The most common treatment is the injection of
cortisone into the bare skin patches. The injections are usually given by a
dermatologist who uses a tiny needle to give multiple injections into the skin
in and around the bare patches. The injections are repeated once a month. Both
the needle prick and the slight tingling are usually well tolerated and there
is no discomfort after leaving the doctor's office. If new hair growth occurs,
it is usually visible within four weeks. Treatment, however, does not prevent
new patches from developing. There are few side effects from local cortisone
injections. Occasionally, temporary depressions in the skin result from the local
injections, but these "dells" usually fill in by themselves.
Five percent topical minoxidil solution applied twice daily may grow hair in
alopecia areata. Scalp, eyebrows, and beard hair may respond. If scalp hair
regrows completely, treatment can be stopped. Two percent topical minoxidil
solution alone is not effective in alopecia areata; response may improve if
cortisone cream is applied 30 minutes after the minoxidil. Topical minoxidil is
safe, easy to use, and does not lower blood pressure in persons with normal
blood pressure. Neither 2 percent nor 5 percent topical minoxidil solution is
effective in treating those with 100 percent scalp hair loss.
Another treatment is the application of anthralin cream or ointment. Anthralin
is a synthetic, tar-like substance that has been used widely for psoriasis.
Anthralin is applied to the bare patches once daily and washed off after a
short time, usually 30 to 60 minutes later. If new hair growth occurs, it is
seen in eight to twelve weeks. Anthralin can be irritating to the skin and can
cause temporary, brownish discoloration of the treated skin. By using short
treatment times, skin irritation and skin staining are reduced without
decreasing effectiveness. Care must be taken not to get anthralin in the eyes.
Hands must be washed after applying.
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