Evaluation of Effectiveness of Bio-Micro Injection in Treating Alopecia Universalis: A Non-Randomized Interventional Study

Background: Alopecia areata (AA) is an autoimmune disorder causing non-scarring hair loss, ranging from patchy baldness to total body hair loss. While mesotherapy has shown potential as a localized therapy, its efficacy in AU remains understudied. This study aims to assess the therapeutic impact of mesotherapy in a substantial cohort of 2,000 patients diagnosed with alopecia universalis at Dr. Shirzad Clinic between 2020 and 2024. Methods and Materials: We conducted a non-randomized interventional study on 2,000 alopecia universalis patients across four treatment groups. Participants were divided into four treatment groups: one group received BMI alone, another received a combination of BMI and JAK inhibitors, the third group received only JAK inhibitors, and the fourth group was treated with a combination of BMI, JAK inhibitors, and adalimumab. All of these drugs were administered through mesotherapy techniques. They received the treatment once a month, for a year. Outcomes, including scalp hair regrowth and patient satisfaction, were assessed monthly over a year. Results: A total of 2000 patients participated in this study, with an average age of 26.82 ±1.84 years. Treatment responses varied across groups, with children showing the highest success rates. In Group 1 (BMI only), 20% responded positively. Group 2 (BMI + JAK inhibitors) had a 30% had favorable outcomes. Group 3 (JAK inhibitors only) showed a 34% response rate. The combination treatment in Group 4 resulted in the highest success rate, with 42% of participants responding positively. Conclusion: This study highlights the unique contribution of mesotherapy, particularly when combined with systemic treatments such as BMI, JAK inhibitors, and adalimumab, as an effective and well-tolerated option for alopecia universalis. The large sample size and innovative application of mesotherapy enhance drug delivery, improve treatment outcomes, and reduce systemic side effects, underscoring its potential as a valuable treatment strategy for this challenging condition.