Treatment of Severe Alopecia Areata Using Methotrexate as an Adjunctive Drug in Combination with Intravenous and Oral Corticosteroids

October 2010 in “ Faṣlnāmah-i bīmārīhā-yi pūst ”

F Malekzad, Gh. Eshghi, Abbas Ebadi, Shima Younespour

methotrexate corticosteroids alopecia areata prednisolone methylprednisolone

From the encyclopedia

autoimmune disorder causing patchy hair loss

Studysummary This study found that using methotrexate with corticosteroids may support hair regrowth in severe alopecia areata, but adverse effects and relapses were common, suggesting more controlled trials are needed.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The study investigated the use of methotrexate as an adjunctive therapy with corticosteroids for severe alopecia areata in 120 patients over one year. Methotrexate was administered weekly alongside low-dose prednisolone and periodic methylprednisolone. Results showed that 57.7% of patients achieved total hair regrowth, and 44.75% remained disease-free at the one-year follow-up. However, 56.25% experienced relapses, and 7.5% had severe adverse effects. The study concluded that methotrexate could be a safe and well-tolerated treatment option, though further controlled trials were recommended to address remaining questions.

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Research cited in this study

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research Placebo-Controlled Oral Pulse Prednisolone Therapy in Alopecia Areata

141 citations , February 2005 in “Journal of the American Academy of Dermatology”

In this study, oral prednisolone pulse therapy led to significant hair regrowth in some patients with extensive alopecia areata, whereas no improvement was seen in the placebo group.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations , July 2003 in “Journal of the American Academy of Dermatology”

In this study, clobetasol propionate 0.05% ointment was found to induce hair regrowth in 28.5% of patients with severe alopecia areata under occlusive conditions, though long-term benefit was limited to 17.8%.

research Pulsed Administration of Corticosteroids in the Treatment of Alopecia Areata

117 citations , February 1996 in “International Journal of Dermatology”

This study found that monthly oral prednisolone pulses of 300 mg were effective and safe for treating widespread alopecia areata, with 58.3% of patients achieving cosmetically acceptable hair growth.

research PUVA Treatment of Alopecia Areata Partialis, Totalis, and Universalis: Audit of 10 Years' Experience at St John's Institute of Dermatology

105 citations , December 1995 in “British journal of dermatology/British journal of dermatology, Supplement”

This retrospective study concluded that PUVA treatment is generally ineffective for alopecia areata, with low effective success rates for partialis, totalis, and universalis types.

research Systemic Steroids With or Without 2% Topical Minoxidil in the Treatment of Alopecia Areata

101 citations , November 1992 in “Archives of Dermatology”

In this study, tapering prednisone followed by 2% topical minoxidil helped limit hair loss in some patients with alopecia areata, with 30% to 47% showing over 25% hair regrowth initially.

research Large Doses of Glucocorticoid in the Treatment of Alopecia Areata

80 citations , November 1975 in “Acta dermato-venereologica”

This study found that while some patients with severe alopecia areata responded to high-dose prednisolone, the response was inconsistent and the therapy's risks prevent recommending it for general use.