Breakthrough Treatment: Topical Metformin Restores Hair in Severe Alopecia as per new Case study

A recent case report published in the International Journal of Dermatology implied that topical metformin 10% compounded cream might be a safe and effective adjunct therapy for patients with CCCA.

A 54-year-old African woman with a history of hypertension was presented to the outpatient department due to significant hair loss affecting the central area of her scalp for the past three years. On examination, alopecia was noted in the vertex region with a negative traction test. Trichoscopy revealed marked perifollicular scaling and whitish-gray perifollicular halos.

Histopathological examination showed concentric laminated fibrosis around pilosebaceous units with sebaceous gland atrophy and moderate lymphocytic inflammatory infiltrate in the dermis, consistent with a diagnosis of central centrifugal cicatricial alopecia in phase 3b. Initially, the patient declined treatment with intralesional corticosteroids and received minoxidil 5% lotion and topical clobetasol 0.05% twice daily, with no improvement after 14 months. Subsequently, the doctors discontinued the topical clobetasol ointment and initiated the once-daily application of topical metformin 10% cream in combination with minoxidil 5% lotion twice daily.

After eight months of treatment, substantial hair regrowth was observed in the vertex region, with new repopulated areas and terminal hair follicles.

"This case report presents findings from a 54-year-old African woman diagnosed with advanced-stage central centrifugal cicatricial alopecia (CCCA), confirmed by histopathology, who experienced persistent hair loss despite initial treatment with topical corticosteroids and minoxidil. Following eight months of daily use of compounded topical metformin 10% cream alongside minoxidil 5% lotion, significant hair regrowth was observed in the vertex area, with no reported adverse effects," Bárbara Vieira Granja, Department of Dermatology and Venereology, Unidade Local de Saúde São João, Porto, Portugal, and colleagues wrote.

"This case report also highlights data from two African American females with advanced-stage central centrifugal cicatricial alopecia who also experienced visible hair regrowth with topical metformin 10% compounded cream."

"The case report underscores the transformative potential of topical metformin 10% cream in managing CCCA, offering hope to patients grappling with this challenging condition. With ongoing research and clinical advancements, dermatologists remain optimistic about refining treatment strategies and improving outcomes for individuals affected by CCCA worldwide," they concluded. 

Reference:

Granja BV, De Matos PR, Rosa GP, Pinheiro J, Azevedo F, Pedrosa AF. Treatment of central centrifugal cicatricial alopecia with topical metformin 10% cream: case report and literature review. Int J Dermatol. 2024 Jun 23. doi: 10.1111/ijd.17345. Epub ahead of print. PMID: 38923417.