Treating Mild (Patchy) Alopecia Areata
There are no FDA approved treatments specifically for alopecia areata, however, many medical professionals are willing to try treatments off label. There are treatment options available for mild, patchy alopecia areata (less than 50% scalp hair loss) though there is currently no acceptable treatment that works in all cases.
Cortisone Injections: The most common treatment is the injection of cortisone into the bare skin patches. The injections are usually given by a dermatologist who uses a tiny needle to give multiple injections into the skin in and around the bare patches. The injections are repeated once a month. Both the needle prick and the slight tingling are usually well tolerated and there is no discomfort after leaving the doctor’s office. In new hair growth occurs, it is usually visible within four weeks. Treatment, however, does not prevent new patches from developing. There are few side effects from local cortisone injections. Occasionally, temporary depressions in the skin result from the local injections, but these “dells” usually fill in by themselves.
Topical Minoxidil: Five percent topical minoxidil solution applied twice daily may regrow hair in alopecia areata. Scalp, eyebrows, and beard may respond. If scallp hair regrows completely, treatment can be stopped. Two percent topical minoxidil solution alone is not effective in alopecia areata; response may improve if cortisone cream is applied thirty minutes after the minoxidil. Topical minoxidil is safe, easy to use, and does not lowe blood pressure in persons with normal blood pressure. Topical minoxidil solution is not effective in treating those with 100 percent scalp hair loss.
Anthralin cream or ointment: Another treatment is the application of anthralin cream or ointment. Anthralis is a synthetic, tar-like substance that has been used widely for psoriasis. Anthralin is applied to the bare patches once daily and washed off after a short time, usually thirty to sixty minutes later. If new hair growth occurs, it is seen in eight to twelve weeks. Anthralin can be irritating to the skin and can cause temporary, brownish discoloration of the treated skin. By using short treatment times, skin irritation and skin staining are reduced without decreasing effectiveness. Care must be taken not to get anthralin in the eyes. Hands must be washed after applying it.