Failure to treat alopecia areata with photodynamic therapy

We treated six patients with static alopecia areata (AA) with photodynamic therapy (PDT). All patients had received other treatment before starting PDT, but with no benefit. All previous treatments were stopped at least 3 months before beginning PDT, and no other treatment was given during the study period. PDT was used on only one of the affected areas, or if there was only one affected area, to only part of that area; untreated areas served as controls. For all patients methylaminolaevulinic acid was applied under occulsion 3 h after irradiation with red light at 630 nm (37 J/cm(2), 7.5 min). One session was carried out each month. Clinical and fluorescence photographs were taken with a digital camera connected to ultraviolet flashes, both before and after each treatment. None of the patients with AA of the scalp achieved complete hair regrowth, either in the treated or the untreated areas. Two of the patients showed growth of some thin hair over < 10 of the treated area. The remaining patients had no change. However, the patient with AA of the beard experienced complete regrowth after four sessions. To our knowledge, this is the first case of AA treated with PDT in this location. It may be that AA of beard hair responds better to PDT, but further studies are necessary.