What are remedies for alopecia areata

Circular hair loss

Circular hair loss: treatment

"Circular hair loss - what really helps?" This is the question that worries those affected the most. Since the exact cause of alopecia areata is not known, there is no causal therapy either. There are just different treatment options that aim to stimulate new hair growth. Sometimes they help, but often they are also unsuccessful.

In the following you will find a list of different therapies that are effective either locally (on site) or systemically (in the whole body) and are intended to stimulate hair growth:

Skin-irritating substances against circular hair loss

The oldest form of treatment for alopecia areata is the application of skin-irritating substances to the bald areas. The resulting skin irritation is said to allow new hair to grow.

For example, about 0.5 or 1 percent anthralin (cignolin) can be applied to the bald areas and removed again after a short exposure time with a cloth (this prevents discoloration of the skin). In some patients, this treatment actually makes the hair grow back over time. However, if after three months there is still no success, the anthralin treatment should be discontinued.

Other skin irritants that are sometimes used for circular hair loss are chrysarobin, capsaicin (hot substance made from chilli) and tincture of pepper. However, they were only able to trigger hair growth in individual cases.

Minoxidil against circular hair loss

Solutions with the active ingredient Minoxidil are actually approved for the external treatment of hereditary hair loss. Sometimes, however, they are also used on a trial basis for circular hair loss, although no resounding success is to be expected here.

If circular hair loss is to be treated in children, a low-dose minoxidil solution can be used in combination with a medium-strength cortisone preparation (externally).

Glucocorticoids ("cortisone") against circular hair loss

Circular hair loss is today often with glucocorticoids ("cortisone") in the form of Creams or solutions treated. Long-term successes vary and relapses are common. In a maximum of half of all cases, this local treatment method can make the hair grow again.

Sometimes cortisone is also injected into the bald patches of skin. Such Cortisone Syringes but are only suitable for small herds of circular hair loss and not for the temples and crown area. The doctor should use caution when injecting and observe the total dose of glucocorticoid injected. Otherwise the active ingredient can get into the bloodstream in relevant quantities and trigger undesirable effects throughout the body (systemic side effects). These include, for example, a weakening of the immune system (with increased susceptibility to infection), water retention in the tissue (edema), menstrual disorders and Cushing's syndrome.

The likelihood of such side effects, however, is higher if cortisone is taken internally in the form of Tablets is applied. Systemic cortisone therapy of this kind is therefore only possible in severe, extensive cases of circular hair loss. It does indeed allow the hair to grow back in most patients. For this, however, cortisone must be taken for a long time in a dose that can trigger the above-mentioned side effects. If the cortisone dose is then reduced or the drug is stopped completely, the hair loss will start again.

Topical immunotherapy for circular hair loss

The effectiveness of local immunotherapy with the active ingredient diphencyprone (diphenylcyclopropenone, DPCP) for circular hair loss is scientifically proven. This method is only used for larger, bare herds:

First, the active ingredient is applied in a highly concentrated manner to the bald areas. It is supposed to trigger inflammation there and sensitize the patient's immune system to the active ingredient. After three to four weeks, a low dose of DPCD is reapplied, which then causes allergic skin irritation. The application is repeated weekly, usually for months.

Experts assume that this allergic skin inflammation on the bald areas of the scalp attracts certain immune cells that “displace” those immune cells that attack the hair root cells. In favorable cases, new hair growth begins after about three months, with initially pigmentless (white) hair sprouting. A few weeks later, pigments are usually stored in this hair, but sometimes the new hair also remains white.

Topical immunotherapy can actually make the hair grow again in around 80 percent of patients with circular hair loss. In almost every second patient, however, there is a relapse (shortly after the end of therapy). In the long term, this treatment is only successful in around 40 percent of patients.

Topical immunotherapy is quite complex and involves risks (such as excessive eczema). It should therefore only be carried out by specially trained doctors.

PUVA against circular hair loss

The abbreviation PUVA stands for psoralen plus UV-A. This photochemical treatment method is used for various skin diseases such as psoriasis and neurodermatitis. It can also be used for circular hair loss:

A phototoxic psoralen (such as methoxalen) is applied to the affected areas of the skin. After a quarter of an hour, the area is irradiated with UV-A light. This can inhibit damage to the hair follicles by immune cells.

Local PUVA is just as effective in treating circular hair loss as topical immunotherapy. However, the risk of relapse is even higher here.

Sometimes PUVA is also used systemically: The psoralen is taken internally before the hairless areas are irradiated with UV-A light an hour later. On the one hand, this type of therapy is not more successful than local PUVA. On the other hand, it carries a higher risk of skin cancer.

Zinc against circular hair loss

Zinc preparations are often recommended for circular hair loss (or other hair loss). The trace element ensures, among other things, a strong immune system and healthy skin and hair. However, taking zinc rarely helps with circular hair loss. But at least it has no side effects.

Support groups for circular hair loss

A surprisingly successful “therapy method” is participation in a self-help group: Patients with circular hair loss benefit from the joint work-up of the disease with other people affected. Especially with children, participation in a self-help group can be more effective than any drug treatment.

Alternative healing methods for circular hair loss

Sometimes patients with circular hair loss use homeopathy, Schuessler salts and other alternative healing methods. Their effectiveness has not been scientifically proven, but in general there is no harm in trying.

For example, homeopaths recommend taking alopecia areata Arsenicum album, Lycopodium clavatum, Phosphorus or Vinca minor. No. 5 is considered to be a suitable Schüßler salt Potassium phosphoricum. But also other means like No. 11 Silicea or No. 21 Zincum chloratum should help with circular hair loss.