Alopecia areata Treatment

Alopecia areata
Treatment
Treatment is not mandatory because the condition is benign, and spontaneous remission and recurrence are common. The treatment used stimulate hair growth but does not influence the natural evolution of alopecia. For patients with extensive alopecia areata spontaneous remission rate is below 40%. Relapse rate is high in patients with severe forms. Patients with total or universal alopecia have a negative prognosis. Since alopecia areata is considered an autoimmune condition were tried various immunomodulatory. Additional treatments include minoxidil.
Topical Therapies
Steroid therapy Intralesional or topical corticosteroids include administration. Intralesional steroids are first taken in terms of localized treatment. Hair growth may persist for 6 months after a single injection. Triamcinolone is used. Side effects include injection site pain, minimal transient atrophy. Injections are administered every 4-6 weeks. For topical corticosteroids, fluocinolone cream is used twice daily betamethasone dipropionate cream. Treatment should be maintained at least 3 months before hair growth occurs. Maintenance therapy is necessary. The most common side effect is local folliculitis occurring in a few weeks after treatment. Teleangiectaziile and local atrophy have been reported. Not reported systemic effects.
Immunotherapy It is defined as contact dermatitis induced by periodic exposure to a potent allergen. Topical immunotherapy can be used for 20 years without serious adverse effects. The most common adverse effect is slight contact dermatitis. Severe adverse effects include: pigmentation changes and cervical lymphadenopathy: vitiligo, leucoderma, hyperpigmentation, erythema-like eruption, urticaria. Initial regeneration of hair can be seen at 12-24 weeks. Once we reached the comfort of cosmetic treatment can be reduced gradually. All patients have relapsed if treatment is interrupted. Maintenance treatment is necessary.
Antralin Therapy Most patients experience contact dermatitis. Regeneration acceptable cosmetic therapy is maintained at 75% of patients. Side effects include itching, redness, scar folliculitis, pyoderma local, regional lymphadenopathy. Discontinuation of treatment for several days cause rapid disappearance of adverse effects. The mechanism of action of antralinei is unknown. It is thought to cause inflammation through the generation of free radicals with immunosuppressive and antiproliferative actions.
Minoxidil therapy It seems to be effective in the treatment of patients with extensive alopecia areata. Regeneration of the initial loss is observed in 12 weeks, but it is necessary to achieve a continuous application of cosmetic acceptable growth. It is well tolerated. Side effects include irritation and distal hipertrichoza. Mechanism of action of minoxidil is not fully known. There seems to be hormonal or immunosuppressive effect. Is assumed to have a direct mitogenic effect on epidermal cells.
Systemic Therapies
Psoralen and ultraviolet A therapy Varies between 20-70% initial response. Relapse rate is high, 50-80%. Most patients do relapse in these few months after treatment is stopped. The number of sessions required varies but usually 20-40. An early onset, long duration of disease and the presence of alopecia totalis or universalis seem to indicate a negative prognosis.
Corticosteroids-prednisone The use of systemic prednisone cause hair regenearea sometimes. Regeneration rate varies between 30-90%. Although regeneration seems promising initial maintenance therapy is needed to keep growth aprului cosmetic. Most patients do relapse after treatment interrupt pins. Side effects include diabetes, weight gain, hypertension, psychological changes, osteoporosis, suppression of adrenocorticotropic axis, stretch marks, acne, hypertrichosis, and purpura.
Cyclosporine therapy Topical and systemic cyclosporin has been used to treat alopecia areata. All patients have relapsed after discontinuation. The mechanism is unclear. It can act as immunosuppressant. Other therapies include tacrolimus, dapsone, interferon, methotrexate. Cosmetic therapies include eyebrows eyeliner to camouflage patients with alopecia areata. Wigs are indicated for patients with extensive alopecia.
Prognosis
Alopecia areata natural evolution is unpredictable. Most patients have only a few areas of alopecia, and spontaneous regeneration occurs In a year. Less than 10% of patients have extensive alopecia, alopecia universalis and less than 1%. People who injure hair follicles through different regimes during regenerative cosmetic shows. Negative prognostic factors include nail abnormalities, atopy, early age onset and severe forms of alopecia areata.