How to treat alopecia areata: Corticosteroids

Once diagnosed, alopecia areata treatment decisions will most likely depend in part on the severity of the disease. All treatment options are considered off-label but there are examples with a long history which have been used regularly with some success. For instance, corticosteroids are often used as front line therapy. There are three delivery methods with the optimal choice usually depends on the extent of alopecia.

For Mild Cases

Small patches of hair loss may be treated with either intralesional steroids or topical steroids. Intralesional steroids are injected directly into the problem areas while avoiding eyebrows. Similarly, topical steroids can be a cream or foam applied to the areas of hair loss on the scalp1. It’s possible for topical steroids to cause skin atrophy, which is the thinning of the upper layer of skin, causing a person to become more susceptible to tears. Intralesional steroids may lead to scalp folliculitis2, which is the appearance of small itchy blisters in the area of injection.

For Severe Cases

If topical or intralesional steroids are not doing the job, the next step is to move to systemic steroids3–6. Systemic steroids are taken orally as a pill. They are usually used when alopecia areata is more severe and have the best chance at success during the first appearance of the disease (recurrences are common) or when disease has been present for less than six months7–10. Systemic steroids are less likely to improve conditions where all scalp hair has been lost or loss of body hair has occurred5,6,9. Side effects can also be more severe with systemic treatments11.

Overall, depending on the progression of your disease, it is common to be prescribed corticosteroids, whether intralesional, topical or systemic for the treatment of alopecia areata. Your physician can help determine if one of these treatments may be helpful to you.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.


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