Evaluation of the Efficacy of Topical Metformin 10% and 20% Versus Topical Potent Steroid in the Treatment of Patients With Alopecia Areata

October 2025 in “ Archives of Dermatological Research ”

Radwa El‐Sayed Mahmoud Marie, Moustafa Eyada, Samah M. Elaidy, Radwa El-Sayed Mahmoud Marie

topical metformin clobetasol propionate alopecia areata SALT scores topical steroid metformin gel potent steroid

Studysummary Topical metformin gel is as effective and safe as steroids for treating alopecia areata.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This study compared the effectiveness of topical metformin (10% and 20%) to a potent steroid (clobetasol propionate 0.05%) in treating alopecia areata in 60 patients over three months. Both metformin concentrations showed significant improvement in SALT scores, with new hair regrowth in 60% and 65% of patients for 10% and 20% concentrations, respectively. The steroid treatment resulted in new hair regrowth in 85% of patients. The metformin gel was well-tolerated with minimal side effects, and the study concluded that topical metformin gel is as effective and safe as topical steroids for alopecia areata treatment.

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research Treatment of Central Centrifugal Cicatricial Alopecia with Topical Metformin 10% Cream: Case Report and Literature Review

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In this article, a case report examines the use of topical metformin 10% cream for treating central centrifugal cicatricial alopecia, contributing to existing literature on potential treatments for this condition.

research Alopecia Areata: Trichoscopic Markers in Determining Disease Activity

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This study concluded that exclamation mark hairs are the most reliable marker of disease activity in alopecia areata, with broken hairs, triangular hairs, and black dots also increasing the probability of active disease.

research Topical Metformin as a Novel Therapy for Alopecia Areata Due to Its Immunologic Effects

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In this review, researchers discussed the anti-inflammatory and immunomodulatory properties of metformin and hypothesized that its topical application could benefit those with alopecia areata, given its effects on immune pathways, hair regrowth, and autoimmune disease management.

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This review discusses current and emerging therapies for alopecia areata, highlights the challenges in managing this chronic disease, and emphasizes the importance of addressing its psychosocial impacts; it reports no new clinical results.

Metformin Promotes the Hair-Inductive Activity of Three-Dimensional Aggregates of Epidermal and Dermal Cells Self-Assembled In Vitro

research Metformin Promotes the Hair-Inductive Activity of Three-Dimensional Aggregates of Epidermal and Dermal Cells Self-Assembled In Vitro

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In this study, metformin promoted hair follicle regeneration in vitro by enhancing the hair inductive capability of dermal cells, warranting further exploration for pattern hair loss treatment.

research Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management

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JAK inhibitors show promise for treating alopecia areata, but more research is needed.

research Alopecia Areata: An Autoimmune Disease of Multiple Players

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This review compiles current evidence on the molecular mechanisms, etiologies, and targeted immunotherapies for alopecia areata and reports no new experimental results, emphasizing the need for further research to manage the disease.

research Hair Regrowth in Two Patients with Recalcitrant Central Centrifugal Cicatricial Alopecia After Use of Topical Metformin

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This article discusses the staging of central centrifugal cicatricial alopecia in women of African descent and reports no new clinical results.

research Stimulation of Hair Growth by Small Molecules That Activate Autophagy

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This study found that activating autophagy with specific small molecules and drugs can stimulate hair growth by initiating the anagen phase in dormant hair follicles, suggesting a potential treatment for hair loss.

research Autophagy Is Essential for Maintaining the Growth of a Human Mini-Organ: Evidence from Scalp Hair Follicle Organ Culture

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This study found that autophagy plays a novel role in human hair growth, with altered autophagic flux during hair development phases influencing hair follicle behavior in a preclinical model.

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This study found that metformin did not prevent gentamicin-induced hearing loss and even worsened auditory threshold shifts and caused adverse effects at higher doses in guinea pigs.