Definition
Alopecia areata is a chronic inflammatory disease that affects the hair follicles of the scalp and of the body in general. It is defined as "areata" because there is hair loss and hair loss in small rounded areas.
When alopecia affects the entire scalp, it is referred to as "total alopecia areata"; if it affects all the hairs on the body, on the other hand, it is called "absolute alopecia areata".
Causes
Alopecia areata is caused by a series of factors, among which a certain genetic predisposition accompanied by an autoimmune component stands out. In fact, in this form of alopecia, the individual's immune system attacks the hair follicles, but the reason for this happens has not yet been identified.
In addition to the autoimmune response and genetic predisposition, other factors that can contribute to the development of the disease are malnutrition, iron deficiency and psychological stress.
In addition, patients with other immune disorders (such as, for example, systemic lupus erythematosus, atopic dermatitis, rheumatoid arthritis, vitiligo, type I diabetes mellitus, some types of allergies, etc.) are exposed to an increased risk of developing alopecia areata.
Symptoms
The characteristic symptom of alopecia areata consists in the loss of hair in circumscribed areas with a rounded shape. The most commonly affected regions are the occipital and temporal ones.
In addition to hair loss, however, patients with this disease may also have symptoms such as leukonychia, nail pitting, brittleness of the nails or coarse and dull nails.
The information on Alopecia Areata - Medicines for the Treatment of Alopecia Areata is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Alopecia Areata - Medicines for the Treatment of " Alopecia Areata.
Medicines
The treatment of alopecia areata involves the use of topical corticosteroid drugs, because of their side effects, in fact, it is preferable to avoid administering them systemically.
However, in the most severe cases of alopecia areata, the doctor may deem it necessary to resort to the administration of the aforementioned intramuscular corticosteroids, or may decide to resort to the use of immunosuppressive drugs.
Minoxidil-based lotions, on the other hand, have proved to be quite effective in the symptomatic treatment of the disease.
Finally, P-UVA phototherapy is also commonly used for the treatment of alopecia areata.
The following are the classes of drugs most used in the therapy against alopecia areata and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
Corticosteroids
As mentioned, the pharmacological treatment of alopecia areata involves the administration of corticosteroids for topical use. Except for very serious cases, in which it may be necessary to resort to the parenteral administration of these same drugs.
Among the active ingredients that can be used, we remember:
- Betamethasone (Ecoval ®, Beben ®): Betamethasone can be used topically in the treatment of alopecia areata. It is available in various formulations for skin use, including creams, emulsions or skin solutions and ointments. Generally, it is recommended to apply the product directly on the affected area once or twice a day, or according to the doctor's judgment.
- Triamcinolone (Kenacort ®): Triamcinolone can be administered intramuscularly in the most severe cases of alopecia areata. The starting dose usually used in adults and children over 12 years of age is 60 mg of the drug. The maintenance dose, on the other hand, is between 20 and 80 mg of active ingredient. However, the exact dosage of the medicine must be determined by the doctor.
Minoxidil
Minoxidil (Regaine ®, Aloxidil ®, Carexidil ®) is a drug that - when taken orally - has strong antihypertensive properties, but - when used topically, in the form of a solution - stimulates hair and hair growth. The mechanism of action with which minoxidil carries out this activity is not yet fully known, but - precisely because of these properties - it is used in the symptomatic treatment of alopecia areata, as well as in the symptomatic treatment of androgenetic alopecia.
Generally, it is recommended to apply the minoxidil solution to the affected area twice a day, for a period of not less than 3-4 months. In any case, you should always follow the directions given by your doctor.
It should also be remembered that topical minoxidil treatment should not be stopped abruptly, as there could be a risk of returning to the pre-treatment situation within a few months.
Immunosuppressants
Immunosuppressive drugs can be used in the most severe cases of alopecia areata. Thanks to their activity, in fact, these drugs reduce the attack of the immune system against the hair follicles.
Among the various active ingredients that can be used, we mention cyclosporine (Sandimmun ®, Ciqorin ®). It is available in different pharmaceutical formulations suitable for different routes of administration, including oral and parenteral. When used for the treatment of alopecia areata, the dose of cyclosporine to be administered should be determined by the physician on an individual basis for each patient.
