Systemic Steroids for Treatment of Alopecia Areata

In a rebuttal to Winter et al.'s rejection of corticosteroid therapy for alopecia areata, the author reported treating over a dozen patients with systemic steroids, achieving disease clearance in all cases with only one instance of a manageable side effect (a peptic ulcer). The treatment protocol involved weekly intralesional steroids for three weeks, followed by a combination of intralesional and intramuscular steroids (usually betamethasone valerate suspension) if no hair regrowth was observed. Intramuscular triamcinolone acetonide suspension was also used but found to be less effective.