Comparative evaluation of the efficacy of topical tacrolimus 0.03% and topical calcipotriol 0.005% mixed with betamethasone dipropionate versus topical clobetasol 0.05% in treatment of alopecia areata: A clinical and trichoscopic study

BackgroundAlopecia areata (AA) is a common non-scarring hair loss disorder that affects children and adults with a great psychological burden because of its recurrent and sometimes treatment-refractory nature. ObjectiveTo compare the efficacy of topical calcineurin inhibitor, topical potent steroid combined with vitamin D analogue versus topical superpotent steroid in treatment of localized AA. Patients and MethodsSixty subjects with chronic (>1 year) localized (SALT score < 25%) AA, confirmed clinically and dermoscopically, were randomized into three groups. Group I used topical 0.03% tacrolimus (Tarolimus (R)), group II used topical potent steroid combined with vitamin D analogue (Daivobet (R)). and group III used topical superpotent steroid (Dermovate (R)). All patients continued a daily therapy for three successive months and were followed up for three other months. Assessment was done using PULL test, SALT score, and dermoscopic comparison before and after therapy. ResultsGroup II showed comparable statistical results to group III with lower values in a non-statistically significant way. Group I achieved the least improvement among all groups. ConclusionCombined vitamin D analogues with potent steroid appears to be a more convenient treatment for localized AA than superpotent steroids because of less side effects and comparable efficacy. Tacrolimus needs further research or formula customization to be used as a topical therapy for AA.

Automated summary

This study compared the efficacy of three different treatments for localized alopecia areata, and found that the combination of vitamin D analogues with potent steroids was more effective and had less side effects compared to superpotent steroids. This suggests that combined treatment with vitamin D analogues and potent steroids is a more convenient and beneficial approach for localized alopecia areata.