Each of the above-mentioned methods of treatment is selected individually by the doctor. The choice of one of the methods is dictated by, among other things, his health, medications taken on a regular basis or the probable cause of the problems. The decision is made on the basis of a carefully conducted interview, results of blood tests, histopathological tests or trichoscopy.
In the case of PUVA treatment, contraindications to its use may be, for example, pregnancy and breastfeeding, the patient’s age, kidney and liver damage, or some ophthalmic diseases. It is also not used in people who have had cancer in the past or are at increased risk of developing oncological diseases. A contraindication to light therapy may also be the use of photosensitizing agents other than those administered during treatment, or general hypersensitivity to UV radiation.
Glucocorticosteroids are not administered to people who suffer from severe and unregulated pressure disorders, osteoporosis or advanced ophthalmic problems, but it depends on the specific case and the drug used. On the other hand, immunotherapy is not usually used in the treatment of children under the age of 5, unless it is very well justified. Contraindication to its conduct is also HIV or the presence of other diseases that prevent the proper response of the immune system to this type of treatment.