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DCP treatment - Yah or nah?
Asking anyone if they have tried DCP treatment. Just got back from the doctors today and we decided not to do the injections and try DCP. Just recently my alopecia has gone berserk. I have lost alot of hair on the top of my head. Not sure what my next step should be. I would like to know if I should continue with treatments or take some time away from it. Any and all opinions are appreciated.
Replies to This Discussion
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Permalink Reply by Bernard Stevens on
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hey Terri, i was doing the DPCP treatment as an outpatient at the Cleveland clinic. I did it for a year with no regrowth, and I also developed RA during the time I was doing it! It is still not ok'd by the FDA so you have to sign a release. unless they have ok'd it since I tried it. i regret it now since I think it screwed up my immune system even more. Hope this helps you make a decision. Peace, Bernie
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Permalink Reply by Tuesday on
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I started DCP ... the doctor at Sunnybrook Hospital in Toronto assured me they had some great results with the treatment. I believe I was treated about a month after my hair loss began. I found the treatment painful and itchy. I realize you must return for repeated sessions but my hair loss accelerated after I had the treatment and pretty much I went AU a few weeks later. So no point in going further, I felt. ( I didn't like how the doctors and residents at that hospital treated me as well.) I could be wrong but I thought Gail Porter had taken this treatment and had complete regrowth? My only caution is research its effects. You don't want to further confuse/harm your immune system.
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Permalink Reply by Bald and Fabulous AKA Terri on
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thanks guys, my biggest concern with the DCP if the results were going to be the same as the first time I tried it which was a few years ago. I had blistering, itchiness, weeping. It was not only painful but it took about the length of time to heal the area treated, then I was back in for another treatment. My new doctor assured me that the concentration that I would start at would be the weakest and start from there. Needless to say that the first treatment caused itchiness and redness but no weeping and blistering.
But since that first treatment I have shaved my head, and Im deciding that maybe to stop treatments for now. Give myself a bit of a break.
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Good luck with whatever you decide to do, Terri. The doctor who was going to treat me assured me he had successfully treated some very well known t.v. newscasters (Canadian) with alopecia areata. I was eager to try but my hair loss was so FORCEFUL and increased so rapidly in volume ... my gut instinct told me the DCP wouldn't overpower the hairloss. I did feel I made a safe decision to shave my head and stop treatments. It is the effects of DCP on rest of body that concern me ...
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Permalink Reply by tim kay on
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terri, i currently use dpcp and have mixed results. it is very powerful and creates a strong allergic skin reaction. burning, bubbling, and pussing, and itching. i actually use a tiny amount on the end of a q tip and mix it with vanacream, probably 10:1 ratio to keep the severity of the reaction down. i only leave it on 2 hours before i wash with soap and water. i only use on my scalp. this may sound like i am really weakening it's potency, but i still get a strong reaction. on top of this, if the reaction is still to strong after 2 days, i will use topicort to help the healing process. now on the positive side, i have seen regrowth in my bald spots (which are generally nickel to quarter size). i've had spots fill in fast from one use and spots fill in slowly after 5 uses, but i do get growth from it. try a small sample area and give it a few days before you apply to larger areas. hope this was helpful, tim.
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When I went AU in 2005 after 4 previous bouts of AA (WHICH ALL GREW BACK) I decided i would attempt a course of DCPC.
1st mistake- no one with AU should try it. In my opinion only those with long lasting, recalcitrant AA should offer themselves up.
You need to realise it's a long course ( 6 to 9 months)
After 3 months the 'control side' of my head started to grow hair. This continued until i had a good covering of short, patchy hair. After 6 months they allowed the other side to be done. This in turn started to grow in a patchy, diffuse way.
"No pain no gain" - very appropiate with DCPC. My head was itchy for 3 days after application. I sometimes had weeping sores ( blood and puss). All die down after a while. On one occasion my lymph glands swelled up and i had flu for 4 days. "No pain no gain". Most of the time i was fine and knew about the side effects.
I started to shave the patchy growth after the flu. I was given a month off. It grew and i shave the "rag doll". On returning i noticed it was not growing as much and the hair felt weak. It started to fall out from then. I went back and desisted the treatment. the staff were very nice and we use to have a laugh every week.
Within a month i was AU again. I also got a few small spots of Vitiligo but hardly noticeable.
Was it worth it? Yes
It proves like all the "heavy " treatments that they only suppress the immune system and once stopped, the hair will fall out; so you only learn by experience. In fact they are not treatments! They are in my opinion only used so you will get use to Alopecia lol. Doctors who say they have "results" on people with AU are talking "flannel" I saw 6 people with AU when i was there and all grew vellus hairs but they all fell out. DCPC, PUVA, PREDNISONE....they had taken all or combinations. Most felt better just by going there and talking to staff and other people with Alopecia lol. Forget the treatments. They don't work for AU and never have but we still try them! We are stubborn!
2010- This summer i have more hair on my head than i did with DCPC. I have to shave both sides of my face. The left and right parietal (back top of skull). The sides of my head and some of the back. It's all white and it does not fall out.
I still have AU and i would never take a treatment again. My AU is a benign presence in my life. I long ago accepted it but not my Golf handicap! lol That has fallen this Summer.
N.B- "Catch up" A sad, common condition with us is that we are always the last to "Catch up". Our friends/family largely after a while, have moved and upgraded their perception of you. They don't mind and are use to your bald head/wig ....whatever. Yet we often are so 'way behind' in realising that most people have moved on and they find you 'just as you are right'. I learnt that a long while back. People expect you to have a bald head/wig! That's you! lol
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Permalink Reply by Valerie Tirro on
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I have had some regrowth from this treatment!!! It just became expensive with co-pays and was requested to do twice a week.
Psoralen Plus Ultraviolet A Radiation (PUVA) for Alopecia Areata
Psoralen Plus Ultraviolet A Radiation or PUVA has been used in alopecia areata treatment since 1974. PUVA is a photo chemotherapy that involves a topical or oral application of psoralen plus followed by a measured dose of ultraviolet radiation. Psoralen plus is a drug, which in its natural state is found in many plants. It contains a chemical 8-methoxypsoralen or 8 MOP, which is sensitive to ultraviolet rays. It enhances the effect of the ultraviolet rays on the skin by making the skin photosensitive. Psoralen has been known since ancient times as a cure for skin diseases.
Prior to its application in alopecia areata PUVA was used for treating skin disorders such as psoriasis, vitiligo, atopic dermatitis and pruritis or itching. PUVA therapy has shown the following effects:
* It depresses the number of circulating E rosette forming cells in psoriatic patients and controls.
* It reduces the fraction of circulating helper T-cells in psoriatic patients.
* It induces suppressor T cells in mice.
* It may prevent attack on the hair follicles by the immune system by depleting the number of Langerhan’s cells.
* It has been to known to stimulate the dopa negative melanocytes in the outer root sheath to divide and multiply.
By its photo immunologic effect on T cells, PUVA may be a good alopecia areata therapy. The last two effects may also make PUVA an effective treatment for alopecia areata. Increasing evidence indicates an important role of melanocytes in alopecia areata. Studies have shown that oral applications were more effective than topical applications, perhaps, due to some kind of change in the immune system.
A typical PUVA session consists of, firstly, an oral or topical administration of psoralen plus and two hours later, irradiation to UVA rays. UVA is a broad spectrum, high intensity artificially sourced radiation. As the situation demands, the irradiation could be on the whole body or restricted to the area affected by hair loss. The source of UVA is a square or hexagonal light box, fitted with fluorescent tubes, emitting these UVA rays. The duration of each session is progressively and gradually increased.
Response Rate to PUVA
In practice, PUVA has shown mixed success in several studies. Under uncontrolled conditions, cosmetically acceptable hair growth was observed in 40% to 50% of the patients. Since studies were uncontrolled it was difficult to find out how much was genuine growth and how much spontaneous remission. One significant finding of these studies was the high relapse rate of 30% to 40% cases when PUVA treatment was discontinued. The reason for such high relapse rates is not known, the current belief being that the new hair growth prevents the UVA rays penetrating the skin. Technical improvements such as comb emitting UVA failed to show any significantly better response.
A five-year study on PUVA treatment was conducted on 23 patients. Out of these 23 patients, seven had patchy alopecia, thirteen had alopecia totalis and three had alopecia universalis. Irradiation was done in a stand-up light box with fluorescent tubes emitting radiation of 320 to 400nm strength. Twenty patients were orally administered 8-MOP two hours before irradiation. Out of these 20 patients, 17 were given total body UVA and three were given scalp-only treatment. The dosage ranged from 10mg for patients weighing less than 25kgs, to 60mg for those weighing more than 90kgs. Three alopecia totalis patients were given 0.1% 8 MOP application and scalp-only irradiation. Irradiation was given three times a week and was gradually increased with each session. Vellus hair growth was observed at the 30th session and complete hair growth was seen between the 50th and the 80th sessions. Of the 17 given an oral application and total body irradiation, 11 showed 90% or more hair growth. Complete hair regrowth was observed in:
* 4 of 7 patients with patchy alopecia
* 5 of 7 patients with alopecia totalis
* 2 of 7 patients with alopecia universalis
The three who received topical application and scalp only UVA exposure were failed treatments and the three who received an oral application and scalp only irradiation reported partial response. Nausea was the most observed side effect affecting 30% of patients given oral application of eight MOP. No definite conclusions were possible from this study.
In another study, conducted along largely similar lines on 30 patients, the response of five patients with alopecia totalis and the rest with patchy alopecia was observed. After treatment for 7 to 9.4 months, one patient showed excellent response, 8, of which 3 were alopecia totalis patient, showed good results, seven gave poor results and 10 were treatment failures. All those who showed good results, had a relapse within a mean time of 7.7 months after the end of treatment.
Several such studies showed that there was no significant difference in response between patients having different types of alopecia areata.
Taylor and Hawke reporting on their 10-year study on PUVA, mention that the response rate – taken as more than 90% regrowth – was 43% in patchy alopecia and 50% in alopecia totalis and alopecia universalis. However, if cases of vellus hair growth and relapse after 4 months of treatment were excluded, the response rate was an unsatisfactory 6.3% for patchy alopecia and 12.5% for alopecia totalis and universalis. Not surprisingly, they concluded that PUVA was not a very effective long-term treatment for alopecia areata.
Side Effects of PUVA
Due to UVA irradiation, side effect posing the greatest risk to PUVA patients is the threat of various types of skin cancer, especially, potentially fatal melanoma. Therefore, post treatment monitoring of PUVA patients is essential. These patients should immediately contact doctors in case of skin abnormalities like unusual coloring, pain or itches. Nausea is the most prominent side effect reported. Other minor side effects include:
* Sunburns called photoxic erythema
* Headache and dizziness
* Redness of the skin
* Skin darkening
* Skin ageing
* Itching
Conclusion
The risk of cancer makes PUVA unsuitable for long-term therapy. Even otherwise, due to other factors, especially, high relapse rates; several studies have cast a doubt on their long-term efficacy. However, PUVA may have a role in alopecia areata management. Narrow band UFB may be a better alternative, once research on it is complete.
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I have read more studies than i care to mention and i have read thousands of posts on many forums ,over the past 6 years. Yet when i compare thousands of posts with these studies ( and i have). I find that no one who has AU has ever retained (most impt) the hair ( and i mean full head of hair) I examined the treatment posts on one forum for 5 years and no one had recovered their hair from above treatments or anything else.
Many like me who had AA went into natural remission and kept their hair for years. Natural!
These "heavy treatments" don't work! Why ? because as soon as you stop.....it falls out...and most have bad side effects. I know one person who has DCPC for AA and they have been on it for years. They can tolerate the small surface area of application but AU would beyond the pain threshold of most. Where are these people with PUVA. DCPC STEROIDS who have taken treatment. grown hair and stopped treatment? I can't find any posts in 6 years.
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Puva has started to work for me. However, due to insurance co-pays, I was unable to continue due to unemployment. And the new hair I did grow so far has not fallen out. But I still have to wear a wig obviously. Hope is the only thing I have. If you don't try, you'll never know.
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Permalink Reply by Gloria S. on
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I have met personally one person and spoke with another who have done a similar treatment with great success. They also had AU and their outcome was great.
My daughter is also doing this treatment and she is AU.
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thank you everyone for your opinions, it has helped alot. Especially considering the effects from being AA, AT, to AU (which i am AU)
I have decided that after all the years of doing injections and PUVA and now the DCP, Im going to take a good long break from it. And heal my soul. I have definitely caused myself alot of pain over the years, thinking that I had to do these treatments. Not wanting to give up the battle or something. Fight the good fight and all. If at a later point I decide to start treatments again, it will not in some sense that I need to "fix" it.
You are absolutely right Dom.....we do find ourselves in a "catch up" condition. And I must admit I got abit weepy reading your comment, it sounded all too familiar.
You are all beautiful, wonderful people and thank you for caring enough to add your comments
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I have not noticed any changes after stopping the Puva treatments. But I have not lost the hair I did grow back. I think taking a break certainly helps. You get so wound up hoping the treatments will work and then it's a huge let down when it doesn't. I did Puva treatments since last March. So,,,,yea..it takes a while. Everyone is different as well. Will post some pics soon..Until next time..
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