A Randomised Comparison Trial Comparing Topical Betamethasone Diproprionate Lotion with Topical Latanoprost for the Treatment of Localised Alopecia Areata

Abstract

Background: The conventional treatment for alopecia areata is topical corticosteroids. Eyelash alopecia areata has recently been reported to respond well to topical latanoprost therapy.

Objectives: This research aimed to assess the effectiveness of topical betamethasone diproprionate lotion (group 2) and topical latanoprost ophthalmic solution (group 1) in the treatment of localised alopecia areata.

Methods: This was a parallel-group, single-center, randomised, two-armed effectiveness study. A 1:1 randomization was used to assign 50 patients with localised alopecia areata to either topical betamethasone diproprionate 0.05% lotion or topical latanoprost 0.005% ophthalmic solution. 44 of the 50 patients—21 in group 1 and 23 in group 2—finished the course of therapy.

Results: In the latanoprost group compared to the betamethasone group, the percentage decrease in area associated with alopecia areata at 16 weeks (primary endpoint) was lower (median [interquartile range], 11.1 [0–99.1] vs. 100% [13.6–100], P = 0.02). Compared to the betamethasone group, significantly fewer patients in the latanoprost group showed a full response to therapy (6 [24%] vs. 14 [56%], P = 0.02). When comparing the latanoprost group to the betamethasone group, the median (interquartile range) hair regrowth score was considerably lower (1 [0–4.5] vs. 5 [1–5], P = 0.02). The betamethasone group's subjects had a quicker decrease in the affected region.

Limitations: The study was limited by the brief treatment period and follow-up.

Conclusion: our findings imply that topical latanoprost 0.005% ophthalmic solution is a safer but less effective therapy for localised alopecia areata than topical betamethasone dipropionate 0.05% lotion.