Treatment options for alopecia areata

Hair regrowth and maintenance in alopecia universalis patient treated with nonablative Er:YAG laser

“…The repetitive nature of topical immunotherapy with its frequent side effects, including eczema, severe urticaria, dermographism, and sleep disturbances, results in low patient compliance. Consequently, recurrences of hair loss are common and unfortunately, more recalcitrant to treatment 3 . Patient compliance might represent an important advantage of the nonablative 2940‐nm Er:YAG therapy over the traditional treatment modalities, as it demonstrates efficiency with an absence of adverse effect, and a high level of patient comfort and satisfaction.…”

“…18 The main challenge in AA/AT/AU treatment is maintenance of regrown hair. 3 The repetitive nature of topical immunotherapy with its frequent side effects, including eczema, severe urticaria, dermographism, and sleep disturbances, results in low patient compliance. Consequently, recurrences of hair loss are common and unfortunately, more recalcitrant to treatment.…”

“…Alopecia totalis (AT) occurs when scalp and face hair such as eyebrows, eyelashes, and beard are affected, while the term alopecia universalis (AU) refers to cases of entire body hair loss 3 . AA affects people of all age groups, sexes, and ethnicities and represents a source of frustration due to the unpredictable nature of the disease for which there is currently no definitive treatment 4 .…”

“…2 Alopecia totalis (AT) occurs when scalp and face hair such as eyebrows, eyelashes, and beard are affected, while the term alopecia universalis (AU) refers to cases of entire body hair loss. 3 AA affects people of all age groups, sexes, and ethnicities and represents a source of frustration due to the unpredictable nature of the disease for which there is currently no definitive treatment. 4 The etiology of AA is not completely understood, 5 but it supposedly results at least in part from a loss of immune privilege in the hair follicle, autoimmune-mediated hair follicle destruction, and the upregulation of inflammatory pathways.…”

“…4 Many patients do not find existing therapies helpful and seek mental health treatments to alleviate the psychological burden of this disease. 6 Treatment options are aimed at hair regrowth and control of remissions 3 and include injectable corticosteroids, systemic immune suppressants, psoralen plus ultraviolet light A radiation (PUVA), minoxidil, and topical irritants, such as anthralin and diphencyprone, aimed at blocking the T-cell-mediated hair loss process using immunosuppression or competitive immunostimulation. 7 Effectiveness of immunotherapy may be proportional to the severity of hair loss, as was shown in the case of topical diphencyprone having the greatest effect in patients with less than 50% hair loss and smallest effect in patients with AT and AU.…”