American Journal of Clinical Dermatology

, Volume 6, Issue 6, pp 403–406 | Cite as

Comparison of Azelaic Acid and Anthralin for the Therapy of Patchy Alopecia Areata

A Pilot Study
  • Sezai SasmazEmail author
  • Ozer Arican
Original Research Article


Background: Although topical azelaic acid has been previously used for the treatment of alopecia, no controlled trials of azelaic acid for this condition have been conducted to date.

Objective: The goal of this study was to determine the efficacy, tolerability, and safety of azelaic acid treatment in patients with patchy alopecia areata (AA) in comparison with anthralin (dithranol) treatment.

Subjects and methods: This study included 31 subjects with patchy AA who did not receive any treatment for at least 1 month prior to the study. Demographic and clinical characteristics of these subjects were recorded at baseline. Subjects were randomized to apply either 20% azelaic acid (15 subjects) or 0.5% anthralin (16 subjects) for 12 consecutive weeks. In a subsequent 8-week follow-up period no cream was applied. Two independent investigators performed an efficacy evaluation with clinical examination using a terminal hair regrowth score (RGS) with a scale ranging from 0 (inadequate response) to 2 (complete response) at week 20. Partial response was accepted as score 1.

Results: Both groups were well matched for the relevant demographic and clinical indicators affecting treatment response at baseline. All subjects completed the trial. At week 20 the RGS was 1.27 ± 0.9 in the azelaic acid group versus 1.37 ± 0.8 in the anthralin group (p > 0.05). A complete response was observed in 53.3% of cases in the azelaic acid group (8 of 15) compared with 56.2% (9 of 16) in the anthralin group (p > 0.05). No serious adverse events were observed in either group during the study.

Conclusion: The present pilot study showed that the use of azelaic acid gave similar results to anthralin with regard to hair regrowth, and that it can be an effective topical therapy for patchy AA. More extensive trials are necessary, however, to reach a definitive conclusion.


Minoxidil Alopecia Areata Azelaic Acid Dithranol Androgenetic Alopecia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.


  1. 1.
    How can azelaic acid be used to treat baldness? [online]. Available from URL: [Accessed 2004 Jul 30]
  2. 2.
    Frampton JE, Wagstaff AJ. Azelaic acid 15% gel in the treatment of papulopustular rosacea. Am J Clin Dermatol 2004; 5 (1): 57–64PubMedCrossRefGoogle Scholar
  3. 3.
    Santiago AC, Schwartz RA, Solis CS. Cosmeceuticals [online]. Available from URL: [Accessed 2004 Jul 30]
  4. 4.
    Note about Skinoren (azelaic acid) [online]. Available from URL: [Accessed 2004 Jul 30]
  5. 5.
    Harrison S, Rodney S. Optimal management of hair loss (alopecia) in children. Am J Clin Dermatol 2003; 4 (11): 757–70PubMedCrossRefGoogle Scholar
  6. 6.
    Kaplan AL, Olsen EA. Topical 5-fluorouracil is ineffective in the treatment of extensive alopecia areata. J Am Acad Dermatol 2004; 50 (6): 941–3PubMedCrossRefGoogle Scholar
  7. 7.
    Lebwohl M. New treatments for alopecia areata. Lancet 1997 Jan 25; 349 (9047): 222–3PubMedCrossRefGoogle Scholar
  8. 8.
    Tosti A, De Padova MP, Minghetti G, et al. Therapies versus placebo in the treatment of patchy alopecia areata. J Am Acad Dermatol 1986; 15 (2 Pt 1): 209–10PubMedCrossRefGoogle Scholar
  9. 9.
    Hull SPM, Wood ML, Hutchinson PE, et al. Guidelines for the management of alopecia areata. Br J Dermatol 2003; 149: 692–9CrossRefGoogle Scholar
  10. 10.
    Schmoekel C, Weissman I, Plewig G, et al. Treatment of alopecia areata by anthralin-induced dermatitis. Arch Dermatol 1979; 115 (10): 1254–5CrossRefGoogle Scholar
  11. 11.
    Fiedler-Weiss VC, Buys CM. Evaluation of anthralin in the treatment of alopecia creata. Arch Dermatol 1987; 123 (11): 1491–3PubMedCrossRefGoogle Scholar
  12. 12.
    Krautheim A, Gollnick H. Transdermal penetration of topical drugs used in the treatment of acne. Clin Pharmacokinet 2003; 42 (14): 1287–304PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  1. 1.Department of Dermatology, School of MedicineKahramanmaras Sutcuimam UniversityKahramanmarasTurkey

Personalised recommendations