A Cochrane review [Abstract] 1 included 17 studies with a total of 540 subjects. Each trial included from 6 to 85 participants and they assessed a range of interventions that included immunosuppressant therapies (topical and oral corticosteroids and topical ciclosporin), topical immunotherapies (combination immunotherapy versus squaric acid dibutyl ester or interferon), photodynamic therapy and topical minoxidil. Most of the studies were of short-term (less than six months) duration and reported only short-term outcomes. Overall, none of the interventions showed significant treatment benefit in terms of hair growth when compared with placebo. There were no studies where the participants self-assessed their hair growth or quality of life. No RCTs were found on the use of diphencyprone, dinitro chlorobenzene, intralesional corticosteroids or dithranol although they are commonly used for the treatment of alopecia areata.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and study limitations (several issues).
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