Seven to ten percent have very severe disease. Patients with atopy or ophiasis usually have a poorer prognosis. If the initial presentation is in childhood, these patients usually do not do as well as those patients who have their first presentation as adults. The NIH has commenced a study on a limited number of patients. The longer one has the disease and the greater severity of the disease, the smaller the chance of success.
Side effects are eczema, lymph node enlargement and change in pigment of the skin.
Combination treatments will be used more commonly. Alopecia areata is a heterogeneous disease in the same patient and may require multiple modalities to regrow hair on differing portions of the scalp.