From the Guidelines
Treatment for alopecia areata should prioritize minimizing morbidity, mortality, and improving quality of life, with the most recent and highest quality study suggesting that PRF is a valuable treatment for managing alopecia areata, particularly in mild cases 1.
Overview of Treatment Options
Alopecia areata is a condition that can cause significant psychological and social disability, and treatment options vary depending on the severity of the condition.
- For limited patchy hair loss, intralesional corticosteroid injections are a recommended treatment option, with reasonable evidence to support their use 1.
- For extensive patchy hair loss, contact immunotherapy may be considered, although the evidence for its effectiveness is limited 1.
- Topical corticosteroids, such as clobetasol 0.05%, may also be used to treat alopecia areata, although the evidence for their effectiveness is limited and they can cause side effects such as folliculitis 1.
Recent Developments in Treatment
Recent studies have investigated the use of autologous platelet concentrates, including platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), in the treatment of alopecia areata.
- A 2025 study found that PRF is a valuable treatment for managing androgenetic alopecia, particularly in mild cases 1.
- Another 2025 study recommended a framework for the use of PRP in the treatment of alopecia areata, including the use of a manual double-spin method for preparation, a minimum of 3-5 sessions, and a recommended dose of 5-7 mL PRP 1.
Recommendations
Based on the most recent and highest quality evidence, PRF is a recommended treatment option for alopecia areata, particularly in mild cases 1.
- Intralesional corticosteroid injections and topical corticosteroids may also be considered, depending on the severity of the condition and the patient's response to treatment.
- Patients should be monitored for side effects and treatment duration should be adjusted based on response.
From the Research
Treatment Options for Alopecia Areata
The treatment options for alopecia areata include:
- Topical minoxidil solution 5% 2
- Platelet rich plasma injections 2
- Topical corticosteroids 3, 4
- Intralesional corticosteroids 4
- Systemic antifungal therapy associated with the daily use of ketoconazole shampoo for tinea versicolor of the neck as a side effect of topical steroids 3
Efficacy of Treatment Options
- Platelet rich plasma is more effective in the treatment of alopecia areata than topical minoxidil 5% as evaluated by clinical and trichoscopic examination 2
- Topical corticosteroids are safe and well tolerated with moderate efficacy in mild alopecia areata, but recurrence is common after treatment cessation 4
- Intralesional corticosteroids are more effective than topical steroids given their ability to penetrate the dermis, where the hair follicle resides 4
Limitations and Future Research
- Most trials have been reported poorly and are so small that any important clinical benefits are inconclusive 5
- There is a desperate need for large well-conducted studies that evaluate long-term effects of therapies on quality of life 5
- Further research is needed on ideal treatment regimens, long-term safety, preferred candidates, and the role of combination therapy to further elucidate the role of local corticosteroids for alopecia areata in clinical practice 4