Childhood alopecia areata: What treatment works best?

Abstract

There are no validated effective treatments for alopecia areata (AA). Topical immunotherapy (squaric acid dibutylester [SADBE] and diphenylcyclopropenone [DPCP]) induces the most significant short-term hair regrowth in children with severe AA (strength of recommendation [SOR]: C, 4 small individual cohort studies and 1 moderately sized retrospective case review). Intralesional steroids can induce hair regrowth greater than 50% in children with limited AA (SOR: C, 1 retrospective cohort study). Other commonly used treatments--topical and oral corticosteroids, topical cyclosporine, photodynamic therapy, and topical minoxidil--have no benefit over placebo (SOR: A, 14 randomized controlled trials [RCTs] and 3 within-patient studies).