Three monthly doses of corticosteroid pulse therapy yields a satisfactory but temporary response in severe alopecia areata patients

Alopecia areata (AA) is a common, nonscarring type of alopecia that can cause chronic and severe hair loss in some cases. Although there is no standard established protocol for the use of corticosteroid pulse therapy, it has been reported to be an effective and well-tolerated treatment option for patients with severe AA. This study retrospectively analyzed 29 patients who were diagnosed with severe AA (>50% hair loss) from January 2010 to December 2020 and treated with 3 monthly sessions of intravenous corticosteroids. Methylprednisolone (500 mg/day) was administered for 3 consecutive days during the first session, followed by a 1-day treatment regimen for the second and third sessions. The treatment had an overall satisfactory response rate of 58.6% and a complete response rate of 13.8%. Eleven of the 13 patients who achieved a satisfactory response experienced relapse. A subgroup analysis showed that patients with a shorter duration of AA (≤6 months) had a significantly better response to corticosteroid pulse therapy. This study highlights that 3 monthly sessions of corticosteroid therapy are sufficient to induce satisfactory but temporary response.