Update on Pulse Corticosteroid Therapy for the Management of Alopecia Areata

February 2024 in “ JEADV Clinical Practice ”

J. Bernhardt, Joerg Wenzel

pulse corticosteroid therapy alopecia areata Severity of Alopecia Areata Tool Score PCT

TLDR Pulse corticosteroid therapy helps many with severe alopecia areata regrow hair, but has side effects.

This review on pulse corticosteroid therapy (PCT) for alopecia areata analyzed 20 studies with 2,144 patients, revealing that while 48.16% of patients achieved more than 50% hair regrowth, only 38.53% experienced complete regrowth. PCT is not recommended for severe cases like Alopecia Universalis and Alopecia Totalis due to poor outcomes and significant side effects, which were reported in 76.31% of cases. The review emphasizes the need for evaluating predictive factors before treatment to improve outcomes and calls for future research to develop safer and more effective treatments for severe alopecia areata.

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research Alopecia Areata and Dexamethasone Mini-Pulse Therapy: A Prospective Cohort Study on Real World Evidence and Factors Related to Successful Response

16 citations , March 2022 in “Journal of Clinical Medicine”

Dexamethasone mini-pulse therapy is effective for alopecia areata but less effective for those with early onset or hypothyroidism.

research Whole Exome Sequencing in Alopecia Areata Identifies Rare Variants in KRT82

9 citations , February 2022 in “Nature communications”

Rare changes in the KRT82 gene are linked to a higher risk of Alopecia Areata.

research Weekly Azathioprine Pulse Versus Betamethasone Oral Mini-Pulse in the Treatment of Moderate-to-Severe Alopecia Areata

10 citations , July 2019 in “Indian Journal of Dermatology”

Weekly azathioprine pulse is a better alternative to corticosteroids for treating alopecia areata due to fewer side effects.

research The Effectiveness of Oral Mini-Pulse Methylprednisolone in the Treatment of Alopecia Areata in Vietnam

4 citations , January 2019 in “Open Access Macedonian Journal of Medical Sciences”

Oral mini-pulse methylprednisolone is an effective and safe treatment for alopecia areata.

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations , December 2018 in “Journal of autoimmunity”

Alopecia areata is an autoimmune disease causing patchy hair loss, often with other autoimmune disorders, but its exact causes are unknown.

research Chronological Clinicopathological Characterization of Rapidly Progressive Alopecia Areata Resistant to Multiple Intravenous Corticosteroid Pulse Therapies: An Implication for Improving Efficacy

8 citations , July 2018 in “The Journal of Dermatology”

Current corticosteroid pulse therapy is not very effective for severe rapidly progressive alopecia areata.

research Alopecia Areata: Overview and Insights from January 2018

290 citations , December 2017 in “Journal of The American Academy of Dermatology”

Alopecia areata is an autoimmune condition causing hair loss, influenced by genetics, stress, and diet, and may be prevented by a high soy oil diet.

research Objective Outcome Measures: Collecting Meaningful Data on Alopecia Areata

39 citations , November 2017 in “Journal of The American Academy of Dermatology”

The document suggests using standardized methods to track and measure hair loss in alopecia areata, including patient self-assessment and a 50% improvement in specific scores as a treatment goal.

research Sequential High- And Low-Dose Systemic Corticosteroid Therapy For Severe Childhood Alopecia Areata

18 citations , January 2017 in “Journal der Deutschen Dermatologischen Gesellschaft”

High and low doses of prednisolone helped 62% of children with severe alopecia regrow hair with some weight gain and mild acne as side effects.

research A Systematic Review of Pulse Steroid Therapy for Alopecia Areata

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.

research A Comparative Study of Oral Cyclosporine and Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata

14 citations , January 2016 in “Annals of dermatology/Annals of Dermatology”

Oral cyclosporine is more effective and safer than betamethasone for treating alopecia areata.

research Epidemiology and Burden of Alopecia Areata: A Systematic Review

144 citations , July 2015 in “Clinical, Cosmetic and Investigational Dermatology”

Alopecia areata is a common autoimmune disease affecting about 2% of people, causing significant disability and often associated with mental health issues and other autoimmune conditions.

research Comparison of High-Dose Corticosteroid Pulse Therapy and Combination Therapy Using Oral Cyclosporine with Low-Dose Corticosteroid in Severe Alopecia Areata

14 citations , January 2015 in “Annals of dermatology/Annals of Dermatology”

Corticosteroid pulse therapy is more effective for severe alopecia areata than combination therapy.

research Intravenous Methylprednisolone Pulse Therapy in Severe Alopecia Areata

14 citations , January 2015 in “Indian journal of dermatology, venereology, and leprology”

Methylprednisolone infusions can help some people with severe alopecia regrow hair.

research Early Intervention with High-Dose Steroid Pulse Therapy Prolongs Disease-Free Interval of Severe Alopecia Areata: A Retrospective Study

19 citations , January 2013 in “Annals of Dermatology”

Early high-dose steroid treatment helps prolong disease-free periods in severe alopecia areata.

Alopecia Areata: An Autoimmune Disease Causing Hair Loss

research Guidelines for the Management of Alopecia Areata

182 citations , October 2003 in “British Journal of Dermatology”

The 2003 guidelines suggest that while some treatments can regrow hair in alopecia areata, none alter the disease's progression, and wigs may be the best option for extensive hair loss.