Topical Methotrexate vs Minoxidil for Localized Alopecia Areata

Summary

Alopecia areata is an autoimmune disorder characterized by well-defined, non-scarring patches of hair loss on the scalp and other hair-bearing areas. Although several treatment options are available, there is no universally accepted standard therapy, and treatment responses vary widely among patients. Minoxidil is commonly used for hair regrowth due to its ability to stimulate hair follicles and prolong the anagen phase of the hair cycle. Methotrexate, an immunosuppressive agent traditionally used in inflammatory and autoimmune diseases, has also been explored as a potential treatment for alopecia areata because of its ability to suppress immune-mediated follicular damage. This randomized controlled trial aims to compare the efficacy and safety of topical methotrexate 1% gel versus minoxidil 5% spray in patients with localized alopecia areata. Eligible participants will be randomly assigned to receive either topical methotrexate gel or minoxidil spray and will be followed for 24 weeks. Treatment response will be assessed using the Severity of Alopecia Tool (SALT) score. The findings of this study may help identify an effective therapeutic option for patients with localized alopecia areata and contribute to improving clinical management strategies for this condition.

Timeline

Start

2026-03-15

Primary completion

2026-09-15

Completion

2026-09-15

Publications

• Results Ahmed G, Khare S, Ganguly S, Chhabra N, Prabha N. Topical methotrexate 1% gel for the treatment of localized alopecia areata. Int J Dermatol. 2020 Aug;59(8):e292-e293. doi: 10.1111/ijd.14898. Epub 2020 Apr 28. No abstract available.
• Results Alshahrani AA, Al-Tuwaijri R, Abuoliat ZA, Alyabsi M, AlJasser MI, Alkhodair R. Prevalence and Clinical Characteristics of Alopecia Areata at a Tertiary Care Center in Saudi Arabia. Dermatol Res Pract. 2020 Mar 13;2020:7194270. doi: 10.1155/2020/7194270. eCollection 2020.
• Results Olayinka JJT, Richmond JM. Immunopathogenesis of alopecia areata. Curr Res Immunol. 2021 Feb 6;2:7-11. doi: 10.1016/j.crimmu.2021.02.001. eCollection 2021.
• Results Davey L, Clarke V, Jenkinson E. Living with alopecia areata: an online qualitative survey study. Br J Dermatol. 2019 Jun;180(6):1377-1389. doi: 10.1111/bjd.17463. Epub 2019 Feb 21.
• Results Ghassemi M, Yazdanian N, Behrangi E, Jafari M, Goodarzi A. Comparison of efficacy, safety and satisfaction of latanoprost versus minoxidil, betamethasone and in combination in patients with alopecia areata: A blinded multiple group randomized controlled trial. Dermatol Ther. 2022 Dec;35(12):e15943. doi: 10.1111/dth.15943. Epub 2022 Oct 25.
• Results Islam N, Leung PS, Huntley AC, Gershwin ME. The autoimmune basis of alopecia areata: a comprehensive review. Autoimmun Rev. 2015 Feb;14(2):81-9. doi: 10.1016/j.autrev.2014.10.014. Epub 2014 Oct 12.
• Results Mao Y, Xu Z, Song J, Xie Y, Mei X, Shi W. Efficacy of a mixed preparation containing piperine, capsaicin and curcumin in the treatment of alopecia areata. J Cosmet Dermatol. 2022 Oct;21(10):4510-4514. doi: 10.1111/jocd.14931. Epub 2022 Apr 24.
• Results Toma DM, Atallah RB, Eldahshan RM. Comparative study between topical methotrexate 1% gel and minoxidil 5% gel in the treatment of localized alopecia areata. Dermatol Ther. 2022 Sep;35(9):e15696. doi: 10.1111/dth.15696. Epub 2022 Jul 26.

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