Escalating dosimetry of UVA-1 in the treatment of alopecia areata

Int J Dermatol. 2017 Jun;56(6):653-659. doi: 10.1111/ijd.13572. Epub 2017 Feb 23.


Background: Phototherapy can be an option in unresponsive alopecia areata (AA); however, variable results have been reported with its use. We could not find literature of treatment with UVA-1 in AA. A study was designed to evaluate progressive dosimetry to determine the initial dose and its increments.

Methods: Patients with unresponsive AA were recruited. Twenty-five sessions of 30 J/cm2 were administered. If hair regrowth was <75%, the dose was escalated to 60 J/cm2 . If hair improvement remained <75%, an additional 25 sessions at 120 J/cm2 were indicated. If total hair regrowth occurred before 75 sessions, a final visit was performed for biopsies and severity of alopecia tool (SALT) evaluation. Clinical and histopathological assessments were performed blindly. Adverse effects were recorded.

Results: Nine men and 13 women were included; 16 were initially S1 , one S3 , and five S4 . Median age was 32 years and median evolution 10 months. Nine patients achieved an S0 , eight S1 , and five S4 (P = 0.005). The most notable improvement was with 60 J/cm2 (P = 0.02). Biopsies exhibited an absence of inflammation in five patients and mild persistence in 17. An increase of 43.75% in anagen hairs (P ≤ 0.001) was achieved, telogen hairs decreased 16.3% (P = 0.06), and catagen hairs were reduced 22.7% (P = 0.005). Pearson's correlation was -0.82 and P ≤ 0.001, when correlating anagen hairs with final SALT. Improvement has continued for 6 months post treatment. Mild xerosis was observed in all patients, and six (28.6%) developed transient mild hyperpigmentation.

Conclusions: This study provides a basis for UVA-1 dosimetry evaluating its therapeutic value in AA.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Alopecia Areata / drug therapy
  • Alopecia Areata / pathology
  • Alopecia Areata / radiotherapy*
  • Female
  • Hair / growth & development
  • Hair Follicle / pathology*
  • Hair Follicle / radiation effects
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiotherapy Dosage
  • Retreatment
  • Scalp / pathology
  • Severity of Illness Index
  • Ultraviolet Therapy / adverse effects
  • Ultraviolet Therapy / methods*