VIDEO: Treatment options for alopecia areata

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There are several known treatments for alopecia areata which we could broadly divide into topicals versus systemic therapies. Amongst the topical therapies are included hypertensive corticosteroids, intralesional corticosteroids, creams, solutions. The second is contact immunotherapy that has been around for a long time, and the most common one in that category that's used is called Diphenylcyclopropenone, DPCP in short, it's popularity is slowly going down. The new other topical that we sometimes employ is minoxidil and lights and laser therapies are also an option depending on the patient. Amongst this category are excimer laser, which is a 308 nanometer laser, and the second would be Psoralen along with UV-A light, ultraviolet-A light which can be employed for the treatment. In the systemic therapy category we have oral corticosteroids, which are used either as pulse therapy or some other sort of dosage format. Then second would be disease modified anti rheumatic medications. And under this category, the two common ones that we use are methotrexate and sulfasalazine Also, cyclosporine is another medication that is fast acting and sometimes can be used for short-term usage in patients that need quick response. Seamless continues down to Phosphodiesterase for inhibitors. These are newer drugs relatively and have shown some benefit in alopecia areata. And last but not least, the most recent development in this area was the JAK inhibitors of which baricitinib was approved in June, 2022 as one of the treatments for alopecia areata. Now all these treatments are usually available however, we decide what treatment to use for a certain patient based on age, their other comorbidities, what other medications they're on, how extensive their disease is, how many alopecia patches they're presenting with, what is the duration of treatment, et cetera.