Confused About Dr Strick’s Alopecia Areata Treatment
hi dr.,
i have a question about dr. richard strick. i went to see him because of your very positive comments about him on this site regarding his treatments of alopecia areata using his dncb treatment.1. He claims its successful 90% of the time, if it is that successful, i would imagine the fda would approve it & other doctors would use it to treat patients because that would be a huge deal for those who have alopecia areata.
2. After speaking with him and his staff, I have heard about 2-3 contradictions (or at least apparent). For example one of his staff said “it does not work on body hair” & he said no it definitely does work on body hair. (different conversations at different times)
Basically my question to you is, do you think or would you put it past dr. strick to outright lie or maybe exaggerate about the effectiveness of this treatment for whatever reasons he may have? Im not sure what to make of this, i want to have confidence in this treatment but my confidence is shaken.
Are you sure you heard him right? What you experienced sounds like confusing signals and you should go back to him to get clarification. To my knowledge, he does not use this dinitrochlorobenzene (DNCB) treatment for body hair alopecia areata.
I provided photos of a patient that I met with who had a great result from the treatment, so the effectiveness was clear to me. I can’t vouch for success rates, but I’d be honest with him and ask Dr. Strick to clarify some of the issues you had from your previous visit.
From my review of published reports about contact sensitizers for alopecia areata, DNCB is the substance used in very large case numbers by Dr. Jerry Shapiro at the University of British Columbia. While Dr. Shapiro’s protocol (intensity, frequency and duration)have been modified over the years, the result that only up to 40% of people have successful regrowth has been pretty much consistent. Keep in mind that if you were in the successful 40% that your hair would in most cases only continue to grow if you continued the treatment. And is your definition of success aligned with your doctor’s? Is peach fuzz as acceptable to you as complete hair length?
There’s variability in the definition of success and the skill/experience of the doctor applying contact sensitizers. Published reports are varied: 38% success rate for DPCP (Shapiro 1993), 63% for DNCB (Swanson 1981) and up to 70% for SADBE (Flowers 1982).
With all of these chemical treatments for alopecia areata there must be an allergic reaction of the skin to the chemical for the treatment to work. Patients respond differently to the chemicals. Once the irritant is stopped, the hair will fall out again. There are many variables. Different patient sensitivity to the chemical and the skill of judging the concentration required to produce regrowth are but two. Some dermatologists will permit patients to self administer maintenance treatments and others believe the chemicals are too strong to permit self application.
It seems that while contact sensitizers of this kind are considered to be safe, not enough is known about long term systemic consequences.
Thea Chassin, founder
BaldGirlsDoLunch.org