Current and future treatments of alopecia areata and trichotillomania in children

ABSTRACT

Introduction: Treatment options for hair disorders are generally very limited. These options are even more limited in children due to the lack of trials and clinical research. Moreover, physicians are sometimes scared to treat children with drugs without safety data, especially because most hair disorders are benign.

Areas covered: The objective of this paper is to review current and future treatments for alopecia areata and trichotillomania, two disorders that are sometimes encountered in differential diagnosis or even occur together and probably affect the mental condition of the patient involved more than others.

Expert opinion: Hair disorders are very stressful in paediatric population. Both physicians and families are often unsatisfied leading to non-compliance. New drugs with less side- effects are needed to increase the percentage of cure. It is also crucial to refine genetic studies on alopecia areata in order to identify new potential drugs worth studying. Moreover, studies on trichotillomania should not be evaluated only by psychiatrics, but also by dermatologists.

KEYWORDS:

• Alopecia areata
• trichotillomania
• hair disorders
• children
• treatment

Article highlights

• Hair disorders in general are difficult to treat. In children these disorders are even more difficult to handle due to the limited availability of drugs, lack of clinical trials and evidence-based treatments.

• The psychological stress related with having hair disorders may be more important for the patient and his/her family than the fear of a severe side-effect related to a drug.

• Most drugs used to treat hair disorders are currently off-label.

• It is crucial to continue refining genetic studies in AA in order to identify potential drugs worthy of study and to minimize side-effects related to current treatments.

• Studies for trichotillomania should not only be evaluated by psychiatrics, but also by dermatologists.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded