Safety and Efficacy of Phototoxic Doses of Ultraviolet A for Treatment of Alopecia Areata

Background: Alopecia areata (AA) is a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin. A number of treatments can induce hair growth in alopecia areata but none has been shown to alter the course of the disease. The high rate of spontaneous remission makes it difficult to assess efficacy, particularly in mild forms of the disease. The present study aims at determining the efficacy and safety of using the phototoxic doses of ultraviolet A (UVA) after application of topical 8- methoxypsoralen in the treatment of extensive and resistant cases of AA. Patients and Methods: 20 patients receiving phototoxic doses of UVA after topical application of psoralen (test therapy group). Each patient was treated for 3 months and followed up for additional 3 months. Results: At 3 months, patients receiving phototoxic doses of PUVA showed a mean SALT reduction of –46.01%±30.65 from baseline [95% Confidence interval (CI): –60.35% to –31.66%]. Treatment success, defined as achievement of SALT change ≥75% in comparison to baseline, was achieved by 20% of patients. The mean cumulative dose achieved at the end of treatment was 100J/cm²±21.56 (range 40-120 J/cm²).At 6 months, patients receiving phototoxic doses of PUVA showed a mean SALT reduction of –55.32%±37.53 from baseline (95% CI: –72.88% to –37.75%). Conclusion: The current study offers a proof that phototoxic regimen of PUVA exerts a safe and effective in the treatment of AA.