41 patients with severe alopecia areata were treated with either local or oral 8-methoxypsoralen and UVA irradiations. In 26 cases (73%) a good to excellent result was obtained. The number of irradiations required for regrowth varied but 20--40 treatments were sufficient in most cases with a positive response. Patients with circumscribed or ophiasic alopecia responded better than patients with total or universal alopecia, atopy or a family history of alopecia did not seem to influence the outcome of the treatment. The age of onset of the disease seemed to be of importance as well as the duration of the treated attack. Patients over 20 years at the first attack of alopecia showed a better response than patients with an earlier onset of the disease. During a follow-up period of 6--12 months of 20 successfully treated patients only 2 had a recurrence.