Individuals with small patches of hair loss may benefit from anti-inflammatory treatment, using a topical steroid in the form of shampoo, lotion, or foam. Topical steroid treatment should be used for at least three months to see results, and stopped at six months if there is no new hair growth. Potential side effects include folliculitis, rash, and skin thinning. Topical steroid treatment is not indicated for alopecia totalis and alopecia universalis. Another treatment option for patchy hair loss is intralesional steroid application in the form of an injection directly into the top layer of skin. Multiple injections are typically needed, and this can lead to the skin atrophy on the injection site. Intralesional steroid injections are not recommended for individuals with rapidly progressing alopecia areata, or those with alopecia totalis or alopecia universalis.  Another topical treatment is anthralin (Dritho-Scalp), which is available as a cream, ointment, or lotion. Anthralin has anti-inflammatory properties, and typically takes about eight weeks for any new hair growth to appear. Potential side effects of anthralin are skin discoloration and irritation, thus making it an undesirable choice for long-term treatment.  Alopecia can also be treated with oral medications, such as minoxidil (Rogaine). Minoxidil acts as a vasodilator, which enhances blood flow to the scalp. With minoxidil, it may take months to see hair growth, so it is typically used in combination with a topical steroid. Common side effects seen with minoxidil can include skin inflammation, headaches, and hair overgrowth.  For alopecia totalis and alopecia universalis, the potential treatments involve long-term use of a corticosteroid and contact immunotherapy. Systemic corticosteroid treatment with oral prednisolone should be continued for up to 6 months to maintain the hair growth. Due to the side effects of long-term oral corticosteroid use, it is reserved for those individuals with very extensive alopecia. A weekly treatment with a topical immunotherapy allergen, such diphenylcyclopropenone, has been shown to be effective in some cases. In order to see adequate hair growth, treatment should be continued for at least six months.  In addition, many people seek psychological support and cosmetic items, such as wigs or hair weaves.