Options for Sub-Optimal Responders
Diphencyprone (DPCP) is a topical treatment used for adults and children with more advanced stages of alopecia areata - especially in those who have lost greater than 50 % of their hair. The treatment is typically applied weekly. It had been studied for well over 30 years.
DPCP can be an effective treatement in many patients and is much more effective for patients with localized AA than in those with complete scalp hair loss (alopecia totalis and universalis). In this post, I'd like to focus on options for patients who are responding "partially" to treatment with DPCP but not fully. What can be done?
There are several options including:
- increasing DPCP concentrations slowly upwards of 6-8% as tolerated by the patient
- adding minoxidil daily to the treatment plan
- using anthralin with DPCP or
- using imiquimod together with DPCP,
- adding tretinoin gel prior to DPCP application to make the DPCP more irritating and
- applying DPCP twice weekly rather than once weekly.
These are 6 options that can improve outcomes for patients that aren't fully responding to the DPCP. They should be carried out in conjunction with a physician knowledgable about the use and application of DPCP.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Vancouver office at 604.283.9299