| Alopecia areata |
| Topical steroids | Applied twice daily to scalp | B | Evidence for short-term growth, but none for long-term growth5 |
| Topical minoxidil (Rogaine) | Applied twice daily | B | Evidence for short-term growth; one study showed more hair regrowth with 5% than 1% formulation5,6 |
| Topical immunotherapy with diphenylcyclopropenone or squaric acid | Treatment applied by dermatologist every few weeks | B | Unlicensed treatment; may cause severe dermatitis7 |
| Oral steroids | Six-week tapering course of prednisone starting at 40 mg per day | B | Continued treatment is needed to maintain hair growth; risks of prolonged steroid use outweighs the benefits6 |
| Intralesional corticosteroids | Triamcinolone acetonide (Kenalog) 5 to 10 mg per mL; 0.1 mL injected with a 30-gauge needle into the dermis 1 cm apart to a maximum of 3 mL; can be repeated every four to six weeks | C | Hair regrowth lasts a few months; effect on long-term outcome is unknown6 |
| Anthralin cream (Dritho-Creme HP) | 0.5% to 1% cream once daily for 20 to 30 minutes, increasing by 10 to 15 minutes every two weeks | C | Hair staining prevents use in fair-haired patients6 |
| Female pattern hair loss |
| Minoxidil 2% | Apply twice daily to dry scalp | B | 20 percent of women using the drug versus 7 percent of women taking a placebo reported moderate new hair growth after 32 weeks; number needed to treat = 88; 7 percent of women using minoxidil experience undesirable hypertrichosis9 |
| Spironolactone (Aldactone) | 100 to 200 mg orally daily | C | 88 percent of women had a modest decrease in hair loss with treatment10 |
| Flutamide (formerly Eulexin) | 250 mg orally daily | C | Treatment for one year resulted in a modest improvement in alopecia; 32 percent of participants experienced elevated liver function tests while taking the medication, resulting in some safety concerns11 |
| Male pattern hair loss |
| Finasteride (Propecia) | 1 mg orally daily | A | Promotes hair growth for more than two years, with the effect waning by year three12,13; does not significantly affect sperm production and poses no risk to a female sex partner; when screening men on finasteride for prostate cancer, the upper limit of normal prostate specific antigen levels should be doubled to ensure appropriate interpretation14,15 |
| Minoxidil (2%) | 1 mL to scalp twice daily | A | Consistent evidence showing moderate to dense regrowth of hair16 |
| Minoxidil (5%) | 1 mL to scalp twice daily | A | Consistent evidence showing moderate to dense regrowth of hair16 |
| Ketoconazole (2%) shampoo (Nizoral) | Daily | C | Increased hair density, size, and proportion of anagen follicles after shampooing two to four times per week for 21 weeks17 |
| Pyrithione zinc (1%) shampoo (Head and Shoulders) | Daily | C | Increased total visible hair count, but 5 percent less than treatment with minoxidil 5%18 |