Topical corticosteroids have been used in compounds for hair loss treatment. Their mechanism is disputed, but they probably act through an anti-inflammatory and immunosuppressive mechanism which is effective mainly in alopecia areata and autoimmune types of alopecia, such as lichen planus and discoid lupus erythematosus. Corticosteroids in the form of infusions (injections) are used for treatment of alopecia areata.
Hormonal preparations, such as contraceptives, antiandrogens, and spironolactone are also used in the conservative treatment of hair loss with hormonal aetiology in women.
Conservative treatment of alopecia areata also includes sensitising substances such as diphencyprone, which is used for extensive cases like total and universal alopecia. Topical immunomodulators such as calcineurin inhibitors (tacrolimus, pimecrolimus) can be used for conservative hair loss treatment. These are administered in cases of autoimmune alopecia and alopecia areata.
As a therapy for alopecia areata, the use of biological agents (anti-TNF) such as Remicade, Enbrel, and Humira, has also been reported. However, their use in conservative hair loss therapy has not been widely accepted because of the side effects of these drugs and their controversial mechanism.
Immunosuppressive drugs are also administered as hair loss treatment for autoimmune types such as follicular lichen and discoid lupus erythematosus.. Plaquenil (the anti-malaria drug hydroxychloroquine) is the treatment of choice for hair loss caused by lichen planus.
Furthermore, there is a multitude of lotions, herbs, and vitamins of dubious origin and effectiveness that are sold in drugstores and online. Particular caution is needed for substances that promise hair loss treatment in some magical way, because their results are often minimal.
One should know that there are no magical methods to treat hair loss and the only definitive solution and permanent therapy for extensive hair loss is transplant surgery.
Lastly, advanced forms of alopecia that can not be solved with transplantation, can be covered perfectly with hair prostheses (wigs). Today, high quality prostheses made from natural hair are available with excellent aesthetic results. In some cases of alopecia, excellent coverage can also be offered by a medical tattoo which, if performed correctly by an experienced specialist, mimics normal hair. Of course there are many cases of tattoo application with the method of micropigmentation which attempt to cover a bald part or a scar on the scalp, but the aesthetic results do not live up to expectations because of bad application, discolouration of the dyes, or diffusion of the dye into adjacent areas with concurrent fading of the colour (bleaching phenomenon). It usually requires several repeated micropigmentation sessions in order to achieve a satisfactory outcome, while there is always the risk of allergic reaction or infection during the application of the tattoo.