Which medications in the drug class Glucocorticoids are used in the treatment of Alopecia Areata?

Updated: Aug 06, 2020
  • Author: Chantal Bolduc, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Glucocorticoids have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

Topical corticosteroids (including intralesional corticosteroids) are safe and easy to use. They are acceptable cosmetically and allow patients to wear hats or wigs shortly after application. They also are relatively inexpensive. While the usefulness of high-potency topical corticosteroids is under debate, they remain a good (painless) option in children.

Intralesional steroids are first-line treatment in localized conditions.

Oral prednisone usually is reserved for patients with rapidly progressive alopecia areata. The relapse rate is high, and the potential for multiple severe adverse effects when used long term limits its usefulness.

Clobetasol propionate (Temovate)

Clobetasol propionate is a class I superpotent topical steroid. It suppresses mitosis and increases the synthesis of proteins that decrease inflammation and cause vasoconstriction. Treatment should continue until cosmetically acceptable regrowth is achieved or for a minimum of 3-4 months.

Prednisone (Deltasone, Meticorten, Sterapred)

Prednisone is an immunosuppressant occasionally used in rapidly progressive alopecia areata in an attempt to halt the condition, but the relapse rate is high. Use of systemic steroids for the treatment of alopecia areata is under much debate. Prednisone stabilizes lysosomal membranes and suppresses lymphocytes and antibody production.

Many drug doses and regimens have been used in the treatment of alopecia areata, but no formal recommendation exists.

Triamcinolone (Kenalog 10 mg/mL or 40 mg/mL)

In alopecia areata, intralesional triamcinolone is believed to suppress the immune system locally and thereby allow hair to regrow. Injections are administered with 3-mL syringe and 30-gauge needle intralesionally.

Pediatric patients generally are less tolerant of intralesional injections because of local discomfort.

Betamethasone dipropionate cream 0.05% (Diprosone)

Betamethasone dipropionate is used for inflammatory dermatoses responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

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