Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

Abstract Background Alopecia areata is a highly frequent disease with a great impact on quality of life and several treatment options with little clinical confirmatory evidence. Objective To disseminate the recommendations of Brazilian dermatologists with experience in the treatment of alopecia areata. Methods Eight specialists with experience in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. Results/Conclusions Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.