Efficacy and Safety of Topical Corticosteroid Treatment Under Occlusion for Severe Alopecia Areata in Children: A Single-Center Retrospective Analysis

This study evaluated the efficacy and safety of potent topical corticosteroid (TCS) treatment under occlusion in 23 children under 10 years old with severe alopecia areata (AA), including alopecia totalis (AT) and alopecia universalis (AU). After 6 months, 19 patients achieved a Severity of Alopecia Tool (SALT) score of 20 or less, indicating significant clinical improvement. However, 6 patients relapsed, and 4 were suspected of adrenal insufficiency, though their cortisol levels normalized after adjusting treatment. Despite the small sample size and retrospective design, the study suggests that TCS occlusion may be a safe treatment option for severe pediatric AA, warranting further long-term research.