What are the treatment options for alopecia?

From the Guidelines

Treatment for alopecia should prioritize intralesional corticosteroids for limited patchy hair loss, as they have shown to stimulate hair regrowth at the site of injection in some patients 1. When considering treatment options for alopecia, it's essential to differentiate between the various forms of the condition, such as androgenetic alopecia, alopecia areata, and scarring alopecias.

• For androgenetic alopecia, FDA-approved medications like topical minoxidil and oral finasteride are commonly used.
• For alopecia areata, treatments include topical or injectable corticosteroids, with intralesional corticosteroids being a recommended option for limited patchy hair loss 1.
• Additional options for various forms of alopecia include platelet-rich plasma injections, low-level laser therapy, and hair transplantation.
• Lifestyle modifications, such as gentle hair care and maintaining good nutrition, can also support hair health.
• Psychological support is crucial, as hair loss can significantly impact emotional well-being. In terms of assessing treatment response, methods like photography, trichoscopy, hair counts, and patient self-assessment questionnaires can be used to evaluate improvements in hair growth 1. Given the most recent and highest quality study available, intralesional corticosteroids are the preferred treatment option for alopecia areata, particularly for limited patchy hair loss, due to their ability to stimulate hair regrowth at the site of injection 1.

From the FDA Drug Label

When do I use minoxidil topical solution 5%? Apply minoxidil topical solution 5% once in the morning and once at night. For best results, minoxidil topical solution 5% should be allowed to soak into the scalp before using any styling products. Directions for Use

1. Remove the cap. To remove, push down and turn in direction of the arrows on the cap.
2. Part your hair in the area of hair thinning/loss Follow the instructions below for using the dropper applicator and apply one mL 2 times a day directly onto the scalp in the hair loss area.

The treatment option for alopecia is to apply minoxidil topical solution 5% twice a day, once in the morning and once at night, directly onto the scalp in the hair loss area. It is recommended to allow the solution to stay on the scalp for about 4 hours before washing.

• Use a mild shampoo if you wash your scalp before applying minoxidil topical solution 5%.
• Hair sprays, mousses, conditioners, gels, etc. may be used on your hair while using minoxidil topical solution 5%, but allow minoxidil to soak into the scalp first.
• Hair coloring or perming is allowed, but make sure all of the minoxidil topical solution 5% has been washed off the hair and scalp before using color or perm chemicals 2

From the Research

Treatment Options for Alopecia

The treatment options for alopecia include:

• Topical minoxidil solution 5% [ 3 ]
• Platelet rich plasma (PRP) injections [ 3 ]
• Oral minoxidil [ 4 ]
• Finasteride [ 4 ]
• Dutasteride [ 4 ]
• Low-dose oral minoxidil [ 5 ]

Comparison of Treatment Options

Studies have compared the efficacy of different treatment options for alopecia, including:

• PRP versus topical minoxidil 5% [ 3 ]
• Oral minoxidil, finasteride, and dutasteride [ 4 ]
• PRP versus minoxidil therapy [ 6 ]
• 10% topical minoxidil versus 5% topical minoxidil and placebo [ 7 ]
• Low-dose oral minoxidil versus topical solution [ 5 ]

Efficacy and Safety of Treatment Options

The efficacy and safety of treatment options for alopecia have been evaluated in several studies, including:

• PRP therapy was found to be more effective than topical minoxidil 5% in the treatment of alopecia areata [ 3 ]
• Oral minoxidil, finasteride, and dutasteride were found to be effective in the treatment of androgenetic alopecia, but with different side effect profiles [ 4 ]
• PRP therapy was found to be a valuable alternative to topical minoxidil therapy in the treatment of androgenetic alopecia [ 6 ]
• 5% topical minoxidil was found to be moderately superior to 10% topical minoxidil and placebo in increasing hair regrowth [ 7 ]
• Low-dose oral minoxidil was found to be as effective and safe as standard topical minoxidil in female and male pattern hair loss [ 5 ]