Dr Jeff Donovan, Canadian Hair Loss Foundation
Alopecia areata is an autoimmune hair loss condition. Medications that reduce or modify the effects of the immune system are used to treat alopecia areata. This includes treatments such as steroid injections, topical steroids, diphencyprone (DPCP), anthralin, or immunosuppressive pills such as methotrexate, sulfasalazine and prednisone.
New research suggests that cholesterol lowering drugs may also be helpful in treating alopecia areata. Interestingly, in addition to the ability of these medications to lower cholesterol levels, these drugs also reduce inflammation. The reduction of inflammation is a key step in treating alopecia areata.
The ‘statins’ are a well-known group of medications used to treat high cholesterol. In fact, it is estimated that about 3 millions Canadians and 30 millions Americans use statins to control their cholesterol. Ezetimibe is a second type of cholesterol lowering medication and works by blocking the absorption of cholesterol.
In a new study, 19 patients with advanced alopecia areata were treated with two cholesterol medications – simvastatin and ezetimibe for 24 weeks. Remarkably, after 24 weeks, 14 of 19 patients (nearly 75% of patients) were found to regrow hair so some extent. The majority of those who continued the drug after then 24 week period maintained their hair and the majority of stopped the drug after then 24 week period lost their hair again.
This is a very exciting study, calling now for even larger studies of the use of these cholesterol lowering drugs in the treatment of alopecia areata. These particular medications are well known in the population as cholesterol lowering drugs and so we have many years of experience with these drugs. Although side effects such as muscle pains, muscle damage, diarrhea, irritation of the liver, and a rise in blood sugars can occur with these medications – these are relatively infrequent.
Study: Lattouf C and colleagues. Treatment of alopecia areata with simvastatin/ezetimibe. J Am Acad Dermatol 2015; 72: 359-61