Efficacy and Safety of Methotrexate in Alopecia Areata

The study from 2014 evaluated methotrexate (MTX) in 31 patients with alopecia areata (AA) and found that 67.7% experienced over 50% hair regrowth, especially those with less than 5 years of disease progression, age over 40, male patients, and those with multifocal AA. Combination therapy with systemic corticosteroids showed higher regrowth rates (77.3%) compared to MTX alone (44.4%). The therapeutic dose ranged from 10-25 mg/week, with no serious adverse effects reported. Relapse occurred in 33.3% of patients with significant regrowth. The study concluded that MTX is a promising and safe treatment for severe AA, either alone or combined with corticosteroids, but larger trials are needed to confirm its efficacy as a first-line therapy.