title: Alopecia areata: Part 2: treatment.
abstract: OBJECTIVE
  To provide family physicians with a background understanding of the therapeutic regimens and treatment outcomes for alopecia areata (AA), as well as to help identify those patients for whom dermatologist referral might be required.
  
  
  METHODS
  PubMed was searched for relevant articles regarding the treatment of AA.
  
  
  RESULTS
  Alopecia areata is a form of autoimmune hair loss affecting both children and adults. While there is no associated mortality with the disease, morbidity from the psychological effects of hair loss can be devastating. Upon identification of AA and the disease subtype, an appropriate therapeutic regimen can be instituted to help halt hair loss or possibly initiate hair regrowth. First-line treatment involves intralesional triamcinolone with topical steroids or minoxidil or both. Primary care physicians can safely prescribe and institute these treatments. More advanced or refractory cases might require oral immunosuppressants, topical diphenylcyclopropenone, or topical anthralin. Eyelash loss can be treated with prostaglandin analogues. Those with extensive loss might choose camouflaging options or a hair prosthesis. It is important to monitor for psychiatric disorders owing to the profound psychological effects of hair loss.
  
  
  CONCLUSIONS
  Family physicians will encounter many patients experiencing hair loss. Recognition of AA and an understanding of the underlying disease process will allow an appropriate therapeutic regimen to be instituted. More advanced or refractory cases need to be identified, allowing for an appropriate dermatologist referral when necessary.
authors.affiliation: Dermatology resident at the University of Ottawa in Ontario.
authors.forename: Frank
authors.initials: F
authors.lastname: Spano
authors.affiliation: Dermatologist, Director of the Women's College Hospital Hair Loss Clinic, and Assistant Professor at the University of Toronto in Ontario. jeffrey.donovan@utoronto.ca.
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Donovan
mesh_terms: D000328:Adult; D000506:Alopecia Areata / Q000188:drug therapy* / Q000523:psychology; D000875:Anthralin; D002648:Child; D003521:Cyclopropanes / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation; D013256:Steroids / Q000627:therapeutic use
chemical_list: D003521:Cyclopropanes; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D013256:Steroids; C029402:diphenylcyclopropenone; D000875:Anthralin