Fractional Carbon Dioxide Laser in Combination with Topical Corticosteroid Application in Resistant Alopecia Areata: A Case Series

Imran Majid, Shazia Jeelani, Saher Imran, Imran Majid, Shazia Jeelani, Saher Imran

Abstract

Introduction: Intradermal steroid injections are used as treatment option in resistant alopecia areata. However, it is difficult and quite painful to treat large areas of alopecia with this modality.

Objective: To assess the efficacy and safety profile of a combination of fractional carbon dioxide (CO2) treatment followed by topical corticosteroid application in resistant alopecia areata.

Materials and methods: Ten cases of resistant alopecia areata who had not responded to multiple treatment modalities were treated with fractional CO2 laser followed by topical application of triamcinolone spray (10mg/mL) on the resistant lesions. Patients received 4-8 sessions that were repeated at an interval of 3-4 weeks. Response to treatment was assessed on a quartile physician assessment scale and labeled as excellent (>75% regrowth), good (50%-75% regrowth), fair (26%-50% response), and poor (<25% regrowth).

Results: Eight of these ten cases completed the treatment process. Seven of these eight patients had complete recovery of the area treated. One patient however did not show good response even after four sessions. No significant adverse effects were noted in any of the patients.

Conclusion: Fractional CO2 laser in combination with topical triamcinolone can prove to be an effective treatment option in resistant alopecia areata.

Keywords: Alopecia areata; fractional laser; fractional laser–assisted drug delivery; resistant alopecia; triamcinolone.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Resistant alopecia subtotalis in a 25-year-old female. (B) Response to five sessions of fractional laser with triamcinolone spray
Figure 2
Figure 2
(A) Same patient as in Figure 1 on the right side. (B) Response after treatment with fractional laser and triamcinolone spray
Figure 3
Figure 3
(A) Resistant alopecia areata in an 11-year-old female (Patient number 7). (B) Excellent response after treatment with fractional laser and steroid combination

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Source: PubMed

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