Is super potent topical steroid (clobetasol) is effective or not?

If effective used alone or with other medication?

It mainly depends upon the type of alopecia patient has.

What do you mean by alopecia patient?

Alopecia areata has many causes and types. Therapy depends on age, severity, recurrence and associations,

topical steroids, and intralesional steroids also help.

Here it is suggested that there is a

relationship with dental infections.

http://www.innovations-report.de/html/berichte/medizin_gesundheit/bericht-96873.html

Regards,

Joachim (not a medic)

Potent topycal esteroids in my opinion.

In extended areas or multiple focus dyphencyprone can be a good option.

It depends on which type of alopecia areata. Plaques? Universal? Total?

There is nothing called as the best treatment.

all therapies are age, severity,cause specific. treatment of choice, specific treatment , cause related , all are taken into consideration

alopecia areata on small patches will follow a good prognosis even without treatment ... Re universal alopecia We could try tacrolimus

dear Dr Bimbi, regarding tacrolimus for alopecia areata, ther are not very many studies which have a given a favourable response to tacrolimus.

I had tried tacrolimus for two cases but both failed.

To what kind of alopecia areata do you refer ? to the people that have one or two small patches of alopecia or to the ones that have a very severe alopecia areata ?

Essential oils have been shown (in at least one reputable published scientific study that I am aware of,  to be effective in the treatment of alopecia). ie

Randomized trial of aromatherapy. Successful treatment for alopecia areata.

Hay IC1, Jamieson M, Ormerod AD.

I personally think they can help in a number of ways:

1. Massage reduces stress, essential oils like lavender also have some sedative properties and can reduce stress 

2. Many essential oils are anti-fungal, anti-bacterial and anti-viral (sometimes alopecia can be caused by fungal, bacterial or virual infections.

3. The act of massaging gently induces circulation

4. The carrier oils used to dilute the essential oils to safe levels of use themselves have healing / soothing properties (eg jojoba, olive oil), and can help if the hair loss is caused by dermatitis/allergies etc

I would be very interested in any other studies linking aromatherapy, essential oils etc.. to treatment of alopecia.

British Association of Dermatologists’ guidelines for the management of alopecia areata 2012

A.G. Messenger, J. McKillop, P. Farrant, A.J. McDonagh and M. Sladden

Version of Record online: 23 APR 2012

DOI: 10.1111/j.1365-2133.2012.10955.x

and

Interventions for alopecia areata

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004413.pub2/full

For patchy alopecia areata, the best treatments are steroid injections. For more widespread AA, some of the most effective treatments include diphencyprone or squaric acid sensitization (DPCP or SADBE). The oral immunosuppressives (methotrexate, tofacitinib, prednisone) may be effective but carry greater risk. 

Alopecia areata may be: alopecia areata patchy , alopecia areata totalis, alopecia areata universalis, alopecia areata diffusa, alopecia areata incognita, alopecia areata annular,  alopecia areata ophiasic, sisaipho and canities subbita. And the treatment differ for child and adult.  More common type is alopecia areata patchy (or focalis) and regrow in 1 year without treatment. More difficult to treat are AA totalis e AA universalis, with few effectives treatments and great rate of fail.

As said above, SADBE and DPCP may be used for AA universalis e totalis. Triamcinolone acetonite injections or cream are good options for alopecia areata focalis and localized types. 

Clobetasol propionate, betamethasone  valerate are good options too.

Aromatherapy has insufficient randomized clinical trials to be used as effective treatment. Hay and cols 1988 publication has many bias in methodology, and Ozmen 2015 has a doubtful outcome. We need more RCT .

Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Archives of Dermatology 1998;134(11):1349-52.

Özmen I, Çaliskan E, Arca E, Açikgoz G, Koç E. Efficacy of aromatherapy in the treatment of localized alopecia areata: A double-blind placebo controlled study [Lokalize alopesi areata tedavisinde aromaterapinin etkinliği: Çift körplacebo kontrollü çalışma]. Gülhane Tıp Derg 2015;57:233-236. [DOI: 10.5455/gulhane.38258]