Verhaltens- und Hypnotherapie bei Alopecia areata: Eine Einzelfallstudie

Alopecia areata (AA) is a form of hair loss with bald circular areas on the head triggered by auto- and/or psychoneuroimmunological mechanisms that are not fully understood. Secondarily, affected individuals suffer from hairlessness. Currently, there are neither dermatological nor behavioural standard therapies. The course cannot be predicted, spontaneous remission often occurs.

The aim of this case report is to identify psychosomatic causes on the one hand and to develop approaches to a combined medical-psychotherapeutic treatment procedure on the other hand.

A patient with dermatohistologically verified AAT was treated (a) cognitive-behaviourally and (b) hypnotherapeutically in 15 sessions each, after frustrated dermatological local therapy attempts. Before starting the treatment, a psychological diagnosis with instruments for body perception, depression and self-acceptance was performed.

The therapy led to positive changes in personality and significantly improved coping with the disease, but not to hair regrowth.

Although alopecia areata can also be triggered by stressors, it has not been proven that psychosomatic approaches are suitable for breaking the trigger mechanism, even though there is evidence in the literature of positive effects of hypnotherapy and behavioural therapy on autoimmune diseases. The authors developed behavioural approaches combined with hypnotherapy for the therapy of alopecia areata. On this basis, studies with a larger collective of affected individuals could possibly substantiate the benefit of these forms of therapy.