Treatment
If the affected region is small, it is reasonable to observe the progression of the illness as the problem often spontaneously regresses and the hair may grow back.
The cause remains unknown. In cases where there is severe hair loss, there has been limited success treating alopecia areata with the corticosteroids clobetasol or fluocinonide, corticosteroid injections, or cream. Steroid injections are commonly used in sites where there are small areas of hair loss on the head or especially where eyebrow hair has been lost. Whether they are effective is uncertain. Some other medications used are minoxidil, elocon ointment (steroid cream) irritants (anthralin or topical coal tar), and topical immunotherapy cyclosporine, sometimes in different combinations. Topical corticosteroids frequently fail to enter the skin deeply enough to affect the hair bulbs, which are the treatment target. And small lesions typically also regrow spontaneously. Oral corticosteroids decrease the hair loss, but only for the period during which they are taken, and these drugs have serious adverse side effects.
For small patches on the beard or head it is possible to suppress with topical tacrolimus ointments such as Protopic. Symptoms may remain suppressed until aggravated by stress or other factors.
In one small study without a control group, diphenylcyclopropenone has shown a significant hair regrowth in 40% of patients with alopecia areata at 6 months, being sustained in two thirds of these after a 12-month-follow up-period. Whether this is significant remains doubtful: there is considerable spontaneous recovery as well.
In terms of adapting to the disease rather than treating in an effort to cure, there are also many options available. Wigs are often used by those with alopecia, particularly alopecia totalis, in which hair is entirely lost from the scalp. Wigs are available at many levels of development and technology, including wigs with suction mechanisms to keep them firmly attached to the scalp.
Read more about this topic: Alopecia Areata
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