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What are the options ?
Overview
Overview
Cortisone injections.
The usual treatment for mild (patchy alopecia areata) with less than 50 % scalp hair loss are the cortisone injections into the skin patches without hair.
Such injections can be given by a dermatologist - several injections are put with a thin needle once a month. After three or four weeks new hairs usually grow although new patches are not prevented. There is no discomfort after the injections although there may appear certain "dells" in the skin, which disappear by themselves after a while.
Topical minoxidil. 5% solution of topical minoxidil can result in new hair growth if applied twice daily on alopecia areata. When the scalp hair grows completely you can stop the treatment.
Alopecia areata does not respond to a 2 % solution of topical minoxidil it should be combined with cortisone cream applied half an hour after the minoxidil. Treatment with topical minoxidil is easy and safe and does not lead to lower blood pressure. But this treatment is ineffective in 100 % hair loss.
Anthralin cream or ointment. Another treatment option is the anthralin cream or ointment application. Anthralin (a tar-like synthetic substance) is widely used for psoriasis and is applied directly to the bare patches once a day (rinse after up to an hour). New hair should grow not later than 12 weeks. Sometimes anthralin can irritate your and can cause temporary discoloration of the treated spot. This could be avoided if you apply the ointment for short treatments. Also be sure to protect your eyes and to wash your hands carefully after application.
Cortisone pills.
Extensive scalp hair loss is usually treated with cortisone pills. These pills are taken orally and are much more effective than the local injections. Be sure to discuss all the side effects possible and to consider this kind of treatment with your physician. Prolonged use of the pills can cause some side effects but the treatment is usually well accepted by young people of good health. There is however the possibility the newly grown hair to fall out after stopping the medication.
Topical immunotherapy. Alopecia areata or alopecia totalis/universalis can be also treated effectively with topical immunotherapy. This method includes producing an allergic contact dermatitis or rash. The treatment represents applying chemicals to the scalp such as squaric acid dibutyl ester (SADBE) or diphencyprone (DPCP). These chemicals lead to an allergic rash such as poison ivy or oak. This treatment is effective in up to 40% of the patients who regrow hair on the scalp after not more than six months. Nevertheless, one should continue the treatment even after the new hair is grown until the disease ceases completely. The rash can be most irritating especially in hot weather or under a wig.
