{ "schema_version": 1, "kind": "condition", "id": "alopecia-areata", "name": "Alopecia areata (patchy hair loss)", "category": "chronic", "sources": "British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205) for the indication, with the product and its application from Dermovate (clobetasol propionate 0.05%) Cream SmPC section 4.2 (eMC product 939): \"Apply thinly and gently rub in using only enough to cover the entire affected area once or twice a day until improvement occurs\". The SmPC carries no alopecia areata indication and states no 3 to 6 month course; that is from the dermatology guideline, which is not held in this corpus. · British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205) · Regaine 5% Cutaneous Solution SmPC section 4.2 (eMC product 5765)", "review_status": "reviewed", "verified_against": "British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205) for the indication, with the product and its application from Dermovate (clobetasol propionate 0.05%) Cream SmPC section 4.2 (eMC product 939): \"Apply thinly and gently rub in using only enough to cover the entire affected area once or twice a day until improvement occurs\". The SmPC carries no alopecia areata indication and states no 3 to 6 month course; that is from the dermatology guideline, which is not held in this corpus. · British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205) · Regaine 5% Cutaneous Solution SmPC section 4.2 (eMC product 5765) · Egyptian National Drug Formulary (endf-endocrine.txt)", "verified_date": "2026-08", "treatments": [ { "id": 141, "generic": "Betamethasone dipropionate", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply 0.05% cream or ointment thinly to bald patches once daily", "adult_duration": "3-6 months once daily, then judge. Stopping at 3 months is early - the guideline's window runs to 6", "dose_source": "British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205)", "rationale": "A potent topical corticosteroid to the patches is the first-line option in primary care. Most limited patchy disease also remits without any treatment within a year, so watchful waiting is a legitimate alternative to offer.", "cautions": [ "Counsel before starting if the skin is Fitzpatrick V or VI - which is most of this clinic. Topical and intralesional corticosteroids carry an increased risk of depigmentation in darker skin, including localised hypo- or hyperpigmentation and frank vitiligo. A patch of pale skin where the bald patch was is not a better outcome, and the patient decides whether that trade is worth making.", "Refer to dermatology for extensive, rapidly progressive, or total scalp or body hair loss, and for any child with more than limited patchy disease.", "Skin atrophy and telangiectasia with prolonged use - stop at 3 months if there is no regrowth.", "Do not apply near the eyes; scalp application should avoid running onto the eyelids.", "Check for associated autoimmune disease, particularly thyroid disease, vitiligo and coeliac disease." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children and young people: 6 weeks on, 6 weeks off, then a further 6 weeks. That cycle is what the guideline recommends rather than continuous use, and it applies to a potent or a very potent steroid.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DIPROSONE 0.05% CREAM 10 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 10000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIPROSONE 0.05% OINT. 10 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 10000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIPROSONE 0.05% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 45.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alopecia-areata" }, { "id": 142, "generic": "Clobetasol propionate", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply 0.05% cream or ointment thinly to resistant patches once daily", "adult_duration": "3-6 months once daily, then judge", "dose_source": "British Association of Dermatologists living guideline for managing people with alopecia areata 2024 (Br J Dermatol 2025;192:190-205) for the indication, with the product and its application from Dermovate (clobetasol propionate 0.05%) Cream SmPC section 4.2 (eMC product 939): \"Apply thinly and gently rub in using only enough to cover the entire affected area once or twice a day until improvement occurs\". The SmPC carries no alopecia areata indication and states no 3 to 6 month course; that is from the dermatology guideline, which is not held in this corpus.", "rationale": "A very potent corticosteroid for patches that have not responded to a potent one. Intralesional triamcinolone is the other escalation and is a dermatology procedure.", "cautions": [ "Counsel before starting if the skin is Fitzpatrick V or VI - which is most of this clinic. Topical and intralesional corticosteroids carry an increased risk of depigmentation in darker skin, including localised hypo- or hyperpigmentation and frank vitiligo. A patch of pale skin where the bald patch was is not a better outcome, and the patient decides whether that trade is worth making.", "Very potent - not for use in children, on the face, or on large areas.", "Skin atrophy occurs sooner than with a potent steroid; keep to the patches and set a stop date.", "No regrowth after 3 months of a very potent steroid means referral, not a longer course." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "A very potent steroid is not off-limits in children here - the guideline puts potent and very potent together for scalp alopecia areata and gives both the same 6 weeks on, 6 weeks off, 6 weeks on cycle. Refer if the loss is extensive or spreading fast.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "CLOBITAT 0.05% TOPICAL CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIORIGINAL INTERNATIONAL GROUP PHARMA EGYPT", "price_egp": 5.5, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMASOL 0.05% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 5.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMASOL 0.05% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 5.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLEROVATE 0.05% TOPICAL OINT. 25 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 25000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLOVACORT 0.05% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMOPHARM 0.05% CREAM 25 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES", "price_egp": 22.0, "pack_count": null, "unit_price": null, "strength_mg": 25000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMOVATE 0.05% TOP. CREAM 25 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": 25000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HEROBETASOL 120 MLSHAMPOO", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > HEROPHARM", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alopecia-areata" }, { "id": 144, "generic": "Triamcinolone", "line": 2, "is_adjunct": false, "form": "injection", "strength_mg": 10.0, "adult_dose": "2-3 mg up to 5mg at one site. If several sites are injected the total dosage should not exceed 30 mg.", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary (endf-endocrine.txt)", "rationale": "Intralesional corticosteroid injection for patchy alopecia areata.", "cautions": [ "Hypersensitivity to Triamcinolone or any component of the formulation.", "The site of injection and volume of injection should be carefully considered due to the potential for cutaneous atrophy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "For adults and children over 6 years: 2-3 mg up to 5 mg at one site; total dosage across several sites not to exceed 30 mg.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Over 6 years", "age_min_months": 72, "age_max_months": 216, "dose_text": "2 to 3 mg, up to 5 mg, at one site. Total across several sites not to exceed 30 mg." } ], "peds_doses": null, "brands": [ { "trade_name": "PHARCOCINOLONE 40MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM > PHARCO B", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMCINOL 40MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC", "price_egp": 11.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPIRELEFAN 40MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 38.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SYNTHECORTIN 40MG/ML I.M AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alopecia-areata" }, { "id": 143, "generic": "Minoxidil", "line": 2, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply 1 mL of 5% solution to the affected patches twice daily", "adult_duration": "at least 4-6 months before judging any effect", "dose_source": "Regaine 5% Cutaneous Solution SmPC section 4.2 (eMC product 5765)", "rationale": "Weak evidence in alopecia areata, unlike in pattern hair loss where it is first line. Offered only alongside a topical corticosteroid, never instead of one.", "cautions": [ "Evidence in alopecia areata is limited - this is an add-on to a topical corticosteroid, not a treatment on its own.", "Any regrowth is lost within 3-4 months of stopping.", "Transient shedding in the first 2-6 weeks is expected and is not treatment failure.", "In women, the 5% strength is licensed as a once-daily foam; the twice-daily 5% solution is the men's regimen. Twice-daily 5% solution in a woman raises the risk of facial hypertrichosis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not recommended in children.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "MINOXIDIL FORTE 5% TOPICAL GEL 60 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > PHARMACARE", "price_egp": 127.0, "pack_count": null, "unit_price": null, "strength_mg": 60000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alopecia-areata" } ] }