Evaluate and compare the efficacy and safety of topical cetirizine 1%, versus topical
betamethasone valerate 0.1% in the treatment of localized alopecia areata.

Topical Cetirizine in Treatment of Localized Alopecia Areata

Alopecia Areata

Alopecia areata (AA) is one of the commonest autoimmune non-cicatricial hair loss that
affects different parts of hair-bearing areas of the body . Nearly 2% of the population
at some stage of their life may be affected by alopecia areata while the prevalence of
alopecia areata was reported to be between 0.1% to 0.2%. Alopecia areata can occur at any
age, although it starts in the first three decades of life in most patients, and both
sexes are equally affected. It can present clinically as a well-defined patch of hair
loss, diffuse hair loss, reticulate hair loss, ophiasis, ophiasis inversus, alopecia
totalis (complete loss of scalp hair), or alopecia universalis (hair loss of all over the
body).

Many treatment options including topical, systemic, injectable and laser modalities have
been used for the treatment of AA . Among the various treatment options for alopecia
areata, topical corticosteroids as betamethasone valerate are considered as standard
therapy.

There have been reports on the efficacy/adjunctive role of systemic antihistamines in
alopecia areata. Moreover, fexofenadine was found to enhance hair regrowth in two cases
of extensive resistant alopecia areata.

Cetirizine hydrochloride belongs to a family of medicines called antihistamines which has
varied medical uses and is commonly used to relieve allergy symptoms such as watery eyes,
runny nose, sneezing, hives, and itching. In addition, it has been demonstrated that
cetirizine inhibits release of prostaglandin D2 and stimulates the release of
prostaglandin E2 .

Topical cetirizine was used with good results and with no notable side effects for the
treatment of androgenic alopecia. Because of this evidence and the absence of hormonal
influence, cetirizine was considered suitable for this kind of hair loss .

Cetirizine is able to increase prostaglandins (PG) E and Fα synthesis, and thus, reduce
inflammation. It also decreases prostaglandin D2 (PGD2) synthesis. Prostaglandins E and
Fα influence positively hair follicle growth, and stimulate and maintain the anagen
phase. So, by increasing the synthesis of prostaglandins E and Fα, cetirizine induces an
increase in total and terminal hair density and hair diameter, and a reduction in vellus
hair density.

A recent study has shown a significantly increased expression of prostaglandin D2 in the
serum and lesional skin of alopecia areata patients than in controls. Also, a case report
has demonstrated the improvement of diffuse alopecia caused by palbociclib for the
treatment of breast cancer, using topical cetirizine 0.5% solution.

Dermoscopy is a non-invasive diagnostic utility, used to evaluate many skin and hair
disorders. It may aid in the diagnosis of many uncertain hair disorders, one of which is
alopecia areata. Different dermoscopic characteristics are seen in alopecia areata such
as, black dots, yellow dots, tapering hairs (exclamation mark hairs). broken hairs and
short vellus hairs.

Topical Cetirizine 1 %

Topical betamethasone valerate 0.1%

Topical Cetirizine Versus Topical Betamethasone in Treatment of Localized Alopecia Areata

an ideal objective method of follow-up and good evaluation of any therapeutic option

The photographs and response to treatment will be evaluated objectively by two-blinded
dermatologists using a five-point semiquantitative score (regrowth scale) defined as
follows: 0 score (regrowth <10%), 1 score (regrowth 11-25%), 2 score (regrowth 26-50%), 3
score (regrowth 51-75%), 4 score (≥ 75)

Asking the patients about their satisfaction towards treatment using a five-point scale
(-1: condition worsened, 0: not satisfied, 1: poorly satisfied, 2: moderately satisfied,
3: very satisfied)

doctor

patients with alopecia areata who will be treated with topical cetirizine 1%

patients with alopecia areata who will be treated with topical betamethasone valerate
0.1%

Topical Cetirizine in Treatment of Localized Alopecia Areata

About this trial

Study ID

Status

Type

Placebo

Accepting

Trial Timing

What is this trial about?

What are the participation requirements?