Treating Alopecia Areata

Alopecia areata is the second most common form of hair loss, after androgenetic alopecia (hereditary hair loss), affecting about 2% of the world’s population. It is an unpredictable disease and very little is known about its true causes and hereditary factors. It is thought to be an autoimmune disease in which the person’s immune system decides to attack its own hair follicles. Due to its patchy balding pattern, it is often called spot baldness or patch baldness. In rare cases this condition can spread to the entire scalp (alopecia totalis) or to the entire epidermis (alopecia universalis). In most patients, their hair grows back after a few years and stays, though it does sometimes fall out again. Although this condition is considered harmless, some suggest that it is associated with an increased risk of developing other autoimmune diseases. Since relatively little is known about this condition and its causes, no ultimate cure exists. Many patients decide to take no treatment in order to avoid possible side effects and wait to see how the situation develops.

The most common treatment option for those who want to see faster results and one that can be effectively used to fill in small bald spots are corticosteroid injections into the bald patch, which suppresses the local autoimmune reaction. Several injections in the same bald area are usually given at each treatment session but the number is often limited by the degree of pain the patient can endure. Topical application of steroid cream or gel is less drastic than injections but also less effective. The second most common form of treatment for small patches affected with alopecia areata is topical minoxidil, which can be used alone or in combination with the aforementioned steroid therapy. Another common method of treating alopecia areata in patients with small bald spots is the topical application of an irritant called anthralin (or dithranol). It is a synthetic tar-like substance used in the treatment of psoriasis that alters the immune function in the affected skin and is applied for 30-60 minutes and then washed off. It can be also used in combination with minoxidil.

Topical immunotherapy, which consists of a topical application of an immuno-suppressant such as cyclosporine or diphencyprone, is considered the most effective treatment for patients with extensive bald areas. Increasing strengths of this substance are placed on the affected skin once a week over a period of several weeks until the skin looks like it has mild eczema. The skin reaction seems to affect the process involved in causing alopecia areata in some way and allows hair to regrow. But immunotherapy is also one of the most drastic approaches when it comes to causing severe side effects. An alternative but less effective treatment for extensive alopecia areata is PUVA, which stands for "psoralen plus ultraviolet A radiation". As its name says, it is a photochemotherapy, consisting of a topical or oral application of the drug called psoralen, followed by ultraviolet radiation. Potential side effects result mainly from the use of ultraviolet radiation.

With the exception of minoxidil, all the aforementioned treatments require professional consultation. However, as is so common with treatments for hereditary hair loss, there are also alternative, non-prescription remedies for alopecia areata out there, which do not require a doctor’s visit. Calosol is one such treatment that has attracted a lot of attention in recent years. It contains a number of ingredients commonly found in natural hair loss products used to treat male pattern baldness, although it claims to be specifically designed to address alopecia areata. The treatment results of alternative treatments are typically questionable, as no clinical proof of their effectiveness exists to support the claims of their manufacturers and marketers. Natural products are sold as cosmetics and, therefore, they are less well regulated and tested than regular pharmaceuticals.