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2015 ; 61
(9
): 757-61
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Alopecia areata: Part 2: treatment
#MMPMID26371098
Spano F
; Donovan JC
Can Fam Physician
2015[Sep]; 61
(9
): 757-61
PMID26371098
show ga
OBJECTIVE: To provide family physicians with a background understanding of the
therapeutic regimens and treatment outcomes for alopecia areata (AA), as well as
to help identify those patients for whom dermatologist referral might be
required. SOURCES OF INFORMATION: PubMed was searched for relevant articles
regarding the treatment of AA. MAIN MESSAGE: Alopecia areata is a form of
autoimmune hair loss affecting both children and adults. While there is no
associated mortality with the disease, morbidity from the psychological effects
of hair loss can be devastating. Upon identification of AA and the disease
subtype, an appropriate therapeutic regimen can be instituted to help halt hair
loss or possibly initiate hair regrowth. First-line treatment involves
intralesional triamcinolone with topical steroids or minoxidil or both. Primary
care physicians can safely prescribe and institute these treatments. More
advanced or refractory cases might require oral immunosuppressants, topical
diphenylcyclopropenone, or topical anthralin. Eyelash loss can be treated with
prostaglandin analogues. Those with extensive loss might choose camouflaging
options or a hair prosthesis. It is important to monitor for psychiatric
disorders owing to the profound psychological effects of hair loss. CONCLUSION:
Family physicians will encounter many patients experiencing hair loss.
Recognition of AA and an understanding of the underlying disease process will
allow an appropriate therapeutic regimen to be instituted. More advanced or
refractory cases need to be identified, allowing for an appropriate dermatologist
referral when necessary.