How Is Alopecia 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
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
of steroids directly into hairless patches on the
scalp and sometimes the brow and beard areas 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, however, because the discomfort and the
amount of medicine become too great and can result
in side effects similar to those of the oral
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.
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.
(Rogaine*)--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.
*Brand names included in this booklet
are provided as examples only, and their inclusion does
not mean that these products are endorsed by the
National Institutes of Health or any other Government
agency. Also, if a particular brand name is not
mentioned, this does not mean or imply that the product
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.
sulfa drug, sulfasalazine has been used as a treatment
for different autoimmune disorders, including psoriasis.
It acts on the immune system and has been used to some
effect in patients with severe alopecia areata.
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.
developed to keep people's immune systems from rejecting
transplanted organs, oral cyclosporine is sometimes used
to suppress the immune system response in psoriasis and
other immune-mediated skin conditions. But suppressing
the immune system can also cause problems, including an
increased risk of serious infection and possibly skin
cancer. Although oral cyclosporine may regrow hair in
alopecia areata, it does not turn the disease off. Most
doctors feel the dangers of the drug outweigh its
benefits for alopecia areata.
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 center where the equipment is available at
least two to three times per week. Furthermore, the
treatment carries the risk of developing skin cancer.
drug treatments fail to bring sufficient hair regrowth,
some people turn to alternative therapies. Alternatives
purported to help alopecia areata include acupuncture,
aroma therapy, evening primrose oil, zinc and 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
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 missing.
Source: Adapted from National
Institute of Arthritis and Musculoskeletal and Skin Diseases
Part 1: What is alopecia areata?
Part 2: Is alopecia heredity?
Part 3: Is my hair loss a serious disease?
Part 4: Treatments for alopecia
Part 5: Will my hair grow back?
Part 6: How can I cope with alopecia?
Part 7: What can I expect later in life?