In addition to corticosteroids, there are other immunosuppressant drugs which can be used for alopecia areata. Some examples of these are cyclosporine, methotrexate and azathioprine. Emma was prescribed methotrexate tablets by her dermatologist who knew it was being researched as a treatment for alopecia areata. She took methotrexate once a week for a year and went for regular blood tests. Taking methotrexate had an impact on Emma because she couldn’t drink alcohol while taking the medicine and she felt run-down.
Emma decided to stop taking methotrexate when she didn’t see any improvement with hair regrowth and had difficult side effects, including flaring-up her eczema.
Emma decided to stop taking methotrexate when she didn’t see any improvement with hair regrowth and had difficult side effects, including flaring-up her eczema.
Age at interview: 23
Sex: Female
Age at diagnosis: 14
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With the methotrexate, it w-, how old, I was in my, I think I was in my second year still. And it was just making me very sort of tired all the time. So I’d be going to university and I couldn’t concentrate on things. I just, I just feel exhausted. And, you know, I just felt very sick. Not, not all the time. But I think after taking it, a couple of hours after I just felt like, you know, when you feel like it’s not right and I, I could be sick. But, you know, I just felt really nauseous. And that, that went on, not all the time I was on methotrexate, but it was just like intermittently. But I just, for the full year I just didn’t feel like a hundred per cent. I didn’t feel like me. I just felt really run down. Like quite heavy-headed as well. I felt like, as I said, you know, I just didn’t feel well for like a 21-year-old girl. You know, I just thought ‘well, it’s not really worth going through without having any positive effects really’. What else? My skin, cos apparently methotrexate is for skin as well and to help with that. I don’t know if it’s just sort of the different dosages and whatnot. But if anything it made my skin worse. I just think it was just like, whether that, that might have been because I felt run down as well, it was just having a bit of a counteracting effect. So, yeah, it was, it was just, and then that was adding to my stress because, because I felt like, I felt, I didn’t feel right. That was making me feel a little bit more sort of stressed about the situation. I wasn’t seeing any positive effects for my hair.
Professor Moss talks about immunosuppressant treatments for alopecia.
Professor Moss talks about immunosuppressant treatments for alopecia.
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So as well as steroids, which work in alopecia areata by suppressing the immune system, sometimes doctors prescribe other immune-suppressive drugs. In children in my practice we actually don't do that, because immune-suppressive drugs do have adverse effects. So obviously if you're suppressing the immune system, you're laying someone open to other infections, that's what the immune system’s there for. But some people would use drugs like cyclosporine, azathioprine, and some other potent immune-suppressive drugs. I think particularly in adults, if they're really, really desperate for a treatment, those are sometimes used. But I think people obviously need to understand the risks of using that treatment, the fact that it doesn't always work. And even if it works, the, the improvement is not always maintained. And that it's not something you would want to do on several, on repeated occasions.
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