Commentimplications for clinical practice

Most patients offered systemic corticosteroids decline to take them because of the potential systemic side-effects and the high relapse rate. Some patients do regrow hair and have sustained remissions following a brief course of systemic corticosteroids, however they are in the minority. Well over 50% of those who regrow hair with systemic corticosteroids relapse on dose reduction or within a few months of ceasing therapy. Long-term high-dose systemic corticosteroids are not recommended for alopecia areata.

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