Topical Metformin Compared with Clobetasol Propionate for Alopecia Areata: Clinical Outcomes from a Comparative Study

Alopecia areata (AA) is alopecia of non-scarring type caused by autoimmune mechanism that affects any area of the body with hair various patterns.

The aim of this research was to assess the safety and effectiveness of topical metformin 30% versus clobetasol propionate 0.05% in the treatment of patchy alopecia areata.

Thirty-four adult individuals with patchy alopecia areata participated in a randomized clinical trial and were categorized into two groups: Group I (17 participants) with metformin 30% applied twice daily for 12 weeks, and Group II (17 participants), with clobetasol propionate 0.05% administered twice daily for 12 weeks. The 5-point semiquantitative regrowth score (RGS), SALT score, and dermoscopic examination were done to evaluate the therapeutic response.3-12-0 RESULTS: At week 12, the median hair regrowth score for group I was 2, whereas for the clobetasol propionate group it was 5. There was no difference of significant importance regarding hair regrowth between the two groups, with P=0.133. Significant reductions in SALT score were observed in the two groups, and the reductions were mostly observed in Group II.

Topical metformin represents a promising and well-tolerated option in alopecia areata treatment. Although the effects of metformin 30% and clobetasol propionate 0.05% were not different, clobetasol was more effective than metformin 30% in treating localized alopecia areata.