SQUARIC ACID DIBUTYL ESTER (SADBE)

Main uses in hair loss: alopecia areata

Other names: Sqauric acid

 

What is SADBE?

  • SADBE is a liquid chemical which is applied to the scalp.
  • It is used mainly as treatment for the hair loss condition known as alopecia areata
  • SADBE is used to cause irritation and an allergic response on the scalp.  This “tricks” the immune system into mounting a response against the chemical rather than against the hair.  This gives the hair a better chance to start growing back.

How is SADBE prescribed?

  • The very first dose is usually a 2 % solution which is applied to a small coin-shaped area on the scalp.  It should be covered to protect from light. The scalp can be washed at the end of the day.
  • When the patient returns for the second treatment in two weeks, a very low dose of SADBE is applied (0.001%). 
  • When the patient returns in one week, he or she is asked if there was any burning, itching, or irritation with the last dose. If not, the dose is increased to 0.005%.  If there was significant itching, burning or irritation, then the dose is kept the same and perhaps even lowered
  • In general, patients should be itchy for 2 days – the day of treatment and the following day. We do not want patients itchy for the rest of the week.
  • The following is the treatment ladder for applying SADBE. This may vary from center to center
  • 0.001 %
  • 0.005 %
  • 0.01 %
  • 0.02 %
  • 0.05 %
  • 0.1 %
  • 0.2 %
  • 0.35 %
  • 0.5 %
  • 0.75 %
  • 1 %
  • 1.5 %
  • 2 %
  • 2.5 %
  • 3 %

Can I use SADBE with other treatments? 

  • SADBE cannot be used with topical steroids. Ask your physician if you are not sure what a topical steroid is. You might have been using this for your alopecia areata in the past, but it must now be stopped
  • SADBE can be used with Minoxidil lotion –either 2 % of 5 %
  • SADBE can sometimes be used with other medications. Your doctor will prescribe if he feels it might be beneficial

Who should not use SADBE?

Your doctor will not prescribe SADBE if

  • You have a history of a severe reaction to it in the past

When will I see results if the SADBE is helping?

  • Hair growth can be seen in about 12 weeks, but can occur earlier
  • If you have active alopecia areata, you may have hair loss before you get hair growth
  • White colored hair may appear first followed by darker hairs

What side effects are possible with SADBE?

  • In general, you should think of SADBE like you would think of “poison ivy”.  Any reaction you can get with poison ivy you can get with SADBE.
  • Rash on the scalp – (this is expected)
  • Swollen lymph nodes (swollen glands) on the neck – this is expected and not serious
  • Full body rash if the SADBE is spread
  • Blisters on the scalp or body
  • Pigmentation changes on the scalp – some areas lighter and some areas darker

What should I also know about SADBE?

  • It should not be used in pregnancy and should not be used if breast feeding

What side effects should prompt me to STOP SADBE and get medical advice?

  • Stop taking SADBE and get medical help if you develop hives, shortness of breath, swelling in the lips or feel unwell
  • Stop if you have any concerns at all