Sequential High- And Low-Dose Systemic Corticosteroid Therapy For Severe Childhood Alopecia Areata

January 2017 in “ Journal der Deutschen Dermatologischen Gesellschaft ”

Karin Jahn‐Bassler, Wolfgang Bauer, Franz Karlhofer, Matthias G. Vossen, Georg Stingl

alopecia areata prednisolone systemic corticosteroid therapy Cushing threshold steroid acne AA corticosteroids

TLDR High and low doses of prednisolone helped 62% of children with severe alopecia regrow hair with some weight gain and mild acne as side effects.

In a study from 2017, 13 children with severe alopecia areata (AA) were treated with an initial high-dose pulse therapy of prednisolone at 2 mg/kg, which was then tapered to a maintenance dose below the individual Cushing threshold over nine weeks. The children were followed for one to three years. The results showed that 62% of the participants achieved complete hair regrowth, with a mean time to response of 6.6 weeks, and the response was maintained throughout the follow-up period with the maintenance therapy. Side effects included weight gain of 1-3 kg in all children and mild steroid acne in 23% of cases. The study concluded that sequential high- and low-dose prednisolone therapy is an effective and safe treatment for childhood AA.

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