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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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Correspondence to Antonella Tosti .

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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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