Corticosteroids in the Treatment of Alopecia Totalis

In a 1978 study, 15 patients with Alopecia Totalis (AT) or Alopecia Universalis (AU) were treated with a combination of corticosteroids, including topical, intralesional, and oral prednisone. Seven patients achieved full scalp hair regrowth and maintained it for an average of 32 months after stopping oral corticosteroids. Two additional patients were on a low maintenance dose. The study indicated that oral corticosteroids could be effective for AT and AU at doses that did not cause serious side effects, and that rapid recurrence of hair loss was not common after ceasing treatment. Side effects were mostly minor, although one patient developed a cataract and another had increased intraocular pressure. The authors recommended a trial of corticosteroids for motivated patients, using lower doses and rapid tapering, along with topical and intralesional treatments for resistant areas.