Effects of Compound Glycyrrhizin and long-acting glucocorticoid in Treatment of Alopecia Areata

  • Dr Zeming Cai, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Ying Zhao, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Sillani Caulloo, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Bin Zhang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Xuhua Tang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Jian Yang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Prof/Dr Xingqi Zhang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China

Objective: Compound Glycyrrhizin is a compound extract from licorice roots with anti-inflammatory and immunoregulatory properties, with rare and mild side effects. We aim to investigate the effects of Compound Glycyrrhizin and long-acting glucocorticoid on treatment of alopecia areata (AA).
Methods: Thirty-nine patients with AA visiting our hair clinic were enrolled in this study. Their clinical and pathological features were investigated. All patients were given oral Compound Glycyrrhizin tablets 50mg three times a day for 1 month. Hair growth was then assessed according to Weiss’s standard. Scores ≥ 2 were considered effective. Scores ≤1 were considered as ineffective and long-acting glucocorticoid (1ml Diprospan) was used subcutaneously in hair loss region or intramuscularly every two to three weeks combined with Compound Glycyrrhizin. 4 months later all patients were assessed again.
Results: Of all 39 patients, 17 (43.5%) patients had the disease for less than 1 year, 24 (61.5%) had focal or multi-focal type AA, 22 (56.4%) patients had less than 30% hair loss area. 13 (33.3%) patients obtained satisfactory hair regrowth with oral Compound Glycyrrhizin alone. No side-effects of Compound Glycyrrhizin were reported.17 (43.5%) patients had hair regrowth only after addition of long-acting glucocorticoid to the treatment protocol. The remaining 9 patients showed no response even with long-acting glucocorticoid, of which 8 patients had AU/AT for more than 12 months. There was no statistical significance on disease duration, subtype and hair-loss area between Compound Glycyrrhizin effective and ineffective groups, but glucocorticoid worked better in patients with shorter disease duration and smaller hair-loss area (P<0.05). Histopathologically, patients with no response to any of the above-mentioned medications seemed to have less inflammation in hair-loss region.
Conclusion: Compound Glycyrrhizin can be used safely and effectively as the first line-treatment in AA to minimize early use of steroids and avoid their side-effects.