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

In a study from 2017, 13 children with severe alopecia areata (AA) were treated with an initial high-dose pulse therapy of prednisolone at 2 mg/kg, which was then tapered to a maintenance dose below the individual Cushing threshold over nine weeks. The children were followed for one to three years. The results showed that 62% of the participants achieved complete hair regrowth, with a mean time to response of 6.6 weeks, and the response was maintained throughout the follow-up period with the maintenance therapy. Side effects included weight gain of 1-3 kg in all children and mild steroid acne in 23% of cases. The study concluded that sequential high- and low-dose prednisolone therapy is an effective and safe treatment for childhood AA.