TLDR Combining high-dose corticosteroids with methotrexate may be effective and safe for severe alopecia areata.
The retrospective case series study evaluated the efficacy and safety of a combined treatment of high-dose pulse corticosteroids and methotrexate for severe alopecia areata. The treatment involved administering 500 mg of intravenous methylprednisolone per day for 3 consecutive days each month over 3 months, with methotrexate initiated after the second pulse regimen. The study included 20 patients treated between January 1, 2007, and December 1, 2010. At the 12-month mark, data were available for all patients: 10 patients (50%) achieved total hair regrowth, and 4 patients (20%) experienced incomplete but satisfactory hair regrowth. The treatment was well tolerated. The study concluded that the initial treatment with pulse intravenous corticosteroids may influence the overall positive response and suggested that this approach should be evaluated in a larger patient series.
70 citations,
April 2011 in “British journal of dermatology/British journal of dermatology, Supplement” Methotrexate sometimes helps regrow hair in children with severe alopecia areata and is generally safe.
717 citations,
June 2010 in “Nature” Alopecia areata involves both innate and adaptive immunity, with specific genes linked to the disease.
244 citations,
January 2010 in “Journal of the American Academy of Dermatology” The document says current treatments for alopecia areata do not cure or prevent it, and it's hard to judge their effectiveness due to spontaneous remission and lack of studies.
97 citations,
January 2006 in “Dermatology” imTA and pulse therapy are effective for alopecia areata with manageable side effects, but relapse rates need improvement.
October 2023 in “Dermatology practical & conceptual” Pulse corticosteroids help regrow hair in alopecia areata but have side effects, especially betamethasone.
48 citations,
April 2021 in “Journal of the American Academy of Dermatology” Topical corticosteroids are the best initial treatment for children's alopecia areata.
15 citations,
May 2017 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology” High-dose corticosteroids and methotrexate had a modest effect on severe childhood alopecia, but side effects and relapse were concerns.
21 citations,
May 2017 in “Paediatric drugs” Individualized treatment plans are crucial for children with alopecia areata, with promising options like JAK inhibitors showing significant hair regrowth.
50 citations,
January 2016 in “Journal of the American Academy of Dermatology” Pulse steroid therapy for alopecia areata shows a 43% complete response rate but has a high relapse rate, especially in children.
