Topical steroids, while often used, may not be
effective when used alone due to insufficient
penetration into the hair bulb,1,14 but when
combined with intralesional corticosteroid
injections, they are of greater benefit.
A recent study of patients with alopecia
totalis and alopecia universalis concluded that
clobetasol propionate 0.05% applied to half
the scalp under occlusion with plastic film is
effective in inducing hair regrowth: 28.5% of
patients had regrowth of more than 75% of
terminal hairs on the treated side by 6 to 14
weeks. Hair regrowth occurred only on the
treated half of the scalp.15 Thus, topical
steroids may be a beneficial treatment option.
Adverse effects of long-term use of highly
potent topical steroids include telangiectasia,
skin atrophy, folliculitis, and adrenal suppression.
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