Combined intralesional platelet-rich plasma and intralesional steroid versus intralesional steroid alone in the treatment of alopecia areata

Abstract

Background Platelet-rich plasma (PRP) is a promising treatment method of alopecia, but there is a debate about its role in the treatment of alopecia areata. Intralesional steroid is the first-line treatment option for patchy alopecia areata. Combination therapy represents an option for increasing the efficacy of the different lines of treatment.Objective To compare the therapeutic efficacy of traditional treatment of alopecia areata with intralesional injection of triamcinolone acetonide versus combination therapy with intralesional triamcinolone acetonide and intralesional PRP alternatively.Patients and methods In this comparative randomized single-blinded study, 30 patients with two nonadjacent patches of alopecia areata were included. One patch was treated with intralesional triamcinolone acetonide alone (group I) every 4 weeks for 3 months, and the other patch was treated with intralesional triamcinolone acetonide alternating with intralesional PRP (group II) every 2 weeks for 3 months. Evaluation was done by MacDonald Hull and Norris grading and dermoscopy.Results A significant increase in the mean grading score was noted before each intralesional steroid injection session in both groups. However, group II patches treated with intralesional triamcinolone acetonide alternating with intralesional PRP showed significantly higher mean grading score as compared with group I patches treated with intralesional triamcinolone acetonide alone. The dermoscopic features of alopecia areata significantly decrease or disappear at the end of treatment sessions in both groups.Conclusion Combined use of intralesional steroid and intralesional PRP in the treatment of alopecia areata yields better results than using intralesional steroid alone and could be considered as a more effective line of treatment. However, further research studies are needed to determine the optimal dose, intervals, and duration of treatment.