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Treatments

How is Alopecia Areata Treated?

While there is neither a cure for alopecia areata nor drugs approved for its treatment, some people find that medications approved for other purposes can help hair grow back, at least temporarily. The following are some treatments for alopecia areata. Keep in mind that while these treatments may promote hair growth, none of them prevent new patches or actually cure the underlying disease. Consult your health care professional about the best option for you.

http://www.cochrane.org/CD004413/SKIN_treatments-for-alopecia-areata-alopecia-totalis-and-alopecia-universalis

Corticosteroids

Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. Because these drugs suppress the immune system if given orally, they are often used in the treatment of various autoimmune diseases, including alopecia areata. Corticosteroids may be administered in three ways for alopecia areata:

Local injections-Injections of steroids directly into hairless patches on the scalp and sometimes the brow are effective in increasing hair growth in most people. It usually takes about 4 weeks for new hair growth to become visible. Injections deliver small amounts of cortisone to affected areas, avoiding the more serious side effects encountered with long-term oral use. The main side effects of injections are transient pain, mild swelling, and sometimes changes in pigmentation, as well as small indentations in the skin that go away when injections are stopped. Because injections can be painful, they may not be the preferred treatment for children. After 1 or 2 months, new hair growth usually becomes visible, and the injections usually have to be repeated monthly. The cortisone removes the confused immune cells and allows the hair to grow. Large areas cannot be treated.

Oral corticosteroids-Corticosteroids taken by mouth are a mainstay of treatment for many autoimmune diseases and may be used in more extensive alopecia areata. But because of the risk of side effects of oral corticosteroids, such as hypertension and cataracts, they are used only occasionally for alopecia areata and for shorter periods of time.

Topical ointments-Ointments or creams containing steroids rubbed directly onto the affected area are less traumatic than injections and, therefore, are sometimes preferred for children. However, corticosteroid ointments and creams alone are less effective than injections; they work best when combined with other topical treatments, such as minoxidil or anthralin.

Anthralin  (DCP)

Anthralin, a synthetic tar-like substance that alters immune function in the affected skin, is an approved treatment for psoriasis. Anthralin is also commonly used to treat alopecia areata. Anthralin is applied for 20 to 60 minutes (”short contact therapy”) to avoid skin irritation, which is not needed for the drug to work. When it works, new hair growth is usually evident in 8 to 12 weeks. Anthralin is often used in combination with other treatments, such as corticosteroid injections or minoxidil, for improved results.

Sulfasalazine

A sulfa drug, sulfasalazine has been used as a treatment for different autoimmune disorders, including psoriasis and rheumatoid arthritis. It is a combination of an aspirin-like anti inflammatory component and a sulphur antibiotic-like component.  It acts on the immune system and has been used to some effect in patients with severe alopecia areata.

Topical sensitizers

Topical sensitizers are medications that, when applied to the scalp, provoke an allergic reaction that leads to itching, scaling, and eventually hair growth. If the medication works, new hair growth is usually established in 3 to 12 months. Two topical sensitizers are used in alopecia areata: squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP). Their safety and consistency of formula are currently under review.

Photochemotherapy

In photochemotherapy, a treatment used most commonly for psoriasis, a person is given a light-sensitive drug called a psoralen either orally or topically and then exposed to an ultraviolet light source. This combined treatment is called PUVA. In clinical trials, approximately 55 percent of people achieve cosmetically acceptable hair growth using photochemotherapy. However, the relapse rate is high, and patients must go to a treatment centre where the equipment is available at least two to three times per week. Furthermore, the treatment carries the risk of developing skin cancer. Long term use has been associated with higher rates of skin cancer.

Minoxidil (5%)

Topical minoxidil solution promotes hair growth in several conditions in which the hair follicle is small and not growing to its full potential. Minoxidil is FDA-approved for treating male and female pattern hair loss. It may also be useful in promoting hair growth in alopecia areata. The solution, applied twice daily, has been shown to promote hair growth in both adults and children, and may be used on the scalp, brow, and beard areas. With regular and proper use of the solution, new hair growth appears in about 12 weeks.

Trichologists

Trichologists claim to treat all forms of hair loss, hair shaft breakage, scalp disorders, and the scalp environment. Pure Academic Trichology is a paramedical area of health care that embraces both naturopathic & western medicine, endocrinology and dermatology.

Alternative therapies

When drug treatments fail to bring sufficient hair regrowth, some people turn to alternative therapies. Alternatives reported to help alopecia areata include acupuncture, reiki, meditation, thought field therapy, aroma therapy, evening primrose oil, zinc, vitamin supplements, and Chinese herbs. Because many alternative therapies are not backed by clinical trials, they may or may not be effective for regrowing hair. In fact, some may actually make hair loss worse. Furthermore, just because these therapies are natural does not mean that they are safe. As with any therapy, it is best to discuss these treatments with your doctor before you try them.

In addition to treatments to help hair grow, there are measures that can be taken to minimize the physical dangers or discomforts of lost hair.

  • Sunscreens are important for the scalp, face, and all exposed areas.
  • Eyeglasses (or sunglasses) protect the eyes from excessive sun, and from dust and debris, when eyebrows or eyelashes are missing.
  • Wigs, caps, or scarves protect the scalp from the sun and keep the head warm.
  • Antibiotic ointment applied inside the nostrils helps to protect against organisms invading the nose when nostril hair is missi

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