Intralesional Corticosteroid Versus Intralesional Corticosteroid and Cryotherapy in Alopecia Areata: A Randomised Split Scalp Study

Abstract Introduction: Alopecia areata (AA) is the common form of non-scarring alopecia. Despite a wide array of treatment options available, the opinion regarding the efficacy of a treatment is highly variable. We propose this study, using two different treatment modalities in the same patient of AA, one of which is an established treatment option being used, since years whereas the other one is a much newer technique for AA; comparing the two in search for a better and faster treatment option. Methodology: It is double arm, RCT. All AA patients ≥18 years of age with ≥2 patches were included. Immunocompromised, pregnant females, and patients, who are contraindicated for cryotherapy such as having cold intolerance, vasculitis, and so on. were excluded. Intralesional triamcinolone injected to all AA patches. Additionally, cryotherapy (liquid nitrogen) given on one AA patch. Results: Total ( n = 62) patients were included (61.3% M 38.7% F). Although the combined therapy vs isolated therapy showed good early response (first visit) in the terms of reduction of cadaveric hair and appearance of vellus hair but no statistically significant difference in reduction of yellow dots in both patches over the course of treatment. In terms of clinical response (MISP) for the study population, were elevated showing a greater number of excellent responses (50.00%) in the combined therapy patch being statistically significant with a P < 0.001. Conclusion: Superficial cryotherapy is also an effective and safe therapeutic modality for AA with advantages of simplicity and non-invasiveness.