Treating alopecia areata: More than shots?

Options for treating alopecia areata

Alopecia areata is an autoimmune condition that affects nearly 2 % of the world's population. The condition is autoimmune in nature, which means that the patient's own immune system is attacking the hairs. Treatments that reduce inflammation can often be helpful - although spontaneous regrowth can occur in some patients even without treatment. 

 

Options for Treating AA:

Steroid injections, also known as "steroid shots" are  helpful treatment for many patients with several patches of alopecia. Steroid injections are less effective for wide spread alopecia areata - and other options need to be considered in these situation. Too often I hear patients say "Is there anything else besides shots?"

Beyond Shots

Steroid injections are extremely important for many patients and if done properly present a treatment option with reasonably good efficacy and quite good safety. I think alot of people are suprised when I say there are at least 25 different treatment options for alopecia areata other than 'shots.'  Here I've listed the treatment options for alopecia areata

Topical Treatments
Topical steroids
Topical bimatoprost
Essential oils
Anthralin
Squaric acid
Diphencyprone
Minoxidil
Topical tofacitinib
Topical ruxolitinib
Onion juice
Garlic gel

Topical retinoids

Topical capsaicin 

Topical liquid nitrogen

Injection Treatments
Steroid injections
Platelet rich plasma

Dupilumab (DUPIXENT)
 

Intramuscular Treatments
Intramuscular triamcinolone 

Oral Treatments
Prednisone
Dexamethasone
Antihistamines
Simvastatin & Ezitimibe
Methotrexate
Tofacitinib, Ruxolitinib, Baricitinib
Azathioprine
Cyclosporine
Sulfasalazine
Oral minoxidil

Zinc supplements

Light and Laser Treatments
Psoralen UVA (PUVA)
308 nm Excimer Lasers

Conclusion:

There are many treatments that can be considered for patients with alopecia areata.  Steroid injections are helpful for many patients and should never be discounted. But patients who find that steroid injections did not help have numerous other options available to discuss with their dermatologists.