Localized Alopecia Areata Research Articles

Comparative Study between Intralesional Pentoxifylline and Steroid in Localized Alopecia Areata

Comparative Study between Intralesional Pentoxifylline and Steroid in Localized Alopecia Areata

Comparison of Intra-lesional Methotrexate and Intra-lesional Triamcinolone Acteonid in the treatment of Localized Alopecia Areata

Background: One of the common reasons of non-scarring, patchy or confluent hair loss that can affect any part of the body, but most frequently the scalp, is alopecia areata. Alopecia areata (AA) has a variety of therapy options, but it is still a difficult condition with varied severity, recurrence, and a significant cosmetic problem. Aim: To compare the effects of intralesional triamcinolone acetate and intralesional metatrexate in the treatment of localized alopecia areata in patients at the dermatology department. Study design: Comparative clinical study. Methodology: The dermatology division of Sheikh Zayed Hospital Rahim Yar Khan conducted the current study. The current study included 128 participants. Each chosen group included 64 patients. The sample size was calculated assuming a research power of 80%, a confidence level of 95%, and an efficacy of 60.0% for methotrexate and 80.0% for triamcinolone. Using a 30-gauge needle connected to an insulin syringe, both groups will get intralesional injections in patches with alopecia areata three weeks apart for a maximum of four sessions. A follow-up will be conducted a year following the end of the treatment. The analysis of the data was done using SPSS 23. Chi-square/exact Fisher's tests were performed to examine the gender distribution, results, respondents, and recurrence rate between the two groups with a p-value of less than 0.05. Results: Patients in group A had an average age of 29.2 +/-3.8 years, whereas those in group B had an average age of 30.0 +/-2.1 years. There was no discernible difference in the mean age of the patients between the two groups, according to an independent sample t test (p = 0.178). The gender distribution between the two groups is not significantly different, according to the p-value of 0.857. The p-value of 0.115 shows that there was no discernible difference in the two groups' rates of remission. The p-value of 0.188 shows that the two groups' recurrence rates did not differ significantly from one another. Practical Implication: This study helped researchers investigate the efficacy of intra-lesional triamcinolone acetonide as a treatment for localized alopecia areata due to its accessibility and safety. Second, it added to the corpus of information in the field regarding alternative, successful treatment options that are comparable. Conclusion: It was determined that there was no statistically significant difference between the outcomes for the Triamcinolone group and the Methotrexate group. Keywords: Alopecia Areata, Efficacy, Intralesional Methotrexate, Triamcinolone Acetonide and Clinical Outcomes.

An overview of the role of carboxytherapy in dermatology.

Carboxytherapy is defined as intradermal and/or subcutaneous microinjections of sterile purified carbon dioxide into different parts of the body for therapeutic aims. The vasodilatation effect and intradermal collagen reorganization associated with carboxytherapy have advantages for aesthetic dermatology and cosmetology. In the current article, we have reviewed some of the most important indications of this modality in dermatology and aesthetic dermatology. Our review is a narrative one which has gathered some of the most important indications of carboxytherapy in dermatology and cosmetology. Carboxytherapy has successfully been applied for some dermatologic and cosmetic conditions among which skin aging, cellulite, localized fat deposits, striae distensae, infraorbital hyperpigmentation, scar, lymphedema, androgenetic alopecia, alopecia areata, psoriasis, morphea, and vitiligo are the most important. Carboxytherapy can be considered as a safe, minimally-invasive modality used for rejuvenation, restoration, and recondition of the skin.

Clinical and Pathological Evaluation of Hemp Seeds Oil Effectiveness in the Treatment of Alopecia Areata

Background: Alopecia areata is an inflammatory, autoimmune, non-scarring, common patchy, hair-loss condition. Many treatment lines are used to treat alopecia areata, but all are palliative. Alternative medicine, like aromatherapy is expected to promote hair growth, but they are still lacking the scientific basis. Hemp oil is one of the aromatherapies that comprises polyunsaturated fat in approximately 76% involving “essential fatty acids” mainly omega-6 fatty acids” and lesser amount of “omega-3 fatty acids.” Objective: The aim of this study was to evaluate hemp seed oil effect in the treatment of patients with alopecia areata. Materials and Methods: This was a clinical trial planned to evaluate the efficacy of hemp seed oil in 20 patients with localized alopecia areata for 2 months. Plant material is hemp oil extract, applied at night daily for 2 months. Regrowth of terminal hair was evaluated by clinically and by trichoscope examination to evaluate the pathologic changes response. The assessment was done at 0, 4, and 8 weeks of the treatment. Results: After 8 weeks of the treatment, the response was marked in five (25%) patients, moderate in eight (40%) patients, and mild in two (10%) patients. Five (25%) patients revealed no response. There was a significant increase in the response of patients who were under the marked improvement group between 4 and 8 weeks of treatment (P < 0.05). Conclusion: Hemp seed oil can be considered as a promising therapeutic agent for localized alopecia areata. Additional clinical trials are advised to adjust the dose and determine the period of time, which is required to obtain a better result.

Comparative study between topical methotrexate 1% gel and minoxidil 5% gel in the treatment of localized alopecia areata.

Alopecia areata (AA) is an autoimmune disease that results in non-scarring hair loss. Topical minoxidil 5% gel and methotrexate (MTX) 1% gel are important modalities used in the treatment of many dermatological diseases. We aimed to evaluate the efficacy of MTX 1% gel versus topical minoxidil 5% gel in the treatment of localized AA both clinically and dermoscopically. A total of 50 patients were randomly divided into two groups of 25 each; the first was treated with topical minoxidil 5% gel and the second was with MTX 1% gel. Dermoscopic and photographic pictures were used to follow up at baseline, 3, 6, and 12 weeks. By comparing the two therapies, we noticed that minoxidil has a statistically significant higher frequency of broken hair and black dots after 6 weeks than MTX. After 12 weeks, dermoscopic revealed that the minoxidil group had a lower frequency of vellus hair than the MTX group. Clinically after 6 weeks, minoxidil showed significantly more excellent improvement than MTX (16% vs. 0%), after 12 weeks, minoxidil and MTX showed excellent improvement (52% and 36%), respectively. There was no significant difference in side effects (erythema and itching) between the MTX and minoxidil groups. Both topical MTX 1% gel and topical minoxidil 5% gel had high efficacy in treating localized AA, with no significant differences between them as evaluated by clinical and dermoscopic examination.

The Efficacy of Azelaic Acid 20% Cream in the Treatment of Scalp Alopecia Areata

Introduction: Alopecia areata is a common, inflammatory, non-scarring type of hair loss that affects persons of both sexes and all age groups, with prevalence in the general population of approximately 0.1–0.2%. It is characterized by variable clinical presentations, ranging from single or multiple well-circumscribed patches of hair loss to extensive involvement with complete absence of body and scalp hair. Alopecia areata is an autoimmune disease of the hair follicle. Its pathogenesis is associated with loss of follicular immune privilege and T-cell mediated inflammatory response, leading to interruption of the hair growth cycle. The diagnosis of alopecia areata is usually based on clinical manifestations in addition to using severity of alopecia tool score. Currently, there is no treatment for alopecia areata approved by the US Food and Drugs Administration. However, several treatment modalities for alopecia areata have been introduced with variable outcomes. Although topical and systemic immunomodulators are the mainstay options, there is still a lack of high-quality randomized controlled trials supporting these treatment modalities. Topical Corticosteroids are considered the first-line therapy for patch-type alopecia areata. Azelaic acid is a dicarboxylic acid, derived from the fungus Pityrosporum ovale and is regarded as an effective topical therapy for patchy alopecia areata. Aim of study: The present study aims to measure the efficacy of topical azelaic acid cream 20% in the treatment of alopecia areata. Patients and Methods: The all 30 patients were collected from Erbil Dermatology Teaching Center. They were divided into two groups: group A includes fifteen patients on topical clobetasol propionate 0.05% cream; group B includes fifteen patients on topical azelaic acid 20% cream. Both treatment groups were followed up for period of around twelve weeks with monthly check up visits. Both drugs were applied topically once daily at night. Results: the comparison between the baseline and 12 weeks visits for each study group concerning severity of alopecia tool score shows that the mean of the score for both groups at 12 weeks visit is lower than that of baseline visit in a statistically significant way (group A, p=0.007, group B, p=0.036). Conclusions: This study showed that topical azelaic acid cream 20% has an acceptable efficacy in comparison to topical clobetasol ointment 0.05% in the treatment of localized alopecia areata of scalp and can be considered as a therapeutic option for this condition.

Efficacy of Topical Clobetasol Propionate 0.05% Ointment and Topical Tacrolimus 0.1% Ointment in Treatment of Alopecia Areata.: RCT

Background: Non-scarring hair loss from the scalp or body occurs as a result of alopecia areata. It is the most prevalent autoimmune disorder. Aims: To compare the efficacy of topical clobetasol propionate 0.05% ointment and topical tacrolimus 0.1% ointment in the management of localized alopecia areata. Study design: Randomized control trial. Methodology: All patients (n=116) having alopecia areata of the scalp were included. SALT Score was calculated at presentation. Group A received topical clobetasol propionate 0.05% ointment applied twice daily over the alopecia patch and group B received topical tacrolimus 0.1% twice daily for 3 months. Patients were followed in OPD at 1month, 2months and 3months interval to ensure compliance. All this information was recorded on Performa. Data was analyzed using SPSS version 26. Efficacy of both groups was compared using Chi square test and keeping P-value of ≤ 0.05 as significant. Results: As per efficacy, in Group A, 46 (79.31%) patients showed effective results whereas in Group B only 26 (44.82%) patients showed effective results with a significant P-value of 0.00013. Conclusion: It was concluded that topical clobetasol propionate 0.05% ointment was more effective as a treatment option in promoting hair re-growth among patients of alopecia areata. Keywords: Alopecia Areata, Tacrolimus, Clobetasol Propionate and Hair Re-growth

Intralesional methotrexate versus triamcinolone acetonide for localized alopecia areata treatment: A randomized clinical trial.

Multiple therapeutic modalities are available for alopecia areata (AA) but still a challenging disease with variable severity, recurrence, and a major cosmetic concern. Compare the effectiveness and safety of intralesional methotrexate (MTX) versus triamcinolone acetonide (TrA) in the treatment of localized AA in adults, both clinically and trichoscopically. 40 adult patients with localized AA were recruited and divided into two groups. 20 patients were treated by intralesional TrA and the other 20 patients were treated by intralesional MTX every 3weeks, for maximum four sessions. Clinical and trichoscopic evaluation at baseline, each session and for 3months after the last session was performed. At the end of sessions (12weeks), regrowth scale was significantly higher in TrA group compared to MTX group (p-value=0.028). But, after 3-month follow-up, regrowth scale was higher in MTX group compared to TrA group (p-value=0.153). A statistically significant reduction in AA specific trichoscopic signs after 12weeks and at the 3-month follow-up in both groups. Local adverse events in both groups were transient and disappeared during the follow-up period. Intralesional MTX in treatment of localized AA in adults can be promising and comparable to intralesional TrA with the need for further controlled and extensive trials. Trichoscopy can reveal early clinical response through disappearance of AA-specific trichoscopic signs and also early detection of adverse effects.

A randomized comparative study of the efficacy of topical latanoprost versus topical betamethasone diproprionate lotion in the treatment of localized alopecia areata.

Topical corticosteroids are the standard therapy for the treatment of alopecia areata. Recently, topical latanoprost has been found effective in the treatment of eyelash alopecia areata. The objective of this study was to compare the efficacy of topical latanoprost ophthalmic solution (group 1) with that of topical betamethasone diproprionate lotion (group 2) in the treatment of localized alopecia areata. This was a single-centre, randomized, two-armed, parallel-group efficacy trial. Fifty consecutive patients with localized alopecia areata were randomized in a 1:1 ratio to receive either topical latanoprost 0.005% ophthalmic solution or topical betamethasone diproprionate 0.05% lotion. Of these 50 patients, 44 patients (21 in group 1 and 23 in group 2) completed the treatment protocol. The percentage reduction in area involved with alopecia areata at 16 weeks (primary outcome) was lower in latanoprost vs. betamethasone group (median [interquartile range], 11.1 [0-99.1] vs. 100% [13.6-100], P = 0.02). Significantly lesser patients in the latanoprost group had a complete response to treatment as compared to the betamethasone group (6 [24%] vs. 14 [56%], P = 0.02). The median (interquartile range) hair regrowth score was significantly lower in the latanoprost vs. the betamethasone group (1 [0-4.5] vs. 5 [1-5], P = 0.02). Subjects in the betamethasone group showed a more rapid reduction in the involved area. Short duration of treatment and follow-up were limitations of this study. Our results suggest that topical latanoprost 0.005% ophthalmic solution is less effective but safer than topical betamethasone dipropionate 0.05% lotion in the treatment of localized alopecia areata (clinicaltrials.gov: NCT02350023).

Identification of novel step-up regimen of intralesional triamcinolone acetonide in scalp alopecia areata based on a double-blind randomized controlled trial.

Although intralesional triamcinolone acetonide (TA) is the most commonly prescribed treatment for localized alopecia areata (AA), the literature regarding the optimal concentration for attaining better efficacy with the most acceptable side effects is scarce. To compare hair regrowth and local side effects of various concentrations of intralesional TA in scalp AA using clinical and dermoscopic parameters. A double-blind randomized control trial with four treatment groups (10, 5, 2.5 mg/ml TA and normal saline [NS]) was conducted between March 2018 and August 2019. After recruitment, each AA patch was divided into quadrants and randomized before first injection. Injections were given and outcome parameters were analyzed every 4-weekly till 12-weeks. Statistical analysis was done by the R software employing generalized estimation equation. P-value <.05 was considered significant. Out of 105-patients (168-AA patches), 75-patients (121-patches) completed the study. Hair regrowth scale of all TA concentrations was better than NS group (P < .001). Other parameters such as quadrants with poor clinical response and dermoscopic disease activity signs were also favorable in TA groups in comparison to NS. However the evidence of atrophy and telangiectasia was maximum in 10 mg/mL group. 10 mg/mL TA showed a comparatively better response at the cost of increased adverse effects. Based on the clinical benefit and adverse risk assessment from our study, it may be better to start with 2.5 mg/mL intralesional TA in limited scalp AA patients. It can be implied that the concentration of TA can be increased as a step-up regimen based on the serial clinical and dermoscopic response.

Intralesional betamethasone versus triamcinolone acetonide in the treatment of localized alopecia areata: a within-patient randomized controlled trial

Background Betamethasone can be used for intralesional infiltration, but there is little evidence in the literature to indicate its effectiveness in alopecia areata. Objective To assess the safety and effectiveness of the use of different doses of intralesional betamethasone, when compared to triamcinolone acetonide for the treatment of alopecia areata. Methods We recruited 12 patients with alopecia patch divided into four quadrants. Each quadrant, after randomization, received an intralesional injection with one of the following treatments: triamcinolone acetonide 2.5 mg/ml, betamethasone 0.375 mg/ml, betamethasone 1.75 mg/ml, or 0.9% saline (placebo). The intervention was repeated in the same quadrant every 4 weeks, totaling 3 sessions. Visual and dermoscopic evaluation of the results were performed. Trial registration: ReBec RBR-5kyg2r. Results At 4 and 8 weeks of intervention, triamcinolone acetonide 2.5 mg/ml provided the best visual results. Nevertheless, at the end of the study, the best visual results were seen with both triamcinolone acetonide and betamethasone 1.75 mg/ml, with significant difference when compared to betamethasone 0.375 mg/ml and placebo (p=.0489 and <.0001, respectively). There was a progressive reduction in the number of dystrophic hairs in all quadrants. Conclusion Triamcinolone acetonide shows earlier results in repilation, but at 12 weeks betamethasone 1.75 mg/ml had similar results.

Trichloroacetic acid 35% as a therapeutic line for localized patchy alopecia areata in comparison with intralesional steroids: Clinical and trichoscopic evaluation.

Intralesional corticosteroids (ILCs) is the first-line therapy for patients older than 10 years having patchy alopecia areata, however some patients do not respond effectively. To evaluate the efficacy of a chemical peel trichloro acetic acid (TCA 35%) in comparison to ILCs. Twenty-two patients with two patches of alopecia areata were included. Two treatment modalities with ILCs and topical TCA 35% were performed in two randomly selected patches. Three sessions were done, 3 weeks apart and were followed-up for three months. Evaluation was done using Mac Donald Hull and Norris grading system and by counting trichoscopic parameters in each patch. Both ILCs and TCA 35% treated patches showed measurable improvement with no statistically significant difference between the results of the two modalities (p>0.05) at different times of the study. Yellow dots, black dots, exclamation marks and dystrophic hair were all reduced by 100%, 82.0%, 100% and 88.3% in ILCs treated patches and by 70.4%, 69.1%, 100% and 75.0% in TCA treated patches, respectively. Topical TCA 35% is an effective and safe treatment for the treatment of AA without serious side effects, despite the slower response when compared to ILCs.

Topical Minoxidil Alone and with Topical Lanoprost in Localized Alopecia Areata Treatment: Comparative Study (2019-2020)

Rationale: Therapeutic choicement for patients with alopacia was of limited success, no hundred percent cure rate, and no choice for absolute remission without recrudescence. Aim: Comparison of topical Lanoprost & Minoxidil versus topical Minoxidil only in treatment of localized alopecia areata. Methodology: Interventional-controlled single blinded study that was involving (95) alopecia areata patients. That extended from1st day of February 2019 to last week January 2020 In Al-Hussain teaching hospitals in Thi-Qar and Al-Muthana governorates., the patients crossly matched well and divided according to lines of treatment into two groups. ethical consent had been taken after full details explanation of research items and purpose. Results: Post interventional assessment of the response difference in terms significant statistical differences (p value=0.002, 0.0001) between the two groups. The SALT II when compared before and after treatment was decreasing in both groups but to a significantly better extent in group II Conclusions: The treatments with 5% minoxidil in a combination with 0.005% latanoprost or 5% minoxidil alone were found to be effective and a better result with minoxidil only. implemented combination in the managements of alopecia areata is of great benefit in reduction of size and duration of treatment.

Topical Minoxidil Alone and with Topical Lanoprost in Localized Alopecia Areata Treatment: Comparative Study (2019-2020)

Rationale: Therapeutic choicement for patients with alopacia was of limited success, no hundred percent cure rate, and no choice for absolute remission without recrudescence. Aim: Comparison of topical Lanoprost & Minoxidil versus topical Minoxidil only in treatment of localized alopecia areata. Methodology: Interventional-controlled single blinded study that was involving (95) alopecia areata patients. That extended from1st day of February 2019 to last week January 2020 In Al-Hussain teaching hospitals in Thi-Qar and Al-Muthana governorates., the patients crossly matched well and divided according to lines of treatment into two groups. ethical consent had been taken after full details explanation of research items and purpose. Results: Post interventional assessment of the response difference in terms significant statistical differences (p value=0.002, 0.0001) between the two groups. The SALT II when compared before and after treatment was decreasing in both groups but to a significantly better extent in group II Conclusions: The treatments with 5% minoxidil in a combination with 0.005% latanoprost or 5% minoxidil alone were found to be effective and a better result with minoxidil only. implemented combination in the managements of alopecia areata is of great benefit in reduction of size and duration of treatment.

Topical Minoxidil Alone and with Topical Lanoprost in Localized Alopecia Areata Treatment: Comparative Study (2019-2020)

This research was conducted due to the problem faced by the artisans, namely the underdevelopment of the batik industry which is one indication that the independence of the community in managing the batik business is still not in line with expectations. The object of this research is the competitiveness and independence of Indonesian batik artisans. Based on the problem and the object of the research, this research is included in the type of qualitative research, and the research strategy used in this study is a case study. The results of this research indicate that the model of community empowerment implemented empowers, enables and makes the community independent in developing themselves and the environment. Meanwhile, the increase in the independence of batik artisans in the utilization of organic waste to increase productivity and batik business income develops again and is able to compete.

Topical methotrexate 1% gel for the treatment of localized alopecia areata

Topical methotrexate 1% gel for the treatment of localized alopecia areata

A comparative study of the outcomes of potent topical steroids versus topical tretinoin in patchy alopecia areata of scalp

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Alopecia areata (AA) is a common condition causing patchy alopecia of scalp. It can follow an unpredictable course with spontaneous exacerbations and remissions. Various therapeutic options have been tried to alleviate the cosmetic concern of the patient. The objective of this study is to compare the efficacy and safety of potent topical steroid versus topical 0.05% tretinoin in limited patchy alopecia areata of scalp.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this study 50 patients of age group above 5 years and of both sexes having localized alopecia areata of scalp (&amp;lt;5 patches and &amp;lt;25% scalp involvement) were included in the study after taking an informed consent. It was a randomized prospective study done for a period of 12 weeks. Excluding the age and sex bias, patients were distributed into two treatment groups A and B. Group A was treated with 0.05% betamethasone dipropionate (BMD) cream applied twice daily. Group B was treated with topical 0.05% tretinoin cream applied twice daily. The response was assessed in every patient subjectively as well as objectively by alopecia grading scale and regrowth score (RGS) at the end of 12 weeks.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; We found that 72% of patients in Group A showed statistically significant clinical improvement (RGS 3 and 4) when compared to 36% patients in Group B.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It can be concluded that 0.05% BMD is still the most effective and economical topical treatment in less extensive forms of AA. However topical 0.05% tretinoin also gives a fairly good response. But further studies with tretinoin are needed to establish its role in limited alopecia areata.&lt;/p&gt;

Best dilution of the best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults

Purpose: To evaluate and compare the clinical efficacy, dermoscopic results and safety of triamcinolone acetonide (TA) and betamethasone dipropionate (BD) injections at different concentrations in localized scalp and beard alopecia.Methods: Intralesional injection of BD or TA in three different dilutions; 1/4, 1/8, 1/12 (BD1, BD2, BD3, TA1, TA2, TA3) and Saline (control) was randomly applied to a total of 231 alopecia patches in 83 patients every four weeks in a maximum of six sessions until a hair regrowth score of 4 was achieved. The number of required sessions, sixth-month hair regrowth scores, treatment success rates and dermoscopic data were investigated.Results: The mean number of required sessions were similar and significantly lower in BD1 and TA1 being 4.21 ± 1.12 and 3.74 ± 0.99, respectively. Dermoscopic examinations revealed similar terminal hair growth rations in Saline (30.3%), BD1 (44.4%) and TA1 (42.9%). However, sixth-month hair regrowth scores, overall treatment success rates and percentage of terminal hair regrowth were similar in BD1 and TA1. However, adverse effects were more common in TA groups (24.3%) than in BD groups (10.6%) at the sixth month.Conclusions: BD ¼ dilution (1.25 mg/dL) seems best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults.

Resistance of Transplanted Hair Follicles to the Onslaught of Diffuse Alopecia Areata

A 55-year-old man who previously underwent a successful hair transplantation for androgenetic alopecia now presents with rapid onset hair loss over the anterior to mid-scalp areas during a 2-month period. The alopecic area noticeably extended diffusely from anterior hairline to scalp vertex while rows of previously transplanted hair follicles appeared intact. Further dermoscopic features and a scalp biopsy were consistent with alopecia areata incognita. This patient was subsequently successfully treated with intralesional steroid injections. This case report is the first demonstrating the relative resistance of transplanted hair follicles to the process of alopecia areata when compared with local indigenous hairs. Prior to this, a few reports have demonstrated the use of hair transplantation to treat stable areas of alopecia areata resistant to medical treatment with mixed results but at least some initial success. This could be related to the local irritation and inflammatory response resultant from needling during hair transplantation that causes a degree of scarring and fibrosis around each transplanted graft, hence lending a protective barrier to an autoimmune-based T-lymphocyte attack on hair bulbs and subsequent increased survival of transplanted hair follicles. This unexpected observation provides new avenues for investigation into alopecia areata pathophysiology and further supports hair transplantation as a viable option for patients with stable, localized alopecia areata that is recalcitrant to other modalities.

Intralesional Triamcinolone Acetonide Versus Topical Betamethasone Valearate in the Management of Localized Alopecia Areata.

To compare the efficacy of intralesional triamcinolone and topical betamethasone in the management of localized alopecia areata. A randomized trial. Dermatology OPD, PNS Shifa Hospital, Karachi, from January to June 2013. Patients aged 18 - 50 years with localized alopecia areata were included in the study. Exclusion criteria were more than three patches and those on already steroid or immunosuppressive therapy. Patients were randomly allocated in two treatment groups: Group A received intralesional triamcinolone acetonide (10 mg/ml) and Group B received topical betamethasone valearate cream 0.1% twice daily. Final outcome was ascertained as re-growth of hair on 12th week of follow-up and labelled as efficacy. The data was entered and analyzed using SPSS version 11. Relevant descriptive statistics were calculated. Chi-square test was used to compare efficacy of hair re-growth in both groups. P-value < 0.05 was considered significant. A total of 226 patients were enrolled, 113 in each group. The mean age was 34.36 ± 8.7 years. One hundred and sixty-four (72.6%) were males and 62 (27.4%) were females with male to female ratio of 2.6:1. Hair re-growth was seen in 84 (74.3%) of the intralesional steroid group and in 53 (46.9%) of the topical betamethasone group (p < 0.001), which was a significant difference. Intralesional triamcinolone had a better efficacy in the treatment of localized alopecia areata as compared to topical betamethasone valearate.