Treating Alopecia Areata with Antihistamines: Just a Co-incidence or a New Avenue of Study?

Alopecia Areata & Antihistamines:

It’s challenging to conduct research studies in alopecia areata. One of the reasons is that hair growth can occur spontaneously – even if no treatments are administered. For this reason, it’s important that any new drug promising benefit in alopecia areata be carefully studied.

Several studies have suggested that antihistamines might be helpful for treating alopecia areata. However, these studies were small and we still don’t know if this might be a helpful treatment.

For example, researchers from Japan recently reported a 19 year old woman patient with alopecia areata at the back of the scalp (called the ophiasis pattern of alopecia areata) who improved following treatment with fexofenadine (marketed under the trade names Allegra, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo). The young woman was initially treated with strong topical steroids but had no improvement over a four month period. After adding fexofenadine, an improvement was seen within 3 months.

Is this a co-incidence or a real effect?

The answer is - we don't know.

A previous study of 121 patients with advanced alopecia areata suggested that fexofenadine could help patients with alopecia who were receiving treatment with immunotherapy (either DPCP or squaric acid dibutyl ester). But the improvement was only seen in patients who had atopic eczema, asthma or hayfever. A handful of other studies have suggested that other types of antihistamines may be beneficial for alopecia areata.

Reference

Nonomura Y et al. Case of intractable ophiasis type alopecia areata presumably improved by fexofenadine. The Journal of Dermatology 2012; 39: 1-2.

Inui S. Fexofenadine hydrochloride enhances the efficancy of contact immunotherapy for extensive alopecia areata: Retrospective analysis of 121 cases. Journal of Dermatology 2009; 36:323-327.