Microneedling with topical platelet-rich plasma versus triamcinolone acetonide for the treatment of alopecia areata in children: a comparative study.

BACKGROUND

Alopecia areata (AA) is a common autoimmune, non-scarring hair loss disorder that presents without visible inflammation, and can substantially affect children and their families.

AIMS: To compare the efficacy and tolerability of microneedling-assisted topical platelet-rich plasma (PRP) versus microneedling-assisted topical triamcinolone acetonide in children with localized alopecia areata.

METHODS

This prospective comparative study included 30 children with localized AA. Participants were allocated into two equal groups using an alternate allocation method. Group I (n = 15) received microneedling with topical PRP, whereas Group II (n = 15) received microneedling with topical triamcinolone acetonide.

RESULTS

Baseline index patch size (p = 0.841) and SALT (Severity of Alopecia Tool) scores (p = 0.08) did not differ significantly between groups. At week 12, Group II had a significantly lower mean SALT score than Group I (1.73 vs. 3.10; p = 0.042) and a greater mean percentage improvement in SALT score (66.4% vs. 18.5%; p < 0.001). Within-group analysis showed significant improvement in both groups (both p < 0.001). Patient satisfaction was significantly higher in Group II (Mann-Whitney U = 39.0, p = 0.002). Both treatments were well tolerated, with no major adverse events.

CONCLUSIONS

Microneedling-assisted topical triamcinolone acetonide produced greater short-term improvement in SALT scores and patient satisfaction than PRP in children with localized AA. These findings support it as an effective and well-tolerated therapeutic option; however, larger randomized controlled studies with longer follow-up are needed to confirm comparative efficacy and long-term outcomes.