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Alopecia Areata

Treatments for Alopecia

There are a range of treatments for AA, but none are effective for everyone and some people with AA don't respond to any treatment. Because some of the available treatments have a high risk of side effects, they are often not used for children.

The most common AA treatment involves the use of corticosteroids. Corticosteroid creams applied to the bald patches are popular with the average dermatologist, although this treatment approach is only successful for the very mildest cases. A more potent approach is to inject corticosteroid solutions into the bald patches. This can work well for some people, but close monitoring is required to ensure that side effects, such as skin thinning at the site of injection, do not occur.

In extensive cases, systemic corticosteroids (those taken in pill or other form to affect your body) are used, though not continuously since they can cause significant side effects like bone thinning. But short-term "pulse therapy" often has good results.

More specialized treatment approaches involve the application of contact sensitizing chemicals to the skin. These cause an allergic reaction that can help promote hair growth. That may sound counterintuitive but it seems to work. A variety of experimental approaches are currently in laboratory and clinical trials. One group of drugs being tested are "biologics," which have bits of protein that interfere in a very specific way with the activity of immune cells. Biologics are injected systemically to damp down the immune activity and allow hair to regrow. The results of these trials are awaited with much interest.

Unfortunately, people with more extensive, long-term AA find the treatments currently available do not work well. For these individuals the only practical answer is a wig and lots of emotional support. It can be depressing not to have hair, especially for children, who don't want to be different from their classmates at school, and women. In North America and many other countries of the world, you can access a network of support agencies for people with AA. Details are on the National Alopecia Areata Foundation website (http://www.naaf.org).


Published on March 1, 2010

WebMD Medical Reference from the American Hair Loss Association

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