Comparative Study Between Ablative Fractional Carbon Dioxide Laser Combined with Topical Steroid Versus Topical Steroid in Treatment of Alopecia Areata

Background: Alopecia areata is a common disease that affects the psychological well-being of the affected individuals. No single treatment option is proved to be effective and safe in its management. Laser-assisted drug delivery is a new method for the management of different dermatological diseases. fractional laser could can act by inducing T cell apoptosis, increasing blood flow and promoting telogen to anagen transitions.Objective: To evaluate the effectiveness of fractional carbon dioxide laser-assisted topical steroid delivery in the management of alopecia areata.Patients and methods: A total of 20 patients with (108 patches) of alopecia areata with two or more nonadjacent patches are included , all patients were given clobetasol propionate 0.05% cream twice daily on all patches then the patches on the same patient are categorized into two groups, group A treated with fractional carbon dioxide laser in addition to clobetasol propionate 0.05% cream and the group B treated with clobetasol propionate 0.05% cream alone. Assessment was done by MacDonald Hull and Norris grading. A total of four sessions were done at 2 weeks interval (baseline, 2nd week visit, 4th week visit, 6th week visit) then patients were seen after 2 weeks (8 weeks) and after 2 months (16week) from the last session for follow up.Results: There is significant statistical difference observed between both groups. Group A had better treatment outcome as compared to Group B during all treatment intervals. Furthermore duration comparison during follow-up period from the last session to two months, showed a significant result obtained regarding Group A . Conclusion: Fractional CO2 laser is a an effective treatment modality for localized alopecia areata when used in combination with clobetasole propionate 0.05% cream. It was found superior to clobetasole propionate 0.05% cream monotherapy.