A comparison of the efficacy and tolerability of three corticosteroid treatment regimens in patients with alopecia areata

Abstract

Background Topical corticosteroids (TC) and/or intralesional corticosteroids (IC) are considered first-line treatments for patch-type alopecia areata (AA). However, the efficacies of TC monotherapy, IC monotherapy, and combined topical and intralesional corticosteroids (CC) in patients with AA have never been compared. Objective To evaluate and compare the efficacy and tolerability of 3 corticosteroid treatments (TC, IC, and CC) in patients with AA. Methods A study of patients with AA who received TC, IC, or CC was conducted. Outcomes including initial hair regrowth (25% regrowth), significant hair regrowth (>80% regrowth), and adverse events were statistically compared. Cox proportional hazards regression analysis was used to identify factors that influence the treatment response. Results One hundred and forty-eight patients were eligible for analysis. The response rates of initial and significant hair regrowth were comparable among 3 treatment groups. Multivariate analysis revealed that an AA treatment duration of longer than 6 months was associated with a lower probability of significant hair regrowth. A small proportion of patients experienced adverse effects. Conclusion The 3 corticosteroid treatment regimens are effective, safe, and show no significant differences in treatment outcomes. However, an AA duration longer than 6 months portends a lack of significant hair regrowth.