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.
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 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
regimen.
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.
Minoxidil (5%) (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 is
unsatisfactory.
Anthralin (Psoriatec)--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. 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.
Oral cyclosporine--Originally
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--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
center where the equipment is
available at least two to three
times per week. Furthermore, the
treatment carries the risk of
developing skin cancer.
Alternative therapies--When 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 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 missing.
Content Courtesy : www.niams.nih.gov
The information provided herein
is intended for your general
knowledge only and is not a
substitute for medical advice or
treatment for specific medical
conditions. The information should
not be used during any medical
emergency or for the diagnosis or
treatment of any medical condition.
A licensed physician should be
consulted for
diagnosis and treatment of any and all medical conditions.
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