Study Improves Topical Immunotherapy for Severe Alopecia Areata?

is an autoimmune condition which causes patchy hair loss in around 1.7% of the population. For those whose hair loss is at a mild-to-moderate level, treatment for alopecia areata is often possible, however, once the condition progresses to a more advanced stage, this becomes less likely to produce results.

However, the latest hair loss study should provide promising news for people with chronic Alopecia Areata as researchers in Turkey may have found a way to improve the efficacy of existing topical immunotherapy for severe alopecia.

Study into treatment of severe alopecia areata

Currently topical immunotherapy is the most common treatment for advanced alopecia areata, even though it has a low success rate. It involves having swabs doused in diphenylcyclopropenone applied to the bald areas of the scalp on a weekly basis and is known to cause a number of side effects.

The research team behind this latest Turkish study published a report concluding that, by combining diphenylcyclopropenone and anthralin (also known as Dithranol) into a 'combination therapy', they achieved results superior to diphenylcyclopropenone monotherapy (regular topical immunotherapy) when treating chronic alopecia areata. For the purposes of this study, 'chronic' was considered to be where more than half the hair on a patient's scalp had been lost to alopecia areata. Patients whose alopecia areata treatment had previously failed ('treatment resistant alopecia areata') were also included in the study group.

The retrospective analysis examined the efficacy, side effects and relapse rates of diphenylcyclopropenone (DPCP), as monotherapy or with anthralin, in the treatment of 47 patients with severe and/or treatment-resistant alopecia areata who had been followed-up for the prior 4 years. The research studied 22 patients, who were treated with DPCP monotherapy and 25 patients who underwent combination therapy with DPCP and anthralin, for at least 30 weeks.

Improved success rate

Of the 22 patients involved in this small scale study, 8 (36.4%) who were treated with DPCP monotherapy saw complete regrowth of hair on their scalp, compared to 18 patients (72%) who were treated with combination therapy. The researchers concluded that combination therapy did not appear to have an effect on the relapse rates of chronic extensive and/or treatment-resistant Alopecia Areata.

The report advises that combination therapy resulted in a shorter duration of hair growth and a higher regrowth rates of eyebrows, eyelashes and beard compared with patients treated with DPCP monotherapy; promising news for Alopecia Totalis sufferers who lose all hair from their head, not just their scalp.

Whilst a 72% success rate for regrowth in cases of severe alopecia is a vast improvement on the current topical immunotherapy success rate of around 40%, this is a very small study so larger scale research would need to be carried out before determining whether this is a suitable treatment. It does, however, present a promising treatment option for this chronic hair loss condition, and any advancement in this area is always welcome.

Side effects in patients

Examples of vesicles on the skin

Another reason for further testing of this type of combination therapy is to ensure its safety. All 22 patients involved in the Turkish research reported side effects of localised pruritus (itching), vesicles (pin-head sized blisters), bullae (large skin blisters) or a combination of these.

The report states that patients treated with combination therapy during the trial experienced side effects more frequently than the DPCP monotherapy patients. These side effects included folliculitis (an infection of the hair follicles); hyperpigmentation, and staining of the skin, hair and clothes.

Pharmacy Manager at Belgravia's City of London hair loss clinic, Funmi Lampejo, explains, "DPCP and Dithranol both work as topical immunotherapy agents by sensitising the area of application. The sensitisation appears to shift the focus of the body's immune response away from the hair follicles, thereby allowing for hair regrowth. Unfortunately, the mode of action means that contact dermatitis and more severe allergic reactions are often seen as a side-effect of the treatment."

Alopecia Areata treatment

Month 1                             Month 3
Click the image above to view Belgravia client Paris' full regrowth results following treatment for Alopecia Areata

There are a number of treatments for alopecia currently undergoing clinical trials, including ruxolitinib and tofacitinib citrate. We await further details as to their findings and will keep you up-to-date with developments.

However, if you are currently experiencing patchy hair loss and would like advice and help with understanding the severity of your condition as well as the treatment options open to you, it is best to seek expert help at the earliest opportunity.

High strength minoxidil has been seen to produce significant regrowth in many of Belgravia's alopecia areata clients, and you can find a number of their images from before and after starting treatment in our Hair Loss Success Stories gallery. To find out more about our bespoke minoxidil preparations or to book your free hair loss consultation, please call the clinic on 020 7730 6666 or send us a message.