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Complementary and alternative medicine for alopecia areata: A systematic review - 14/12/22

Doi : 10.1016/j.jaad.2019.12.027 
Elizabeth Tkachenko, BS a, b, Jean-Phillip Okhovat, MD, MPH c, Priya Manjaly, BA b, d, Kathie P. Huang, MD b, Maryanne M. Senna, MD c, Arash Mostaghimi, MD, MPA, MPH b,
a University of Massachusetts Medical School, Worcester, Massachusetts 
b Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts 
c Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 
d Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts 

Correspondence to: Arash Mostaghimi, MD, MPA, MPH, Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115.Department of DermatologyBrigham and Women's Hospital221 Longwood AveBostonMA02115

Abstract

Background

Despite high use of complementary and alternative medicine (CAM) for alopecia areata (AA), efficacy and safety remain unclear.

Objective

To identify all CAM therapies studied for treatment of AA. Outcomes of interest included disease course and psychologic well-being.

Methods

PubMed and Embase were searched to identify English articles containing original data investigating CAM in individuals with AA from 1950-2018. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria.

Results

Of 1015 initial citations, 16 articles met inclusion criteria: 5 randomized controlled trials, 5 prospective controlled cohorts, 4 prospective noncontrolled cohorts, 1 retrospective cohort, and 1 case series. CAM therapies with best evidence and efficacy for hair growth in AA include essential oil aromatherapy, topical garlic, and oral glucosides of peony with compound glycyrrhizin. Hypnosis and mindfulness psychotherapy represent low-quality evidence for improvement of psychologic and quality of life outcomes. Adverse events were rare and mild for all therapies evaluated.

Limitations

Inconsistent or poorly reported study methodology and nonstandardized outcomes limit the conclusions that can be made from these studies.

Conclusions

This work serves to inform physician treatment of patients with AA seeking CAM while encouraging further investigation into these therapies to address some of the therapeutic challenges of AA.

Il testo completo di questo articolo è disponibile in PDF.

Key words : AA, alopecia areata, alternative, aromatherapy, CAM, complementary and alternative medicine, complementary, herbal, hypnosis

Abbreviations used : AA, CAM, CGT, MBSR, QoL, RCT, TGPC


Mappa


 Funding sources: None.
 Conflicts of interest: Dr Huang receives royalty payments from Pfizer for licensing the Alopecia Areata Assessment Tool (ALTO) tool, participated in clinical trials related to alopecia from Incyte, Aclaris, and Concert, and received consulting fees from Pfizer. Dr Senna has participated in alopecia-related clinical trials from Eli Lilly and Concert, received consulting fees from Concert, and is on the scientific advisory board of Cassiopea. Dr Mostaghimi has received royalty payments from Pfizer for licensing of the ALTO tool, participated in clinical trials related to alopecia from Incyte and Aclaris, and received consulting fees from Pfizer. He is a medical advisor for HIMS and has received payments and equity in exchange for consulting work. Authors Tkachenko, Okhovat, and Manjaly have no conflicts of interest to report.
 IRB approval status: Not applicable.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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