Team Alopecia-Together We Win - The Use of Sulfasalazine in Alopecia Areata

Team Superstar: Laura Hudson

laura hudson Laura developed alopecia at the tender age of nine. She modeled as a teenager, managing to hide that she had lost her hair. But through the strength of her Christain faith and the love of her family, she came out as a beautiful bald woman on the Learning Channel program "A Makeover Story" She and her husband built a successful business managing award winning Christian and Gospel acts. She and her husband now travel the country sharing their inspirational message of faith. Laura continues to encourage people everywhere to accept and love the person they are, no matter what challenges they face.

Team Superstar: Matt Lucas

matt lucas Matt is a really funny guy. He began his career as a stand-up comedian and moved on to a hugely successful film and television career. His biggest television hit so far is the absolutely nutty and wildly popular "Little Britain" on the BBC. Matt has had alopecia since early childhood and is openly gay. In fact, Mr. Lucas is often listed as one of the UK's most influential gay men. You can read more about Matt and his comedy right here.

Member Login

This Is Our Team!

Register with Team Alopecia to get a monthly email update on alopecia related news, research, meetings, events & fundraisers; and to post your comments and reviews. We will never sell or share your information or email address in any way.

Current articles

Alternatives to Medicine

Topical Sensitizers in Alopecia Areata

Reviews That Work

So You Have Alopecia....

For the Newly Diagnosed

Our Team Superstars!

Three Cheers for our Cheerleaders!

Everybody Is Doing It!

Alopecia From The Doctor's Point Of View

For Kids & Parents

Geneticist with Alopecia Working for a Cure

Sometimes You Just Wanna Vent!

Links We Love

The Use of Sulfasalazine in Alopecia Areata

This article is from the Medscape Website and it's 'Ask The Expert' section in General Dermatology. The question was about the uses of sulfasalazine in treating alopecia areata, and particularly for use in teenagers. What follows is the expert's response in which she gives the results of a recent study.

Amy J. McMichael, MD
Associate Professor, Director of Hair Disorders Clinic, Department of Dermatology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina

~Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis. It also has been used to treat inflammatory bowel disease, seronegative arthropathies, and psoriasis.^[1] Sulfasalazine, a compound of sulfapyridine and 5-aminosalicylic acid, works as both an immunomodulator and an immunosuppressant medication. It inhibits inflammatory cell chemotaxis and cytokine and antibody production.

The most common side effects are nausea, vomiting, anorexia, dyspepsia, malaise, and headaches. These side effects become especially problematic at doses higher than 3 g per day. Taking the medication with food or using enteric-coated tablets can help minimize gastrointestinal side effects. Rare side effects include fever, rash, hepatitis, pancreatitis, pneumonitis, and agranulocytosis. Liver function tests and complete blood counts should be monitored closely for the first 3 months, then every 3-6 months thereafter. Because sulfasalazine inhibits folate absorption, folate supplementation is recommended. Finally, patients with allergies to sulfa should not be started on sulfasalazine.

Sulfasalazine is not a first-line therapy, but it has been used to treat alopecia areata.

The literature is primarily anecdotal, and it is important to remember that this drug has not been approved by the US Food and Drug Administration for use in alopecia areata

it is important to remember that this drug has not been approved by the US Food and Drug Administration for use in alopecia areata Quotation

. Patients must be made aware of this prior to starting sulfasalazine. A retrospective chart review performed by Ellis and colleagues^[2] showed that 7 (23%) of 30 patients with alopecia areata treated with sulfasalazine for 3 months achieved cosmetically acceptable regrowth. Doses ranged from 1 to 4 g per day. Eleven patients discontinued the medication due to side effects, mainly gastrointestinal distress.

Although sulfasalazine is not commonly used to treat alopecia areata, the low incidence of severe side effects makes it a reasonable choice for patients who have failed multiple agents and are able to tolerate the side effects. It is typically started at 500 mg per day and increased up to 3 to 4 g per day as tolerated. An adequate trial of at least 4 months on 3 g per day should be tried before discontinuing the drug. In terms of dosing schedules for teenagers, there are no regimens that are different from those in adults, although you may consider starting at a lower initial dose.

Posted 01/01/2003

References

Ellis CN, Brown MF, Voorhees JJ. Sulfasalazine for alopecia areata. J Am Acad Dermatol. 2002;46:541-544.
Wolf JM, Lashner BA. Inflammatory bowel disease: sorting out the treatment options. Cleve Clin J Med. 2002;69:621-631.

Comments (0) >>

Write comment

You must be logged in to post a comment. Please register if you are not yet a member.