Alopecia Areata Treatment

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Uploaded by on May 4, 2010

Dr. Diane M. Hoss, MD discusses Alopecia Areata Treatment. See more at http://www.dermnet.com PLEASE RATE AND

COMMENT!!!
The treatment of alopecia areata depends on the amount of hair loss, location of hair loss and age of the patient being

treated. It is important to stress to the patient and family that treatment will not alter the course of the condition; it

can not cure the condition, and it can't prevent new areas of alopecia from occurring and the treatment does not speed up

regrowth. Localized areas of alopecia areata can be treated with several modalities. Some patients may opt not to treat

small localized inconspicuous areas of alopecia, this is acceptable. These areas will probably spontaneously regrow over

several months to two years.




If the patient desires treatment of localized areas to speed regrowth, several options

can be considered. In a child, a mid-potency topical steroid used once daily for 3 months is an easy first line of therapy.

The patient is seen in follow up in 3 months, if there is no regrowth, the treatment is unlikely to be effective. Topical

short-contact anthralin therapy (SCAT) or topical 5% minoxidil can then be tried. In an older child (greater than 10 to 12

years of age), intralesional steroids can be used. An adult with localized alopecia areata is usually treated with

intralesional steroids (triamcinolone at a concentration of 3 to5 mg/ml).




Adults with an aversion to needles can also

be treated with topical SCAT or 5% minoxidil. Adults and children with alopecia totalis or universalis must be counseled on

the low efficacy of therapy. Support must be given including referrals to local support groups and referrals to reputable

makers and fitters of full cranial prostheses. If an adult or adolescent with totalis or universalis desires a trial of

therapy, topical immunotherapy probably has the highest efficacy. Diphenylcylopropenone (DPCP) is the most commonly used

sensitizer. Up to 25% of patients with totalis or universalis will respond to this therapy.

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