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Alopecia areata is a relatively common, non-scarring type of hair loss. The pathophysiology of alopecia areata is still unclear, but an autoimmune mechanism is the most widely accepted theory. Based on current available data, Alopecia Areata appears to exhibit a TH1 cytokine profile. IL-1 has been found to be associated with alopecia areata, and is a potent inhibitor of hair growth in vitro. Furthermore IL-1 appears to induce histologic changes similar to those seen in alopecia areata. Imiquimod (Aldara) is a topical immune response modifier that stimulates the secretion of different cytokines, most of which are associated with a TH1 response.
Although Alopecia Areata is potentially associated with IL-1 and a TH1 cytokine profile, imiquimod, which most likely enhances TH1 response, has been used anecdotally for alopecia areata with some success. There was a study done to see how affective this method actually worked on individuals suffering from hair loss due to alopecia. The conclusion of the study shows that imiquimod applied 3 times/week is unlikely to have efficacy in severe Alopecia Areata.