High-Potency Topical Corticosteroids Effective for Alopecia Areata in Children

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Am Fam Physician. 2014 Jun 1;89(11):913.

Clinical Question

Are high-potency topical corticosteroids more effective than low-potency corticosteroids for alopecia areata in children?

Bottom Line

Clobetasol propionate, 0.05%, applied in a thin layer for six weeks on, six weeks off, is a highly effective and safe treatment for alopecia areata in children; hydrocortisone, 1%, is not. (Level of Evidence = 1b)


There are limited randomized controlled trial data regarding treatment of alopecia areata. In this trial, 41 children (age range = two to 16 years) who had at least 10% scalp involvement were randomized to receive a high-potency topical corticosteroid (clobetasol propionate, 0.05%) or a low-potency topical corticosteroid

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley- Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.

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