Is Methotrexate an Effective and Safe Treatment for Maintaining Hair Regrowth in People with Alopecia Totalis? A Critically Appraised Topic

July 2018 in “ British journal of dermatology/British journal of dermatology, Supplement ”

Ronald K. Browne, Lora Stewart, Hywel C Williams

methotrexate MTX alopecia totalis systemic corticosteroids hair regrowth adverse effects randomized controlled trials

TLDR Methotrexate's effectiveness for maintaining hair regrowth in alopecia totalis is unclear due to limited and biased data.

The study assessed the effectiveness and safety of methotrexate (MTX) for maintaining hair regrowth in patients with alopecia totalis. It reviewed 2 prospective studies and 11 retrospective case series involving 226 patients. Results showed that MTX, often combined with systemic corticosteroids, induced hair regrowth in 20-90% of patients, but relapse occurred in 20-80%. Adverse effects ranged from 7% to 60%. The evidence was insufficient to conclude MTX's effectiveness for maintaining regrowth due to high risk of bias and limited data. Randomized controlled trials were recommended to better evaluate MTX's role in treating alopecia totalis.

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28 citations , January 2016 in “Dermatology”

Methotrexate with corticosteroids can effectively treat severe alopecia areata but often requires long-term maintenance.

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