Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata

    October 2023 in “ Dermatology practical & conceptual ”
    Fatemeh Rastaghi, Roxana Kaveh, Nazafarin Yazdanpanah, Akram-Sadat Sahaf, Najmeh Ahramiyanpour
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    TLDR Pulse corticosteroids help regrow hair in alopecia areata but have side effects, especially betamethasone.
    Pulse corticosteroids are effective in inducing hair regrowth in alopecia areata (AA), with betamethasone being the most effective but also having more side effects. The efficacy and relapse rates of pulse corticosteroid therapy depend on factors such as the time of AA onset, age, and type of AA. Recent onset, younger age, and multifocal type are associated with better outcomes and lower relapse rates. Patients with a history of atopy, nail pitting, thyroid disease, or severe forms of AA show the least improvement. Combining corticosteroids with other medications can reduce dosage and side effects, with prednisolone and methylprednisolone being safer but less effective options.
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