Superficial Cryotherapy versus Intralesional Corticosteroids Injection in Alopecia Areata: A Trichoscopic Comparative Study.

BACKGROUND

Alopecia areata (AA) is an autoimmune disease leading to noncicatricial alopecia. Topical or intralesional corticosteroid (ILCS) is the accepted therapeutic option for mild cases; however, adverse effects are sometimes difficult to reverse. When the exposure to liquefied nitrogen is limited to a few seconds "superficial" cryotherapy, reactive vasodilation may improve microcirculation and nutritional status around hair follicles.

OBJECTIVE

This study aimed to evaluate and compare superficial cryotherapy and ILCS in the treatment of patchy AA.

MATERIALS AND

METHODS

This prospective comparative study included 21 patients with patchy AA. Every patient received superficial cryotherapy on one patch, every 2 weeks for 3 months, and ILCS injection for another patch, once monthly for 3 months.

RESULTS

Clinical improvement was higher in cryotherapy group compared to ILCS group with a statistically significant difference (P = 0.002). On trichoscopic evaluation, terminal hair count was improved in lesions treated with cryotherapy more than lesions treated with ILCS but without statistical significance (P = 0.595) and vellus hair count was improved in lesions treated with cryotherapy more than lesions treated with ILCS with a statistical significance (P = 0.002).

CONCLUSIONS

Cryotherapy is more effective and less painful than ILCS in the treatment of patchy AA.