Medical Treatment of Alopecia

Abstract

Alopecia means partial or complete loss of hair from a part of the body where it exists naturally. It affects both men and women, and its treatment depends upon its cause, age of onset, and clinical presentation. It is divided into scarring and non-scarring alopecia. Scarring alopecia includes pseudopelade of Brocq, central centrifugal cicatricial alopecia, folliculitis decalvans, acne keloidalis nuchae, lichen planopilaris, frontal fibrosing alopecia and discoid lupus erythematosus, traumatic i.e., injury, radiation and post-operative scarring alopecia and certain neoplasms. Common causes of non-scarring alopecia are androgenic alopecia, alopecia areata, telogen effluvium, anagen effluvium, trichotillomania, traction alopecia, pressure-induced alopecia, alopecia due to iron deficiency, thyroid disease, and polycystic ovary syndrome. Topical remedies available are minoxidil 2 and 5%, topical & intralesional steroids, topical sensitization, anthralin, retinoids, tacrolimus, garlic, ketoconazole and prostaglandin analogs. Among systemic treatments, finasteride, steroids, immunosuppressant like azathioprine, methotrexate, sulfasalazine, zinc sulfate and iron are widely accepted. The phototherapies, photo-chemotherapies, platelet rich plasma (PRP) therapy, pharmacogenetics and hair transplant are new remedies for alopecia. It is concluded that minoxidil, finasteride, PRP, and hair transplant are the most widely being used modalities for alopecia.