Update on the Treatment of Alopecia Areata

The 2009 document reviews treatment options for alopecia areata (AA), highlighting that while treatments like minoxidil, corticosteroids, and contact immunotherapy can promote hair regrowth, they do not cure AA. Contact immunotherapy with DPCP is the most stable and widely used, with a 50% to 60% regrowth rate, but success varies, especially in extensive alopecia. Systemic treatments, including corticosteroids and other immunosuppressors like cyclosporine and methotrexate, are used with caution due to side effects and potential relapse. Methotrexate showed regrowth in 14 out of 22 patients, and biotin and zinc were beneficial in children. Biologic therapies and other miscellaneous treatments have been explored, but more research is needed to confirm their efficacy. The document recommends a stepwise approach to treatment, starting with less aggressive measures and advancing to more aggressive ones based on disease severity and response to treatment.