The use of antihistamines in conjunction with topical corticosteroid (TC) and superficial cryotherapy (SC) in the treatment of alopecia areata (AA) improves the rate of major hair growth, according to results of a study published in the Journal of the American Academy of Dermatology.

Although the understanding of the pathogenesis of AA has advanced in recent years, optimal therapies have not yet been determined. Antihistamines have been shown to have positive effects when used with topical diphenylcyclopropenone, but their efficacy in conjunction with TC and SC treatments has not yet been established.

Data from 148 patients with AA who were treated with SC and TC from February 2012 to November 2018 were analyzed. Of the included patients, 24 were also treated with an adjuvant antihistamine. Antihistamines included in the analysis were fexofenadine (180mg/day for adults and 30 mg/day for children) and ebastine (10 mg/day for adults). There was no significant difference in age, duration of AA, sex, initial Severity of Alopecia Tool score, or total follow-up period in the groups. The average duration of antihistamine use within the treatment group was 6.29 months.


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After approximately 7 months of treatment, 100% of those treated with an antihistamine exhibited major hair regrowth, and  79.3% of patients who were not treated with antihistamines had major hair regrowth (P =.045).

Limitations to this study include its small sample size, deviation of sample size between groups, and lack of investigation into the possibility of a dose-dependent relationship between antihistamine use and disease prognosis.

The results of this study indicated that antihistamine treatment in conjunction with SC and TC treatment is an effective method with no known adverse events. Further research is warranted, the investigators wrote, to determine whether antihistamines are effective in the treatment of alopecia areata due to their ability to act as intrinsic histamine H1-receptor antagonists, as well as whether histamines would be an effective monotherapy.

Reference

Lee YB, Lee WS. Efficacy of antihistamines in combination with topical corticosteroid and superficial cryotherapy for treatment of alopecia areata: A retrospective cohort study. [published online July 15, 2020]. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.06.1026