Topical Immunotherapy (Diphenylcyclopropenone Treatment)

Topical immunotherapy is one of the effective treatment methods used particularly in widespread and resistant alopecia areata. In this method, a special medication called diphenylcyclopropenone (DPCP) is used to create a controlled immune response in the scalp. The aim is to change the misdirected immune response against the hair follicles and enable the hair to grow back.

Topical immunotherapy is preferred particularly in cases of alopecia areata affecting a large part of the scalp, or in patients who do not respond sufficiently to conventional treatments. The decision to treat is made taking into account the extent and duration of the hair loss and the patient's characteristics.

Treatment consists of two stages. In the first stage, the medication is applied to a small area of the scalp so that the immune system develops sensitivity to it. About 2–3 weeks later, treatment sessions applied once a week begin. The dose used during treatment is adjusted individually so as to produce mild redness and itching on the scalp. After application, it is recommended that the scalp is not washed for 48 hours and is protected from the sun so that the medication can take effect.

Hair growth usually begins from the 2nd–3rd month of treatment. Marked improvement is seen in most patients within 6 months. The duration of treatment is planned according to the response achieved and can be supported with maintenance treatment where necessary.

The expected effect of treatment is mild redness, itching and scaling at the application site. These findings are part of the immune response desired for the treatment to be effective. If more severe reactions or rare side effects develop, the treatment plan can be revised. Topical immunotherapy is a treatment that requires experience and must be planned individually; correct patient selection, appropriate dose adjustment and regular follow-up are very important to its success.