AA y tx complementario

Complementary & Alternative Medicine for Alopecia Areata: A Systematic Review

Author links open overlay panelElizabethTkachenkoBS¹⁴Jean-PhillipOkhovatMD MPH²PriyaManjaly³⁴Kathie P.HuangMD⁴Maryanne M.SennaMD²ArashMostaghimiMD MPA MPH⁴

https://doi.org/10.1016/j.jaad.2019.12.027Get rights and content

Abstract

Background

Despite high utilization 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 psychological well-being.

Methods

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

Results

Of 1,015 initial citations, 16 articles met inclusion criteria: 5 randomized controlled trials, 5 prospective controlled cohorts, 4 prospective non-controlled 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 psychological and quality of life outcomes. Adverse events were rare and mild for all therapies evaluated.

Limitations

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

Conclusions

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

Funding sources: None

Conflicts of interest: 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. Dr. Senna has participated in alopecia clinical trials related from Eli Lilly and Concert, received consulting fees from Concert, and is on the scientific advisory board of Cassiopea. Dr. Huang receives royalty payments from Pfizer for licensing the ALTO tool, participated in clinical trials related to alopecia from Incyte, Aclaris, and Concert, and received consulting fees from Pfizer.

CAPSULE SUMMARY

•The complementary and alternative therapies with highest quality and efficacy for hair growth in alopecia areata include essential oil aromatherapy, topical garlic, and oral glucosides of peony with compound glycyrrhizin.

•Low quality studies reveal that hypnosis and mindfulness are effective for improving psychological outcomes and quality of life.