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Comparative study between topical methotrexate 1% gel and minoxidil 5% gel in the treatment of localized alopecia areata

Dermatol Ther. 2022 Jul 7:e15696. doi: 10.1111/dth.15696. Online ahead of print.

ABSTRACT

Alopecia areata (AA) is an autoimmune disease that results in non-scarring hair loss. Topical minoxidil 5% gel and methotrexate 1% gel are important modalities used in the treatment of many dermatological diseases. We aimed to evaluate the efficacy of methotrexate 1% gel versus topical minoxidil 5% gel in the treatment of localised AA both clinically and dermoscopically. Fifty patients were randomly divided into two groups of 25 each; the first was treated with topical minoxidil 5% gel, and the second was with methotrexate 1% gel. Dermoscopic and photographic pictures were used to follow up at baseline, 3, 6, and 12 weeks. By comparing the two therapies, we noticed that minoxidil has a statistically significant higher frequency of broken hair and black dots after 6 weeks than methotrexate. After 12 weeks, dermoscopy revealed that the minoxidil group had a lower frequency of vellus hair than the methotrexate group. Clinically after 6 weeks, minoxidil showed significantly more excellent improvement than methotrexate (16% versus 0%), and after 12 weeks, minoxidil and methotrexate showed excellent improvement (52% and 36%), respectively. There was no significant difference in side effects (erythema and itching) between the methotrexate and minoxidil groups. Both topical methotrexate 1% gel and topical minoxidil 5% gel had high efficacy in treating localised alopecia areata, with no significant differences between them as evaluated by clinical and dermoscopic examination. This article is protected by copyright. All rights reserved.

PMID:35796224 | DOI:10.1111/dth.15696

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