Alopecia Areata Diagnosis can usually be made on clinical grounds, but when diagnosis is uncertain a biopsy can be helpful. Biopsies in AA show a peribulbar lymphocytic infiltrate.
Treatment is not always necessary since alopecia is considered benign. Also, spontaneous remissions are common as are recurrences. Corticosteroids are used to suppress the immune system in patients with alopecia areata. They may be administered orally, as topical ointments, or as local injections administered directly into the area of hair loss. Topical preparations tend to work best when combined with other topical treatments such as minoxidil (Rogaine) or anthralin (Psoriatec).
Other treatments occasionally used for alopecia areata include clobetasol propionate topical foam (Versafoam), betamethasone dipropionate lotion, dexamethasone, sulfsalazine, topical sensitizers such as squaric acid dibutyl ester (SADNE) and diphenylcyclopropenone (DPCP), oral cyclosporine, and photochemotherapy, a treatment used most commonly for psoriasis and vitiligo.
Alternative therapies include acupuncture, aromatherapy, evening primrose oil, zinc and vitamin supplements, and Chinese herbs. In aromatherapy, a combination of oils such as lavender oil, almond oil and rosemary oil are applied to the bald area for 20 minutes to help stimulate hair growth.
Autoimmune disorders are known to develop in persons with certain immune system genes when they are exposed to certain environmental triggers. There are reports of alopecia areata developing after the use of synthetic estrogens in oral contraceptives and permanent remission occurring when these medications were stopped. Viruses are also suspected of triggering alopecia areata, but no specific viral causes have been identified. Stressful life events within the 6 months prior to the development of AA were higher in patients with AA compared to patients with androgenetic alopecia.
