Liquid Nitrogen Cryotherapy in Recalcitrant Alopecia Areata: A Study of 11 Patients.

Abstract

Context:Recalcitrant alopecia areata (AA) is not uncommon in clinical practice. In certain patients, treatment failures are known with almost every conventional therapy either singly or in combination.Aims:To study the efficacy of liquid nitrogen (LN) cryotherapy in patients with recalcitrant AA.Subjects and Methods:We present series of eleven patients of recalcitrant AA, who consulted us after getting no response to various modalities of treatment for 6 months. We treated them with LN cryotherapy every 2 weeks till significant hair regrowth or maximum five sittings (at 0, 2, 4, 6, and 8 weeks) whichever was earlier. Inclusion and exclusion criteria were applied. Each patient was counseled and a written consent was taken. Every session consisted of dual freeze and thaw cycles of 15 s each with a cryo unit spray. Two months of follow-up after last treatment was done to observe sustained re-growth of hair.Statistical Analysis Used:The clinical response was evaluated by using regrowth scale at 4th, 8th, and 16th week.Results:11 patients were recruited, one patient dropped due to inability to attend follow-ups. Remaining ten patients completed the treatment and follow-up. Out of 10 patients, five patients (50%) showed an excellent response, three (30%) had a satisfactory response, one (10%) had a fair response, and one patient (10%) had a poor response. No serious adverse effects were seen. Sustained hair regrowth was seen in 80% of patients at the 16th week.Conclusions:LN cryotherapy may be worth trying treatment in the management of recalcitrant AA.