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Alopecia Areata: Clinical Treatment

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Hair and Scalp Treatments

Abstract

Alopecia areata is a complex immune-mediated disease that targets anagen hair follicles. Therapeutic strategies must be directed as either immunosuppressive or immunomodulating and may consist of monotherapy or combination therapy and should be different depending on patient’s age, extent, and chronicity of the disease. The physician must discuss mild and aggressive options, as well as the possibility of no treatment, camouflage options, and social/psychological support. Topical, intralesional, and systemic steroids, as well as corticosteroid-sparing agents and disease-modifying antirheumatic drugs are useful as local or systemic immunosuppressors. Topical immunotherapy, anthralin, and phototherapy have proved useful as immunomodulators. Target therapy with JAK inhibitors is useful in alopecia areata totalis or universalis. Treatment in special areas such as eyelashes, eyebrows, or beard benefit from treatment with steroids, minoxidil, prostaglandin F2a analogs, and topical tofacitinib. Vitamin D3, ezetimibe/simvastatin, platelet-rich plasma, antihistamines, and aromatherapy may be used as adjuvant therapies. We discuss a practical but evidence-based approach for treatment in different cases of alopecia areata with detailed information about doses, administration, and possible side effects.

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Author information

Authors and Affiliations

  1. Tecnológico de Monterrey, Hospital San José, Monterrey, Nuevo León, Mexico

    Norma Elizabeth Vazquez-Herrera

  2. Fredric Brandt Endowed Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Antonella Tosti

Authors
  1. Norma Elizabeth Vazquez-Herrera
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  2. Antonella Tosti
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Corresponding author

Correspondence to Antonella Tosti .

Editor information

Editors and Affiliations

  1. Fredric Brandt Endowed, Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Antonella Tosti

  2. Dermatoncology & Trichology Clinic, National University of Mexico, Mexico City, Mexico

    Daniel Asz-Sigall

  3. Department of Dermatology, Santa Casa da Misericordia, Rio De Janeiro, Brazil

    Rodrigo Pirmez

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Vazquez-Herrera, N.E., Tosti, A. (2020). Alopecia Areata: Clinical Treatment. In: Tosti, A., Asz-Sigall, D., Pirmez, R. (eds) Hair and Scalp Treatments. Springer, Cham. https://doi.org/10.1007/978-3-030-21555-2_9

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  • DOI: https://doi.org/10.1007/978-3-030-21555-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21554-5

  • Online ISBN: 978-3-030-21555-2

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