Corticosteroids

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Corticosteroids are a group of natural and synthetic analogs (chemical cousins) of the hormones secreted by the pituitary gland. Corticosteroids are commonly used to treat hair loss caused by alopecia areata, an autoimmune condition that occurs when white blood cells attack hair follicles, resulting in hair loss on the head and other parts of the body.

Alopecia areata can affect people of all ages. It is not life-threatening and may be either temporary or reoccur. Symptoms include recurrent episodes of erratic, unpredictable, and patchy hair loss. All those with alopecia areata are capable of re-growing hair even after many years of hair loss. Unfortunately, there is no strong evidence to suggest that drug-induced remissions or therapies alter the course of this disorder. In fact, it is increasingly evident that the available treatment options at best suppress the symptoms of this disease without correcting the underlying process.

Corticosteroids can be administered in several different ways. They can be administered topically as a cream or lotion, through local injections into the bald patches, and systemically either as injections into a muscle or taken orally. These methods of administration vary in their potency. They also have different rates of success and side effects. Treatment should always be undertaken by a dermatologist or a physician with experience in the treatment of hair diseases. As a rule, dermatologists will try a milder form of treatment before attempting to use stronger forms with their greater potential for side effects.

When using topical steroids, it is important that the steroid is just sufficiently potent to control the skin condition in order to avoid significant local and systemic side effects. The risk of systemic absorption and the potential associated side effects with the use of corticosteroids must be evaluated during long-term treatment. Side effects of topical steroid therapy in children and adults include: folliculitis (inflammation of the hair follicle), hypertrichosis (Growth of hair in excess of the normal), acneiform eruption, the potential for developing local atrophy (wasting), and telangiectasias (chronic dilation of groups of capillaries causing elevated dark red blotches on the skin).

There are significant problems in defining and comparing the success rates of topical corticosteroids with other treatment routines for alopecia areata. Many reports on clinical trials involve a small number of patients without any control group for comparison. This situation prevents us from making definitive statements about the relative success of different treatments. The absence of groups with alopecia areata of similar extent and duration and matched for age make comparison between different treatment types almost impossible. In addition, individual clinicians use different parameters to define satisfactory hair re-growth.

Before beginning any hair loss treatments, consult your doctor to confirm whether the cause of your hair loss is alopecia areata and if you should use corticosteroids to treat your condition. If they are appropriate in your case, your doctor may prescribe injections, pills or topical medications, depending on the severity of your condition and your age.

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