Efficiency of UVA1 laser treatment in alopecia areata

Alopecia areata is a disease which is characterized by localized or diffused hair loss more often in scalp, eyebrows, eyelashes, beard or in other areas of the body. Although the etiology is not clear, it is accepted that autoimmunity is responsible for the pathogenesis. Main goal of the treatment for alopecia areata is to stop the disease activity. Among these treatment methods; corticosteroids, anthralin, phototherapy (PUVA, narrow-band UVB), topical minoxidil and contact sensitizers are mostly preferred. Immunosuppressant agents such as methotrexate, cyclosporine, azathioprine and sulfasalazine can be used in resistant cases. In this study we aimed to evaluate the effectiveness of UVA1 laser therapy in the treatment of alopecia areata. Twenty one alopecia areata patients were included in this study who did not receive any treatment within the last 1 month, without concomitant severe systemic disease, UV sensitivity or photosensitivity, systemic immunosuppressive therapy, pregnancy and lactation, skin cancer history. Three patients withdrew from the study due to personal reasons and the remaining 18 patients were evaluated. UVA1 laser therapy was performed with Laser Alba 355 (Elettronica Valseriana, Casnigo, Italy) and every lesion was treated 2 sessions per week and total of 8 weeks. The results were evaluated at the end of week 4 and week 8 and lesion areas were photographed. The response were evaluated in 4 groups as complete response (> % 90 hair regrowth), partial response (% 50-90 hair regrowth), minimal response (% 10-50 hair regrowth) and no response (< % 10 hair regrowth). According to treatment response, patients were divided into two groups for statistical evaluation; good response (complete response + partial response) and poor response (minimal response + no response). Five of 18 patients (% 27.7) had complete response, 5 patients (% 27.7) had partial response, 3 patients (% 16.6) had minimal response and 5 patients (% 27.7) had no response. Additionally, impact of the gender, family history, age of disease onset, duration of disease, nail involvement, history of recurrences, history of atopy, thyroid function abnormalities, presence of disease activity and location of the involvement on treatment response were found statistically insignificant (p > 0.05). As a conclusion, in our study good responses were obtained with 355 nm UVA1 laser treatment and no important adverse reactions were observed. With further clinical investigations, optimal weekly laser application frequency, total duration of treatment, dosage of laser radiation, possible side effects and the factors that effecting the response to therapy can be clearly identified. UVA1 laser and similar laser technology are promising for treatment of recalcitrant skin diseases and these methods will find every day new application areas.