Hi everyone I am new here! My name is Lisa and my son Dell is 4 years old.  He got diagnosed with AA about a year ago.  We have tired olux which made his hair grow back but then his hair fell out again.  Our derm is suggesting squaric acid treatment.  Have any y'all tried this?  Is it painful?  Does it work?

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Look at "Cindy and Samantha" on this website. She grew back all her hair with Squaric Acid
Hi Lisa, My daughter Samantha started squaric acid treatments two years ago at age 6. She has been wig free since June and just had her 8th b-day. I do know of another mom who started it with her daughter a few weeks ago and is noticing regrowth. We also tried many other things with no avail, but this is working. Sam's eyebrows are now coming in as well. She has two bald spots and the nape of her neck, otherwise a full head of hair. The main side effect which can be uncomfortable is the itchy rash. You need to get the rash to know your body is responding. The idea of this treatment is to trick the immune system so the hair will grow. Our doctor has seen good results with this treatment, but it is not for everyone. I would be happy to answer any of your questions and further share our experience. Like Lisa said, if you go to my page you will various stages of regrowth with this treatment. Cindy
Hi Cindy,

My name is Cathy and my son Ryan is starting the Squaric acid treatments next week, did Samantha have any reaction or blisters? how long did it take for her hair to come back. I was excited to read your post, Ryan's hair loss has come and gone through the years, he is now 14 years old and it is the worst it has ever been. Wish us luck. Thank you...

Hi

My son has diffuse alopecia areata - did the squaric acid continue to work? 

I like Dr. McElwee's explanation of the difference between irritants and contact sensitizing elements. Reading Dr. McElwee, you can know more and understand more than you will ever learn at a panel discussion at a conference for parents. On topics like this, "home study" works really well. Will post the results of treatment and relapse separately.

"Contact dermatitis inducers: Dinitrochlorobenzene (DNCB), diphenylcyclopropenone (DPCP), squaric acid dibutyl ester (SADBE) - how they are believed to work

The difference between an irritant and a contact dermatitis inducer is a bit vague. Clinically, the effects of an irritant are much the same as a contact sensitizing chemical with inflammatory dermatitis induction being the key symptom. Essentially, an irritant treatment for alopecia areata acts by disrupting the normal cell growth and differentiation in the skin. This physical damage then stimulates the immune system to respond to clear up the problem and limit the skin damage. A contact dermatitis inducer is a chemical that the immune system is responsive (allergic) to. It may not have a direct action on the skin cells. Rather, the skin immune system identifies the molecules of the chemical as something it should respond to. The resulting inflammation will cause skin dermatitis that varies in severity with each individual depending on how allergic the person is to the contact dermatitis inducing chemical.

The popular belief is that irritants and contact dermatitis inducers work as antigenic competition. That is, the irritant chemical applied to the scalp is far more interesting to the inflammatory cells than the hair follicles. Thus the cells move away from the hair follicles and towards the skin surface where the irritation induced skin damage is or where the contact sensitizer chemical is present. It would seem the cells find the skin damage or irritating chemical much more of a threat than any hair follicle antigens.

However, this assumes that the cells responding to the irritant or contact dermatitis inducer are the same as the cells responding to the hair follicle antigens. I don't agree with this idea. I think the chemical irritation/contact sensitization induces inflammation from a mostly new group of cells and in doing so causes a change in the cyotkine environment of the skin. Cytokines are hormone like chemicals that are produced by inflammatory cells to communicate with each other. Some cytokines excite immune cells to attack and destroy, other cytokines tell immune cells to calm down and go home. I think there might be a change in the cytokine response that encourages cells to move away from the hair follicles and into the upper skin layers and/or to leave the skin entirely. There is some research to suggest irritants cause cytokine production levels to change."


Thea
www.BaldGirlsDoLunch.org..where alopecian beauty is just the start.
Explanation and italics above are fully attributed to Kevin McElwee, MD, University of British Columbia
Painful? shouldn't be. Irritating? Probably somewhat Does it work? only sometimes with a high relapse rate. This is for adults. Looking for the latest pediatric update.

From the February 2010 JAAD: Alopecia Areata Treatment. McElwee, Shapiro et al

TOPICAL IMMUNOTHERAPY
Key points
Diphenylcyclopropenone (DPCP) is the
treatment of choice for adults with more
than 50% scalp involvement
Sensitization with DPCP 2% is followed by
weekly application of the lowest concentration
that can cause mild irritation
Squaric acid dibutylester is an alternative in
patients who do not develop allergic reaction
to DPCP
Treatment should be stopped if there is no
improvement after 6 months
The success rate is 50% to 60%, with a relapse
rate up to 62% at a median period of 2
and a half years
Contact sensitizers that have been used in the
treatment of AA include dinitrochlorobenzene
(DNCB), squaric acid dibutylester (SADBE), and
diphenylcyclopropenone (DPCP). DNCB is not generally
used today because it has been shown to be
mutagenic in the Ames test.DPCP is the topical
sensitizer of choice because SADBE is not stable in
acetone. Because DPCP is very light sensitive, it
should be stored in amber bottles to protect it from
exposure to ultraviolet light.The most important
negative prognostic factors in the treatment of AA
with DPCP are disease severity, duration of AA
before therapy, and presence of nail changes.
Other factors include age at onset, atopy, and a
family history of AA.Full information regarding
therapy should be given to the patient, and signed
informed consent should be obtained from the
patient before beginning treatment.


Thea
www.BaldGirlsDolunch.org
Thank you all for the information. It's great to hear first hand experiences when it comes ot treatments. Thea great info!!!
My son tried DPCP for about 6 months. He had no hair growth and it was very expensive. When the dermatologist changed the strength my son's head got very burned. He had blisters that leaked for several days. Just be careful. Good luck.

Hi Lisa,

How did the treatment go, if you tried it on your son? I'm looking into this now for my five year old daughter. Thanks.

My little girl is breaking out all over her face n arms from the square acid treatment....any tips to clear that up and what to do

It could be that she is touching her head and then touching other areas of her body, like her face and arms.  That is what my son did.  It was in reaction to the itching, so the doctor cut back the number of times per week my son was using the medication.  Also I told him to wash his hands before touching any areas.  My son is 13 though and this may be difficult for a very young child.

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