Treatment of hair loss (Alopecia areata)

Alopecia treatment (Alopecia areata)

Alopecia areata (hair loss) is a dermatological disease characterised by patchy hair loss (excessive hair loss) that affects men and women of different age categories.

Causes of hair loss

Alopecia areata is the most common reason for hair loss just after androgenic alopecia. This form of hair loss forms circular "islets" without hair in otherwise a hairy region of the head. The pathophysiology of this autoimmune disease is not known, but evidence suggests that it can be inherited (genetic) as well as acquired (stress, allergy and viruses). Alopecia areata is not contagious.

Classic treatment may not be appropriate for everyone. Various options are available and appropriate treatment depends on the type of alopecia areata from which patient suffers, their age and extent of hair loss. The main goal of treatment is to block attacks of the immune system on hair follicles and to stimulate hair growth. This can be effective especially for people with a mild form of this disease – i.e. less than 50% hair loss.

For those with a 50% loss of hair, oral treatment (administered in medicaments) and local (applied to the skin) is more appropriate. Photo-therapy and light therapy are also suitable. 

Treatment of hair loss

We can distinguish hairless patches according to whether they are with or without scars. With no-scar alopecia, there is a much higher hope for complete hair removal and recovery. Corticosteroids (local and systemic), retinoids and UVA radiation are used for common treatment – all of these methods, however, expose the body to undesirable effects.

Treatment of mild form of alopecia areata

Injection of corticosteroids

This method is most common in treating hair loss. It uses corticosteroids, which are injected with small needles into bald places. The dermatologist applies injections every 4-6 weeks. New hair is visible after 4 weeks of treatment. This treatment also has its side effects. At the injection site, skin may thin out, and needle application may be unpleasant.

Minoxidil

In this treatment, a 5% Minoxidil solution is applied topically once or twice a day to the hairless areas of the head, eyebrows and chin. Dual and 5% minoxidil solutions are available, but they are not usually effective when used separately. More visible results are when combined under local corticosteroids. Treatment does not function in patients with extensive hair loss.

Anthraline cream or ointment

This synthetic substance, similar to asphalt and also used in psoriasis, is often used to treat alopecia areata. The ointment is applied to hairless areas once a day and then washed after 30-60 minutes. Sometimes it might be left on the head for several hours. When the hair strands grows, they are visible after 8 to 12 weeks. This treatment irritates the skin and causes a temporary browning of the treated skin.

Local corticosteroids

Corticosteroids are used to reduce the inflammation of the hair follicle. Local steroids may have different trade names, intensity, and may be sold in the form of a solution, cream, foam or ointment. Some studies have shown that hair loss has been reduced when using these products, and hair has grown by about 25%. This treatment may also be appropriate for children.

Treatment of serious form of alopecia areata

Corticosteroids (medicaments)

Corticosteroids used in tablets are prescribed in case of extensive hair loss to suppress the progression and promote hair growth. Some patients experience new hair growth in a short time. However, this treatment is not suitable for longer periods of time because it has several side effects. Hair loss may occur again after discontinuation of treatment.

Local immunotherapy

Local immunotherapy is used in case of extensive alopecia areata, alopecia totalis and alopecia universalis. This form involves the application of chemical substances, such as diphencypron (DPCP) or dinitrochlorobenzene (DNCB), on the scalp. Approximately 40% of patients experience hair growth within 6 months, but therapy must continue to maintain it. Treatment has side effects such as redness, itching and rashes.

Immunomodulators: drugs to block immune system attacks – mainly Janus kinase inhibitors. It is a new therapy that is tested in patients with alopecia areata. Clinical trials held in the US are ongoing, and treatment is not approved by the FDA. There is not enough information about this type of treatment yet.

Classical treatment may not be a suitable solution for every patient with hair loss. The latest results show that a 308 nm excimer laser is an effective treatment method, and it presents a safe alternative for patients who are not suitable candidates for the classical treatment or do not respond to it.

Based on the latest research by a prominent physician Dr. Maurizio Bellini from Florence, we started to use a modern method of treatment with XTRAC excimer laser for hair loss treatment at eveclinic in cooperation with the Derma Medical Clinic. Like Dr. Bellini, we achieve unparalleled results using this method that you can see on patients in photos.

A suitable candidate for treatment of alopecia areata with an excimer lase

Treatment is suitable for adult women and men, and children from 16 years of age who suffer from hair loss. The XTRAC excimer laser is suitable for treatment of hair loss in the form of "islets" and in some cases of loss of hair on the chin. It does not work if the hair is lost on the limbs.

Benefits of Xtrac excimer laser treatment

• Effective, safe treatment that does not harm the body because of the laser treatment of affected tissue.
• This eliminates undesirable carcinogenic and ageing effects on healthy skin, which have other methods of photo-therapy and topical medications.
• Treatment is fast.
• We already record 75% hair growth in 20 and 30 treatments.
• New hair growth in 6 to 8 weeks.
• A high percentage of patients respond positively to treatment.
• The result is stable and long-lasting.

Before treatment

No special mode is required before treatment. Skin should be clean, free of creams and ointments. Before treatment, you should tell your doctor about all the medicines you are taking, and about the treatment you have already undergone, and what its results were.

During treatment

The treatment is quick and comfortable. In this treatment, the surgeon or specialist nurse puts a laser applicator on the affected patches and applies a laser beam here. Then he/she shifts the applicator and repeats the process. The treatment time depends on the size of the patch. Most patients are treated within a few minutes.

Session is repeated twice to three times a week.

After treatment

Most patients liken the treatment with excimer lasers to the breaking of a thin elastic band. Some people have reddened skin after treatment where the laser was applied. This naturally takes a few minutes up to days after treatment, depending on the sensitivity of your skin. Other possible side effects may include blisters, burning, swelling, itching or increased pigmentation 1-5 days after treatment.

Effect of treatment

For the optimal hair growth result, 20 to 30 treatments are required. You should observe new hair growth after 10 treatments. The result is different in patients. However, you should observe new hair growth already after 10 treatments. Usually, 20 to 30 sessions are needed for completion of the hair growth in the affected area. This means treatment for 6-10 weeks.

Contraindications

Lupus is a contraindication for treatment with excimer laser. Therapy is also not recommended in the case of excessive sensitivity of the skin to the sun. Treatment is not suitable for pregnant women and children under 16 years of age. Consult your doctor whether the treatment is suitable for you in cases where you have reduced immunity or you have a history of skin cancer in the family.

An example of a patient's treatment at our partner clinic, Derma Medical Clinic, in Prague

"Our client, 35 years old woman with alopecia diagnosed. Figure 1 shows the patient's condition before treatment. During treatment with the XTRAC excimer laser, the unpigmented hair (grey) can firstly grow on the affected location. After further therapy, they will become pigmented. This is an individual matter – in some patients pigmented (coloured) hair grows immediately. Figures 2 to 4 clearly show how hair gradually grows in the affected site.”

Successful treatment of alopecia, patient born in 1976

"Client D.S., born in1976, has been suffering from hair loss for a long time – a local alopecia with unclear causes, always completing 20 applications and responding well to the laser. During half a year his hair has been growing, firstly without pigment (hair is grey), later coloured in his natural shade. Photo at the beginning of treatment, after treatment and after 4.5 months after the completion of 20 applications.”

Before treatment

After 19 treatment sessions

Grown hair – after treatment completion, 20 laser treatment sessions

Another photos for comparison of the state before and after treatment

Provided by Derma Medical Clinic©