From the Guidelines
Immunotherapy topical agents for eyebrow hair loss are primarily diphencyprone (DPCP) and squaric acid dibutyl ester (SADBE), as they are not mutagenic and are more stable in solution 1.
Treatment Regimen
- A typical treatment regimen involves applying a 2% DPCP solution to the affected area once weekly, with gradual increases in concentration as needed, for a duration of 6-12 months.
- The concentration is increased at each treatment until a mild dermatitis reaction is obtained, as described by Happle et al 1.
- It is essential to store DPCP solutions in the dark and advise patients to wear a hat or wig for 24 hours following application, as DPCP is degraded by light 1.
Agents and Efficacy
- DPCP is usually the agent of choice due to its stability in solution and non-mutagenic properties 1.
- SADBE is another option, although its use is less common compared to DPCP.
- The response rate to contact immunotherapy varies widely, with 50-60% of patients achieving a worthwhile response, although this rate can range from 9-87% 1.
- Patients with extensive hair loss are less likely to respond to treatment, and other adverse prognostic features include nail changes, early onset, and a positive family history 1.
From the FDA Drug Label
Directions do not use more often than directed adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily children under 2 years of age: ask a doctor
The immunotherapy topical agent for eyebrow hair loss, specifically alopecia of the eyebrows, is diphencyprone (DPC).
- Key points:
- Apply to the affected area
- Not more than 3 to 4 times daily for adults and children 2 years of age and older
- For children under 2 years of age, consult a doctor 2
From the Research
Immunotherapy Topical Agents for Eyebrow Hair Loss
The following topical immunotherapy agents have been studied for the treatment of alopecia areata, including eyebrow hair loss:
- Dinitrochlorobenzene (DNCB) 3
- Squaric acid dibutylester (SADBE) 3
- Diphenylcyclopropenone (DPCP) 3, 4, 5, 6, 7
- Diphencyprone (DCP) 4, 5
Efficacy of Topical Immunotherapy Agents
The efficacy of these agents has been reported in several studies:
- A large retrospective study found that 44.05% of patients with alopecia areata had a good response to topical immunotherapy with DNCB, SADBE, or DPCP 3
- A retrospective review of DCP treatment found that 72.2% of patients had some hair regrowth, and 15.8% had more than 90% regrowth 4
- A study on DPCP treatment found that 83.3% of patients responded to treatment, with 20 patients achieving a grade 4 response 5
- A prospective study comparing two treatment regimens with DPCP found that 54% of patients in one group and 46% of patients in the other group had significant improvement 6
- A study on DPCP treatment in an Iranian population found that 81.5% of patients had a response to treatment, with 22.2% achieving complete remission 7
Factors Influencing Treatment Outcome
Several factors have been found to influence the outcome of topical immunotherapy treatment: