Sulfasalazine for Alopecia Areata

Alopecia areata is an unpredictable, autoimmune, hair loss disease affecting about 2% of the population. There are several existing treatments for alopecia areata but none of them offers stable and satisfactory results. A recently-conducted study with sulfasalazine shows that there is some hope of regrowing hair, even in patients with severe cases of alopecia areata. Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis. It has also been used to treat inflammatory bowel disease, seronegative arthropathies and psoriasis. During a period of three years, 26 patients with recalcitrant or severe alopecia areata (> 40% hair loss) were enrolled in an open-label, uncontrolled clinical trial. Efficacy evaluation was performed with clinical examination. 22 patients completed the treatment. Based on the response to sulfasalazine, patients were divided into three brackets: no hair regrowth (< 10% terminal hairs), partial hair regrowth (10%-90% terminal hairs), and complete hair regrowth (90%-100% terminal hairs). Overall, 68% (15 patients) responded to the therapy; 27% (six patients) achieved complete hair regrowth, and 41% (nine patients) had partial hair regrowth. Seven patients (32%) had no hair regrowth. 10 patients (45%) suffered a partial or complete relapse after finishing the treatment. Side effects following the treatment were observed in seven patients (32%). The study concluded that sulfasalazine could be considered a therapeutic alternative in the treatment of alopecia areata because of its low incidence of severe side effects, good tolerability and acceptable efficacy.


An uncontrolled, open label study of sulfasalazine in severe alopecia areata.

Aghaei S.

Department of Dermatology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

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