What is the treatment for generalized alopecia?

From the Guidelines

The most effective treatment for generalized alopecia, specifically alopecia areata, is intralesional corticosteroids, which have been shown to stimulate hair regrowth at the site of injection in some patients. This method is most suitable for treating patchy hair loss of limited extent and for cosmetically sensitive sites such as the eyebrows 1.

Key Points to Consider

• Intralesional corticosteroids, such as triamcinolone acetonide, can be effective in promoting hair regrowth, with 62% of patients achieving full regrowth with monthly injections in one study 1.
• The treatment is typically well-tolerated, but patient discomfort and skin atrophy at the site of injection are potential side effects 1.
• Other treatment options, such as topical corticosteroids, may not be as effective in promoting hair regrowth, with one randomized controlled trial showing no significant effect over placebo 1.
• The choice of treatment should be individualized based on the underlying cause of the alopecia, the extent of hair loss, and the patient's overall health and preferences.

Treatment Approach

• For patients with generalized alopecia areata, intralesional corticosteroids can be a viable treatment option, particularly for those with limited patchy hair loss.
• Treatment should be administered by a healthcare professional, with careful consideration of the potential side effects and the need for repeated injections.
• Patients should be monitored regularly to assess the effectiveness of the treatment and to adjust the treatment plan as needed.

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 use by men only Do not use if • you are a woman Minoxidil topical solution 5% is not intended for frontal baldness or receding hairline • your amount of hair loss is different than that shown on the other side of this leaflet or your hair loss is on the front of the scalp.

The treatment for generalized alopecia is not explicitly mentioned in the provided drug label for minoxidil topical solution 5% 2. The label specifies that the product is for use by men only and is not intended for frontal baldness or receding hairline. It also mentions that the product should not be used if the amount of hair loss is different than that shown on the label. Therefore, the use of minoxidil topical solution 5% for generalized alopecia is not directly supported by the label.

From the Research

Treatment Options for Generalized Alopecia

• Systemic corticosteroids have been demonstrated as an effective treatment for severe alopecia areata, with satisfactory hair regrowth achieved in 38.9% of patients 3.
• Topical minoxidil solution can induce hair regrowth in alopecia areata, with a dose-response effect observed in patients treated with 1% and 5% minoxidil 4.
• A combination of systemic steroids and 2% topical minoxidil may be effective in treating alopecia areata, with 47% of patients achieving more than 25% regrowth after 6 weeks of prednisone treatment 5.
• However, 3% topical minoxidil solution was found to be ineffective in treating severe chronic alopecia areata, with no cosmetically acceptable results achieved 6.
• Minoxidil has also been shown to have a stimulating influence on hair growth in women with androgenic alopecia, with normalization of hair root condition and decrease of hair loss observed in some patients 7.

Key Considerations

• The effectiveness of treatment for generalized alopecia may depend on the extent of hair loss and the individual patient's response to treatment.
• Systemic corticosteroids and topical minoxidil may have side effects, such as weight gain, mood changes, and local irritation.
• Treatment outcomes may vary, and hair loss may recur after treatment is stopped or during treatment.