Comparative Efficacy of Topical Clobetasol Propionate 0.05% Ointment and Topical Tacrolimus 0.1% Ointment in the Treatment of Alopecia Areata

Background: Alopecia areata (AA) is a chronic autoimmune disorder characterized by nonscarring hair loss. Various topical therapies are used, yet their relative efficacy remains debated. Objective: To compare the efficacy of topical clobetasol propionate 0.05% and topical tacrolimus 0.1% ointment in the treatment of alopecia areata. Study Design: Randomized controlled trial. Setting: Dermatology Department, Combined Military Hospital (CMH), Nowshera, Pakistan. Duration of Study: 11-October-2024 to 11-April-2025. Methods: A total of 62 patients with ≤3 Alopecia areata patches (≤3 cm diameter) and no systemic autoimmune disorders were recruited. Participants were randomized into two equal groups (n = 31 each) using a blocked randomization method. Group A applied clobetasol propionate 0.05% ointment twice daily, while Group B applied tacrolimus 0.1% ointment for three months. Efficacy was assessed using the Severity of Alopecia Tool (SALT) score, with treatment success defined as a SALT score ≤4. Statistical significance was assessed using the chi-square test, with p < 0.05 considered statistically significant. Results: The mean age in Group A was 33.06 ± 11.67 years, while in Group B it was 30.45 ± 12.33 years. Treatment success was achieved in 23 patients (74.2%) in the clobetasol group, compared to 14 patients (45.2%) in the tacrolimus group, showing a statistically significant difference (p = 0.02). Conclusion: Topical clobetasol propionate 0.05% demonstrated superior efficacy compared to topical tacrolimus 0.1% in the treatment of alopecia areata, highlighting its role as a preferred first-line topical therapy.