Sulfasalazine for Hair Loss: How it Works

Sulfasalazine may be an effective treatment for some forms of hair loss because of its immunosuppressive actions. Some hair loss is caused by auto-immune responses in the scalp.

Because of its immunomodulatory and immunosuppressive actions, sulfasalazine has shown good hair regrowth in the treatment of alopecia areata. The drug is administered orally usually as enteric coated tablets to minimize the gastrointestinal side effects. The treatment is started at a lower dose, usually in the range of 500 mg twice daily and then the dose is gradually increased to 1 g three times a dayAdverse effects include gastrointestinal distress, liver toxicity and haemotological side effects. Sulfasalazine helps in alopecia areata because it causes inhibition of T cell proliferation, and natural killer cell activity and also inhibits antibody production. It also inhibits the secretion of interleukin (IL)-2, IL-1, TNF- and IFN-gamma and even IL-667.
A number of clinical studies have documented a positive effect of sulfasalazine in alopecia areata. In one clinical study, 23% patients showed a really good response with satisfactory hair growth after sulfasalazine therapyOther studies have also shown a beneficial effect of this treatment option in resistant cases of alopecia areata.
British Journal of Medical Practitioners

What is topical sulfasalazine?

Topical sulfasalazine refers to a formulation of the medication sulfasalazine that is intended for application to the skin, typically in the form of a cream, gel, ointment, or lotion. Unlike oral sulfasalazine, which is primarily used to treat inflammatory bowel diseases like ulcerative colitis and Crohn’s disease, topical sulfasalazine is used for a different purpose: to treat certain skin conditions.

Topical sulfasalazine is sometimes prescribed by dermatologists to manage specific skin conditions, such as:

Psoriasis: Psoriasis is a chronic autoimmune skin condition characterized by the rapid buildup of skin cells, leading to thick, scaly patches on the skin. Topical sulfasalazine may be used as part of the treatment regimen to help reduce inflammation and slow down the excessive skin cell turnover associated with psoriasis.

Rheumatoid Arthritis-Related Skin Manifestations: In some cases, individuals with rheumatoid arthritis may develop skin symptoms or nodules. Topical sulfasalazine can be applied to manage these skin manifestations.

The exact mechanism of action of topical sulfasalazine in managing these skin conditions is not fully understood, but it is believed to involve anti-inflammatory properties that help alleviate symptoms.