The randomized trial of "aromatherapy" for alopecia areata by Hay et al1 in the "Alternative Medicine" theme issue in the ARCHIVES is illustrative of several basic principles. Although the treatment resulted in a statistically significant improvement, I have questions about their initial randomization. The only statement on randomization procedure is, "Eighty-four patients were randomized into 2 groups by the aromatherapist."1 There is mention neither of the technique used to randomize the patients nor of disease duration, which is a major predictive factor in alopecia areata.2 It must be remembered that approximately half of adult patients with recent onset of patchy alopecia areata have spontaneous remission within the first year. Thus, the reported results could easily be accounted for by differences in disease duration.
Kalish RS. Randomized Trial of Aromatherapy: Successful Treatment for Alopecia Areata. Arch Dermatol. 1999;135(5):602-b-603. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-5-dlt0599