Treatment Effects of Intradermal Botulinum Toxin Type A Injection on Alopecia Areata

Abstract

There are several different treatment options for alopecia areata (AA); Botulinum toxin type A (BTXA) can induce changes in neurotransmitter levels, directly or via neuroimmunologic mechanisms. Therefore it is thought that BTXA may influence cytokines that are responsible for hair growth arrest that characterizes AA. To prospectively examine the safety and efficacy of BTXA injections for the treatment of patients with AA of the scalp. Seven patients with AA received 10 U of BTXA intradermal injections on each site three times. Subjects were classified according to the extent of scalp hair loss into Severity of Alopecia Tool subclasses. Two patients had one patch of AA; the remaining patients had total or universal type AA. One patient dropped out of the study after experiencing spontaneous recovery from her AA. One patient reported aggravation of her AA after BTXA injections. The remaining patients' AA did not change after BTXA injections. Our results suggest that BTXA injection cannot be used as an alternative treatment for recalcitrant AA. Nevertheless, future studies concerning the treatment efficacy of BTXA for mild to moderate AA are warranted.