A Comparative Clinical and Trichoscopic Study Between Fractional Radiofrequency Microneedling Versus Intralesional Steroids in Treatment of Alopecia Areata.

Background: Alopecia areata (AA) is a common autoimmune disorder with significant psychosocial burden. Intralesional corticosteroid (ILCS) injection is considered the main line of management. More tolerable treatment methods with less side effects are needed. Fractional radiofrequency microneedling (FRM) can be used in the treatment of hair disorders. It was reported to stimulate hair regrowth in patients with androgenic alopecia.

Objective: To evaluate the efficacy and safety of FRM compared to ILCS as a potential therapeutic agent in AA.

Methods: Twenty-four patients with multifocal patchy AA were recruited. In each patient, 3 patches were randomly assigned to 3 different treatment modalities; FRM, ILCS, and control patches not subjected to any treatment. Six sessions were done with 3-week intervals. Comparative assessment was conducted utilizing trichoscopic scaled scores of dystrophic and terminal hairs, Severity of Alopecia Tool score, physician global assessment (PGA) score, as well as the global patients' satisfaction score.

Results: Both treatment modalities showed comparable efficacy demonstrated by the nonsignificant difference in trichoscopic scaled scores of dystrophic and terminal hairs, nor in PGA and patients' satisfaction scores.

Conclusion: Fractional radiofrequency (RF) microneedling could be one of the effective and safe treatment modalities in patchy AA. It is a good alternative to ILCS with less side effects.