Comparative Study on the Efficacy of Intralesional Minoxidil Injection Alone and in Combination versus the Standard Intralesional Corticosteroid Injection in the Treatment of Alopecia Areata

Abstract

Abstract Background Alopecia areata (AA) is a common, inflammatory, non-scarring type of hair loss. Although hair loss can affect all hair bearing sites, patchy alopecia affecting the scalp is the most common type. Hair loss may progress to alopecia totalis (AT) which is complete balding at the scalp, or to alopecia universalis (AU), describing loss of all hairs on the scalp and body. Consequently, this can cause a devastating emotions effects on patients and may be expose them to psychological comorbidities such as depression, anxiety and social phobia. Objectives To assess the efficacy and safety of intradermal delivery of minoxidil 5% alone and in combination with intralesional triamcinolone acetonide for treatment of alopecia areata. Patients and Methods This study is prospective randomized intra-patients comparative control clinical trail that include 20 Egyptian patients suffering from multiple patches of AA during December 2017 till November 2018 which approved by The Dermatology Research Ethical Committee, Faculty of Medicine, Ain Shams University. Each patient had at least 5 scalp patches of approximately similar size (minimally 3 cm2) with a severity of alopecia tool (SALT) score up to S2 (less than 50% of scalp involvement) either in stable or progressive course. Patients were recruited from outpatient clinic of Dermatology, Ain Shams University Hospital and Al-houd Al-marsoud Hospital and informed written consent was obtained from all of them after explanations the study objective before enrollment in it. Results Considering the side effects of the treatment, all patients in all groups develop different types of side effects only the intolerable pain of injection was common between them and it was statistically not significant in comparison between the treatment groups. All the treatment groups showed significant reduction in dermoscopic finding of AA after treatment except in control group. Conclusion Standard intralesional corticosteroids are the mainstay first line treatment of patchy alopecia that involving less than 50% of the scalp and for cosmetics areas such as beard and eyebrows.