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VOL. 11, ISSUE 1 (2026)
Clinical efficacy of intramuscular corticosteroids in the management of alopecia areata: a prospective observational study
Authors
Dr. Nishok S B, Dr. Surya Mallya
Abstract
Background: Alopecia areata (AA) is a chronic autoimmune disorder characterized by
patchy, non-scarring hair loss resulting from collapse of follicular immune
privilege. CD8+ NKG2D+ T lymphocytes, dendritic cells, interferon-γ (IFN-γ),
and interleukin-15 (IL-15) play central roles in disease pathogenesis through
activation of the JAK–STAT pathway. While intralesional corticosteroids are
commonly used for localized disease, extensive or rapidly progressive AA often
requires systemic therapy. Intramuscular corticosteroids (IMC) provide
controlled systemic drug delivery with fewer pharmacokinetic
fluctuations compared to oral corticosteroids.
Objectives: To evaluate the clinical efficacy of monthly intramuscular corticosteroids in alopecia areata, quantify hair regrowth using SALT score reduction, assess relapse and adverse effects during a six-month follow-up, and compare outcomes with published literature.
Methods: A prospective observational study was conducted on 44 patients with alopecia areata (patchy, totalis, and universalis types) aged 18–60 years. Patients received monthly intramuscular corticosteroid injections for three months. Clinical evaluation was performed using SALT scoring and standardized photography at baseline, 1 month, 3 months, and 6 months. The primary outcome was ≥50% reduction in SALT score at 3 months.
Results: The mean age of participants was 31.6 ± 9.4 years with a male-to-female ratio of 1.3:1. Overall, 65.9% of patients achieved more than 50% reduction in SALT score at three months. Patchy alopecia areata showed the best response, while alopecia totalis and universalis demonstrated partial regrowth. Mean SALT score reduction was 58.2%. Sustained regrowth at six months was observed in 79.6% of patients, with relapse in 20.4%. Adverse effects were mild and transient.
Conclusion: Monthly intramuscular corticosteroids are an effective, well-tolerated, and practical therapeutic option for extensive alopecia areata, with outcomes comparable to published literature.
Objectives: To evaluate the clinical efficacy of monthly intramuscular corticosteroids in alopecia areata, quantify hair regrowth using SALT score reduction, assess relapse and adverse effects during a six-month follow-up, and compare outcomes with published literature.
Methods: A prospective observational study was conducted on 44 patients with alopecia areata (patchy, totalis, and universalis types) aged 18–60 years. Patients received monthly intramuscular corticosteroid injections for three months. Clinical evaluation was performed using SALT scoring and standardized photography at baseline, 1 month, 3 months, and 6 months. The primary outcome was ≥50% reduction in SALT score at 3 months.
Results: The mean age of participants was 31.6 ± 9.4 years with a male-to-female ratio of 1.3:1. Overall, 65.9% of patients achieved more than 50% reduction in SALT score at three months. Patchy alopecia areata showed the best response, while alopecia totalis and universalis demonstrated partial regrowth. Mean SALT score reduction was 58.2%. Sustained regrowth at six months was observed in 79.6% of patients, with relapse in 20.4%. Adverse effects were mild and transient.
Conclusion: Monthly intramuscular corticosteroids are an effective, well-tolerated, and practical therapeutic option for extensive alopecia areata, with outcomes comparable to published literature.
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Pages:39-40
How to cite this article:
Dr. Nishok S B, Dr. Surya Mallya "Clinical efficacy of intramuscular corticosteroids in the management of alopecia areata: a prospective observational study". International Journal of Medicine Research, Vol 11, Issue 1, 2026, Pages 39-40
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