Alopecia areata; combination therapy with minoxidil [2%] solution and isotretinoin [0.05%] gel

ABSTRACT

Alopecia areata is a common cause of nonscarring hair loss. The cause is unknown but it is associated with an alteration in the immunological system. Treatment for alopecia areata includes topical corticosteroids, dithranol, tretinoin, minoxidil, systemic cortisone, PUVA therapy, irritants and immunosuppressive drugs. Our objective was to assess the efficacy of combination of topical 2% minoxidil lotion and isotretinoin [0.05%] gel in the treatment of alopecia areata. From 1[st] October 2003 till 30[th] September 2004, over a period of 1 year, clinically diagnosed, fresh cases of alopecia areata, fulfilling the inclusion criteria were enrolled. All the patients were advised to apply minoxidil [2%] solution in the daytime and isotretinoin [0.05%] gel in the night to avoid photosensitivity. The daily treatment was advised for a period of four months and thereafter every alternate day for another two months as a maintenance therapy. Clinical assessment was carried out by patient's self-assessment, investigator assessment and clinical evaluation on follow up visits. The total number of patients studied was 54 comprising 31 males [57.4%] and 23 females [42.6%], male to female ratio being 1 .3. Twenty-nine patients [53.7%] had three lesions, 18 [33.3%] had two lesions and seven [13%] only one lesion. Complete restoration of hair follicles was noted in 45 [83.3%, p < 0.001] by the end of therapy. All the patients with single patch responded [100%], while 15 patients [83.3%] with 2 lesions recovered completely. Twenty-three patients [79.3%] with 3 lesions had a complete restoration of hair follicles. The combination therapy of minoxidil [2%] solution and isotretinoin [0.05%] gel for alopecia areata is cost effective, stimulating hair regrowth within a shorter interval and is well-tolerated