Gabapentin Therapy Trialled as Scarring Alopecia Treatment

A clinical trial being carried out by researchers at the University of Minnesota Clinical and Translational Science Institute, USA, which started in January 2016, has now confirmed a completion date of 30th May 2019.

The trial is investigating neurogenic inflammation and the use of topical 6% gabapentin therapy as a treatment in cases of symptomatic scarring alopecia, also known as cicatricial alopecia.

This group of conditions, which can be painful and generally cause permanent hair loss, includes a number of individually established concerns, such as Frontal Fibrosing Alopecia (FFA), Lichen Planopilaris (LP), and Central Centrifugal Alopecia (CCA).

Small scale pilot cohort study

The cohort study is small in scale, featuring a total of ten participants - both men and women aged 18 years or over - with biopsy-confirmed diagnoses of cicatricial alopecia.

Each volunteer has at least one persistent scalp symptom, besides hair loss, that is associated with inflammation, for instance pain, burning, itching, a tingling or crawling sensation, stinging or tenderness.

They are being administered 1ml of a topical 6% gabapentin solution twice per day for duration of the 12 week pilot study.

Gabapentin is an anti-convulsant prescription medication used for epilepsy, nerve pain and, occasionally, for migraines. It is currently available for these purposes under the Pfizer brand name of Neurontin in the UK.

Researchers from the University explained why they chose to explore gabapentin as a potential treatment for scarring alopecia in the trial registration information.

"There has been no study of topical neurogenic agents, such as gabapentin, to treat scarring alopecia. However topical gabapentin has been safely used in other conditions associated with chronic pain, burning, irritation, itch, or tingling, such as vulvodynia," it states.

"This study will serve as a pilot study to determine the efficacy and safety of topical gabapentin in the treatment of symptomatic scarring alopecia. In this study, 10 subjects with symptomatic lymphocytic-type scarring alopecia will be recruited and treated with topical gabapentin. Disease burden will be evaluated before and after 12 weeks of treatment through reporting of subjective symptomatology via surveys/questionnaire, neurometer study, clinical assessment, and biopsies measuring levels of CGRP before and after treatment."

Treating scarring alopecia hair loss

Whilst there are medications available to help manage symptoms, such as the inflammation associated with cicatrical alopecias, there are currently no established hair loss solutions for these conditions.

Although Central Centrifugal Alopecia treatment - also known as Follicular Degeneration Syndrome - is sometimes possible, depending on the extent of its progression, the resulting baldness these hair loss conditions cause is often permanent.

Although in some instances a hair transplant may be possible, this is decided on a case by case basis as there are many factors involved in deciding whether or not someone is suitable for surgical hair restoration.

It is also vital that anyone considering this type of procedure visits surgeons who are skilled and experienced in this particular type of operation as it should be carried out by a specialist in the field.

At present, there are a number of studies into scarring alopecia and its various phenotypes, as well as research underway into various potential treatments to help those affected regrow hair. These include exploration of fractionated CO2 laser therapy and the analgesic drug apremilast.

For now, however, anyone concerned about scarring hairloss should consult their GP as a first port of call.