BACKGROUND: Alopecia areata is a relatively common disorder of unknown pathogenesis, and there is no satisfactory method to treat it. OBJECTIVE: This study was performed to evaluate the therapeutic response of combined therapy of systemic corticosteroid with topical agents. Also, side effects of the treatment were evaluated. METHOD: We performed the combined therapy of systemic corticosteroid and topical agents, including topical steroids, DPCP sensitization, minoxidil, in 19 cases of severe alopecia areata. Estimated therapeutic results were followed up for 1 year after finishing the therapy. RESULTS: The overall evaluation of the treatment showed good response in 6 cases, fair response in 5 cases, and fail response in 8 cases. The response of combined therapy was revealed to be dependent on the duration of alopecia: disease maturation less than 6 months was a good prognosis factor. Eight of nineteen patients developed side effects, such as acneiform eruption, weight gain, facial edema and DUB. CONCLUSION: The combined therapy of systemic corticosteroids with topical agents was might be effective and relatively safe method to treat severe alopecia areata.