Alopecia Areata Treatment
There is no cure for alopecia areata. A combination of treatments is often the best approach. Treatment usually depends upon how severe the hair loss is and whether it involves only one or two patches or is more extensive. Many advertised treatments have no proven benefit.
Systemic Treatment for Alopecia Areata
Monthly steroid (cortisone) injections are the most common treatment for milder cases and small bald patches. A very small needle is used to inject cortisone into and around the bald areas. The patient may feel a mild tingling sensation during the injection.
New hair growth is usually visible within a few weeks. Injections can initiate new hair growth in bald patches, but don't prevent other patches from developing. Sometimes the injections cause small, temporary depressions in the scalp called dells.
Cortisone pills are sometimes prescribed in patients with more complete hair loss. Patients should be aware that cortisone could cause serious side effects when used for a long period of time. The hair that regrows usually falls out when this treatment stops.
Topical Treatment for Alopecia Areata
The synthetic corticosteroid clobestrol (ointment or cream) and the corticosteroid fluocinonide (cream) are applied to the scalp. They have been used to treat alopecia for years.
Topical minoxidil is applied twice a day to the bald patches, sometimes followed 30 minutes later with an application of cortisone cream. Minoxidil is not effective on severe cases of alopecia. Minoxidil is intended for treatment of hereditary balding only.
Anthralin cream or ointment, a synthetic substance similar to coal tar, has some benefit in treating mild cases of alopecia areata. It is applied to the bare patches once a day and then washed off 30 to 60 minutes later. New hair growth is visible within 8 to 12 weeks. Prolonged treatment with anthralin can cause skin irritation and a temporary brownish discoloration. Some dermatologists prescribe daily anthralin treatment only after monthly steroid injections have proven ineffective.
Topical immunotherapy (cyclosporine) causes an allergic reaction that resembles poison oak or ivy. Hair grows back after about 6 months of treatment. This treatment works for about 40 percent of patients. Because it itches, it can be unpleasant in hot weather, especially if the patient wears a wig.
A combination of medicines such as minoxidil, irritants (anthralin, topical coal tar), and topical immunotherapy (cyclosporine) is effective in some cases.
Other Treatments for Alopecia Areata
Although not a treatment per se, some people with extensive or total hair loss that does not respond to treatment choose to wear wigs.
Aromatherapy with essential oils has proven effective in some patients. In particular, cedarwood, lavender, thyme, and rosemary oils have been used with success.