Antihistamines May Add Benefit in Alopecia Areata Treatment

Fexofenadine and Ebastine May Have Potential Benefit in Treatment of Alopecia Areata

A new study from South Korea offers additional support to the currently accepted notion that antihistamines play a role in the treatment of alopecia areata. This is not a new finding but nevertheless a nice addition to the pool of evidence that antihistamines have some value.

New Study Supports a Role for Antihistamines

This new small study from South Korea involved study of two antihistamines - Fexofenadine (marketed under the trade names Allegra, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) and Ebastine. Fexofenadine and Ebastine are both non-sedating second generation antihistamine. Ebastine is not available in Canada or the United States.

The study examined whether patients with mid to moderate alopecia areata receiving standard treatment with topical corticosteroids and cryotherapy (the treatment the authors used in their clinic) received additional benefit from adding on an antihistamine to the treatment plan. From February 2012 to November 2018, 121 patients were given the authors standard protocol and 24 patients with the standard treatment protocol with addition of an antihistamine. Again, the antihistamines used in this study were fexofenadine (180 mg/day adult, 30 mg/day children) or ebastine (10 mg/day adult).

The authors of the study found after seven months of treatment, 100% of antihistamine patients achieved what was termed “major hair regrowth” (defined as a 60% reduction in SALT SCORE) compared to 79.3% of patients who were treated with the standard treatment plan. There was no difference in the percentage of patients achieving complete regrowth after 12 months. There were no adverse effects resulting from treatment in this particular study.

COMMENT

This is an interesting study and supports the notion that antihistamines have a role as an add on treatment of mild to moderate cases of alopecia areata. These medications are relatively safe and are a helpful add on for many patients.

Reference

Lee et al. Efficacy of antihistamines in combination with topical corticosteroid and superficial cryotherapy for treatment of alopecia areata: A retrospective cohort study. Journal of the American Academy of Dermatology. April 2021.

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.