The efficacy of topical treatments may vary and tend to be less effective for more advanced types of alopecia areata. However, they are often a good starting point.

Topical treatments include corticosteroid creams and lotions such as betamethasone, clobetasol, and halobetasol; calcineurin inhibitor ointments such as tacrolimus and pimecrolimus; minoxidil foam/spray (known commonly as Rogaine, or Equate Minoxidil); or contact irritants like diphenylcyclopropenone/diphencyprone (DPCP/DCP) and anthralin. Less common topical treatments include vitamin D analogues such as calcipotriol/calcipotriene.