One percent may go on to alopecia totalis, affecting all body hairs, including eyebrows and eyelashes. The disease frequently resolves spontaneously within 1 year. Recurrences, however, are common. Severe disease has less of a tendency to resolve on its own, especially in children or atopic individuals. Frequently, fingernails may show dystrophic changes such as pitting, ridging, and thinning of the nail plate.
Treatment depends on the extent of the disease, and the age of the patient.
For small patchy disease, intralesional corticosteroid is the treatment of choice. The total amount should not exceed 10 mg of triamcinolone acetonide per visit. Injections are repeated every 4 to 6 weeks. Other options include topical minoxidil, anthralin, and steroid. Diphencyprone is difficult to obtain in the United States but is more readily available in Europe and Canada.