, but reports no new clinical results.

research Interventions for Alopecia Areata

164 citations , April 2008 in “Cochrane library”

This review of interventions for alopecia areata found no significant treatment benefits for hair growth compared to placebo, indicating a need for larger, well-conducted studies.

research Efficacy And Safety Of A New Clobetasol Propionate 0.05% Foam In Alopecia Areata: A Randomized, Double-Blind Placebo-Controlled Trial

114 citations , October 2006 in “Journal of the European Academy of Dermatology and Venereology”

In this study, clobetasol propionate foam demonstrated effectiveness and good patient compliance as a safe topical treatment for moderate to severe alopecia areata, with significant hair regrowth compared to placebo.

research Placebo-Controlled Oral Pulse Prednisolone Therapy in Alopecia Areata

141 citations , February 2005 in “Journal of the American Academy of Dermatology”

In this study, oral prednisolone pulse therapy led to significant hair regrowth in some patients with extensive alopecia areata, whereas no improvement was seen in the placebo group.

research Large Doses of Glucocorticoid in the Treatment of Alopecia Areata

80 citations , November 1975 in “Acta dermato-venereologica”

This study found that while some patients with severe alopecia areata responded to high-dose prednisolone, the response was inconsistent and the therapy's risks prevent recommending it for general use.