Once a diagnosis of alopecia areata has been made, one should not rush for any type of treatment. More than 50% of individuals regrow their hair without any type of treatment. In general, the longer the period of hair loss, the less likely will all the hair come back spontaneously.
There are various treatments for alopecia areata and they should only be tried after a time period of observation of at least a few months.
Steroids: Some physicians recommend topical applications of steroids on the patch of skin. The steroids have to be applied until a response is seen. This treatment does not help everyone and the hair growth is slow and in most cases never helps.
There are some who recommend steroid injections into the scalp. These painful injections can resolve the hair loss. These injections are performed every month for a few months.
Steroid shampoos. For those who do not like needles, there are also steroids shampoos available (clobetasol or fluocinonide). The scalp has to be washed for many months and even years and still there may be no response in many individuals.
Minoxidil (Rogaine). Minoxidil can be used to treat alopecia areata. It comes as a liquid and is applied on the scalp twice a day. It is available over the counter in strengths of 2-5%. The drug basically has never lived up to its expectations and is a waste of money. In most cases, it may grow a strand of hair here and there.
Coal tar Anthralin (Drithocreme). Coal tar is available either as a cream or shampoo and has been tried out as a treatment for alopecia areata. This messy chemical which stains everything in sight is only mildly effective at restoring hair growth. It is recommended as a treatment when steroid injections fail.
Finasteride (Propecia). Finasteride is a pill that is also available as a treatment of alopecia. It is slow in action and the results can take months. There is some hair growth but the drug also decreases libido in males
Cyclosporine: There are some individuals who are desperate for hair and in severe cases, topical cyclosporine has been used. Hair growth does occur after a period of 4-6 months but this treatment does not work for al individuals. It also causes a severe itch when the scalp is exposed to sun. So a hat or wig must be worn at all times.
Combination: The majority of individuals undergo a variety of above treatments in different combinations. Even then the response to hair growth is unpredictable and scant at best.
Herbs & Aromatherapy: There are a lot of internet sites which sell products for hair loss. Some claim that essential oils are effective in some patients. In particular, cedarwood, lavender, thyme, and rosemary oils have been used with success. None of these claims can be verified.
The other things recommended for hair growth are wild and beyond the realms of one's imagination- from crow's feet, bear's penis, scorpion's arse, snake's gall bladder, meditation, yoga, etc etc. There is not one iota of proof that any of these work
Phototherapy: There is some evidence that phototherapy with UV light and psoralen may help regrow the hair. At least 50 or more treatments are required and may take several years to see the results
Alopecia areata is a completely benign disorder and hair loss does recover on its own in the majority of individuals. Before embarking on any of these expensive and painful therapies to grow hair, one must be patient and wait at least 3-6 months to allow fro spontaneous hair growth. And even then, wait some more because your hair will eventually come back
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