Introduction: Alopecia areata (AA) is a chronic, remitting–relapsing dermatological disease that is associated with a substantial psychological impact. Despite the availability of a wide range of therapeutic options, none provides a cure for AA. This study aimed to compare the effectiveness of topical betamethasone as a monotherapy with combinations of topical betamethasone with either topical minoxidil 5% or a herbal preparation of castor and jojoba oils.

Methods: This was a multicenter, cohort study in which patients diagnosed with AA were taking one of three treatment regimens: a reference monotherapy of topical betamethasone 0.064% w/w; combined topical minoxidil and betamethasone 0.064% w/w; or combined topical betamethasone 0.064% w/w and a herbal preparation of castor and jojoba oils. The data were collected at the beginning of the study using a questionnaire. Patients were assessed at three follow-up visits for hair regrowth using trichoscopy as the primary outcome. Patient satisfaction and compliance were assessed using 10-point scales.

Results: The final sample consisted of 278 patients. Combined topical minoxidil–betamethasone therapy was significantly associated with higher rates of hair regrowth (p = 0.006), patient satisfaction (p < 0.001), and shorter median time to first improvement (p < 0.001). Combined minoxidil/betamethasone was more likely to achieve hair regrowth than the other two treatments at the multivariate level (aRR = 2.239, CI = 1.153–4.347). Moreover, hair regrowth was significantly different between the treatment groups after each phase, with hair regrowth at the final phase observed in 83.2% of patients using combined topical minoxidil and betamethasone.

Conclusions: The use of topical minoxidil–betamethasone combination for AA was superior to betamethasone monotherapy or combined with herbal preparations. Randomized clinical trials are needed to strengthen the evidence.

Title

Dermatologic Therapy

Publisher

Wiley

Publisher Country

United Kingdom

Indexing

Scopus

Impact Factor

3.4

Publication Type

Both (Printed and Online)

Volume

2025

Year

2025

Pages

6631359, 15 pages