Treatments

 

1) Steroid creams and lotions:  

 

 Sometimes steroid creams and lotions can be tried on the bald patches, but they are usually not very effective and can only be used for short (up to 4-6 weeks) periods of time. Steroid injections are more effective (see 2).

 

2) Local steroid injections:

 

These are most effective on small patches of hair loss. Injections of steroid are inserted at the edge of a patch of hair loss. This procedure is usually repeated every 2 – 3 months. An expected side effect is thinning of the skin, felt as a dip in the skin, at the site of the injections but this generally tends to get better within a few months.

 

3) Dithranol cream:

 

This is a cream that is licensed for treating psoriasis, another skin condition. It acts by causing some irritation in the skin and it is this irritation which seems to ‘kick- start’ the hair into growing back again. The cream comes in different strengths and it is usual to gradually increase the strength if there is no response until there is either some hair re-growth or significant irritation. It can be continued for several months. The main side effects are irritation and brownish discoloration of the skin. This latter side effect can be useful as camouflage for the hair loss in those individuals with brown/black hair.

 

4) Immunotherapy / Contact sensitisation

 

This treatment is only available in certain specialised centres.  It is a useful treatment for those individuals with more extensive hair loss. A chemical called Diphencyprone is applied to the scalp at weekly intervals to the bald area. All individuals who come into contact with Diphencyprone become allergic to it, and so by applying it to the skin repeatedly, it causes inflammation in the skin and this over-rides the mechanisms that are preventing hair growth. It is not possible to predict how many people will respond to this treatment but it is usually tried for about 6 months. Studies suggest that just over half of treated individuals show some response. Side effects of this treatment include itching, redness , occasionally blistering at the site of application. Enlarged glands in the neck can occur. In darker skins, loss of pigment can occur at the site of application.

 

5) Minoxidil

 

Minoxidil is a lotion used for male pattern hair loss. There are some reports of it being effective in individuals with Alopecia Areata. It can be bought over the counter (Regaine) in chemists.

 

6) Ultra violet light

 

This involves taking a tablet to make the skin more light sensitive and being exposed to ultraviolet (UV) light 2-3 times per week. Although it can be effective, the reports suggest that there is a high incidence of relapse (hair falling out again) after stopping the treatment. Unfortunately the UV treatment has to be limited because there is a real risk of skin cancers with UV light.

 

7) Immunosuppressive therapy

 

Any treatment that suppresses the immune system, such as oral steroids  and cyclosporine, are likely to allow the hair to re-grow. However, these treatments are not used for Alopecia Areata as they have serious side effects and would need to be continued long term.