Alopecia treatments: an overview of steroid treatments

Corticosteroid treatments, often referred to as just ‘steroids’, are used to treat various types of alopecia such as alopecia areata.

Many people we talked to had tried steroid treatments. Topical steroids (applied on top of the skin) were usually tried first and, if these didn’t help, some people moved on to steroid injections and oral steroids (swallowed as tablets). Meghan saw this as a “scale” of treatments which she had moved up over several years. People often said the decision to try steroid treatments and which ones depended on how much alopecia areata they had and whether it had worked for them in the past. Emily says her hair loss is too severe for steroid injections and Grace had to stop this treatment when her bald patches became “too big”. Topical and injection steroid treatments were often offered to help hair regrowth on the scalp, but can be used for other areas of hair loss such as the eyebrows. Sometimes people had two types of steroid treatment at the same time. Arti and Hannah both continued using steroid creams daily alongside regular steroid injections.

Steroids help control alopecia areata by reducing the inflammation and suppressing the immune system, to stop the body from attacking the hair follicles. There are different types of steroids, such as hydrocortisone and betamethasone butyrate, and treatments can have different strengths (how much steroid the product contains). Steroid treatments are usually prescribed or, in the case of steroid injections, the procedure is performed by a medical professional. Rochelle was shocked to find out that some beauty product creams she had bought and previously thought of as ‘natural’ actually contain steroids.

Professor Moss talks about steroid treatments (creams, injections, tablets) for alopecia areata.

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There were mixed experiences of steroid treatments. Some people found they worked well, such as Michael who is pleased that steroid injections have helped his eyebrows to regrow. Sometimes steroid treatments worked and hair regrew but then fell out again when treatment stopped. This happened for Hannah after using topical steroids. Others felt frustrated by using steroid treatments with no improvement. Not everyone was interested in trying steroid treatments or some people, like Annie Y, hadn’t tried any for many years. Some of the reasons people didn’t want to try steroid treatments or stopped using them include:

  • Low expectations about the treatment working;

Imogen says she doesn’t “see the point” in trying steroid treatments as she’s heard they often don’t work and that the hair can fall out again once treatments stop.

  • Emotional impacts it could have if it didn’t work;

As Emma said, “Am I just building my hopes up to knock them back down again?”

  • Worries about side effects and risks of treatment, such as skin thinning with topical steroids and weight gain with tablet steroids;
  • Being time-consuming and ongoing;

As Kayla explained, “I’m used to my wigs and I would rather just [be] comfortable. I don’t wanna have to take something for the rest of my life.” Annie X decided to focus on trying alternative therapies instead.

Some people who continued to use steroid treatments still had doubts about it. Elizabeth had a bald patch regrow when she was 7. Her doctors put it down to steroid creams but she thinks it was a coincidence that her hair grew back at the same time. Becky says she’s “not entirely convinced” by steroids but uses them because doing a treatment helps her “feel in control.” Michael finds it hard to tell if steroid treatments make a difference as his hair loss and regrowth is in an ongoing cycle.

Emily explains some of her concerns about steroid treatments for alopecia.

Age at interview 20

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Age at diagnosis 19

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Alopecia treatments: topical steroids

Most people who had a treatment for alopecia areata tried topical steroids. These can come in different forms including gels, creams and ointments. Becky remembers...