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Clobetasol propionate, 0.05% effectively, safely treated children’s alopecia areata

Topical clobetasol propionate, 0.05% cream was more effective than hydrocortisone, 1% cream in treating children with alopecia areata, according to recent study results.

Researchers conducted a randomized, blind trial of patients of an outpatient dermatology clinic at the Hospital for Sick Children, Ontario. Forty-two children (mean age, 7.3 years) with a clinical confirmation of alopecia areata and at least 10% of the scalp affected were eligible; 41 children were treated.

Twenty patients (57% female) were treated with clobetasol propionate, 0.05% cream while 21 patients (55% female) were treated with hydrocortisone, 1% cream. The creams were applied thinly by patients twice daily to the hair loss areas for 6 weeks, followed by 6 weeks off, which was then repeated for a total of 24 weeks. The change in scalp surface area with hair loss during the 24 weeks was the primary outcome. Assessments were conducted at 6, 12, 18 and 24 weeks.

“After adjusting for baseline hair loss, the clobetasol group had a statistically significant (P<.001) greater decrease in the surface area with hair loss compared with the hydrocortisone group at all time points except 6 weeks,” the researchers reported.

Clobetasol patients had a greater percentage of reduction in scalp surface area at 24 weeks compared with baseline (96.5%; IQR, 63.7%-100%) than the hydrocortisone group (4.6%; IQR, –444.3% to 80.8%; P=.002). Also at 24 weeks, 17 children treated with clobetasol (85%) and seven in the hydrocortisone cohort (33.3%) had at least a 50% reduction in surface area with hair loss (P<.001).

One clobetasol patient who had extensive alopecia areata experienced scalp skin atrophy, which resolved after the 6-week period of no treatment. The number of patients with abnormal urinary cortisol remained constant throughout the study.

“Our study provides evidence that topical high-potency steroids can be effective and safe as first-line agents for limited patchy childhood alopecia areata, before other, more invasive, therapies are considered,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.