Comparative Efficacy of Intralesional Steroid Injections vs Cryotherapy for the Treatment of Alopecia Areata.

INTRODUCTION: The precise etiology of alopecia areata (AA) remains unclear. Various treatments, including corticosteroids, minoxidil, immunotherapy, and phototherapy, have shown varying efficacy. Injectable corticosteroids, despite being invasive, are the first-line treatment, while topical steroids are also commonly used. OBJECTIVE: To compare the efficacy of intralesional steroid (triamcinolone acetate) versus cryotherapy for the treatment of alopecia areata over a 6-month period in the Department of Dermatology at the Pakistan Atomic Energy Commission General Hospital. METHODS: The study included 118 patients (aged 15 to 50 years, both genders) with a single patch of alopecia areata on the scalp. Exclusion criteria included active secondary infections, cold intolerance, multiple patches, iatrogenic or primary immunosuppression, pregnancy, or breastfeeding. Patients were randomly assigned to two groups: Group A received intralesional steroid injections, and Group B underwent cryotherapy with liquid nitrogen. Treatment efficacy was then evaluated. RESULTS: The mean age was 27.78 +/- 4.68 years in Group A and 26.63 +/- 4.91 years in Group B. Most patients (95, 80.51%) were aged 15 to 30 years. Males predominated with 86 (72.27%) participants, resulting in a male-to-female ratio of 2.6:1. The mean duration of alopecia areata was similar in Group A (8.51 +/- 3.94 months) and Group B (8.39 +/- 3.13 months). Group A (intralesional corticosteroids) had a significantly higher efficacy rate, with 49 patients (83.05%) responding positively, compared to 30 patients (50.85%) in Group B (cryotherapy) (P=0.0001), as shown in Table 1. CONCLUSION: The study concluded that the efficacy of intralesional steroids may be superior to cryotherapy for the treatment of alopecia areata. J Drugs Dermatol. 2025;24(3):294-297. doi:10.36849/JDD.8499.