Alopecia areata is an unpredictable hair disease affecting about 2% of the world's population and is the second most common type of hair loss after hereditary baldness. It is often called spot baldness or patch baldness due to its patchy, balding pattern. In severe cases, it can affect the whole scalp (alopecia totalis) or the entire body (alopecia universalis). It is not yet known what causes alopecia areata. It is thought to be an autoimmune disease triggered by a person's autoimmune system, which decides to attack its own hair follicles. Sometimes the hair grows back a few years later and stays and sometimes it falls out again. Although there is no treatment for alopecia areata that works 100%, some treatments have been proven to improve this condition. The most popular treatment option, which does not require a doctor's prescription, is topical minoxidil, such as Rogaine. It can be used alone or in combination with other medicinal treatments that will be discussed later.
The best known prescription treatments for alopecia areata are corticosteroid shots, injected straight into the bald spot, and steroid gels and creams. Corticosteroid injections are a more effective but also the more painful option of the two. The objective of this approach is to suppress the autoimmune reaction but it has been proven to work only on small bald spots. Another common treatment for small bald spots, which is believed to affect the autoimmune reaction, is the application of topical anthralin. Anthralin is a tar-like substance used to treat psoriasis.
Topical immunotherapy is the most commonly prescribed form of treatment for extensive alopecia areata. It uses an immunosuppressant such as cyclosporine that is applied to the skin to trigger a skin reaction similar to mild eczema, which in some cases leads to hair regrowth. This approach is also the most drastic form of treatment, causing an array of negative side effects.
Another treatment for extensive alopecia areata conditions is PUVA, which stands for "psoralen plus ultraviolet A radiation", consisting of a topical or oral application of psoralen, followed by ultraviolet radiation. This method is typically better tolerated than topical immunotherapy but is also less effective.
A recently conducted research study with sulfasalazine also spells some promise for patients with severe cases of alopecia areata. Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis and is hoped to be soon used to treat alopecia areata.
This is the list of the most common medicinal treatments for alopecia areata. There obviously is a number of other alternative therapies that are said to improve this condition and do not require a doctor's visit. Consumers should be aware that none of these products has ever been clinically shown to be effective in treating any form of alopecia areata and such claims are possible only because these products are not regulated pharmaceuticals but non-regulated cosmetic products.
By Dody Gasparik M.Sc.
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