Title : A new combination treatment of scalp alopecia areata
Background: As no. of new patients of Alopecia Areata (AA) is on an increase during last few years. Different regimens in practice are : local irritants like capsicum lotion & others, topical steroids, oral immuno suppressants, oral & injectable steroids. Hair regrowth results are variable, either uniform or like bushes. Recurrence is very common. My paper aims to present a study of a relatively new combination procedure to treat AA. In our study we combined.
Microdermabrasion (MD) with intra lesional steroids (ILST) and compared it with (ILST) alone. A side study of MD alone also done in young children and diabetics with good regrowth in AA.
Methods: This is a study of 50 patients (25 patients with combination of MD+ILST & 25 patients with alone ILST . The study period started 4 years before and continued to-date.
Each patient had 6 sessions with an interval of 1 5 days. Pre and post treatment photos taken. 0.02cc ILST given to about 2 inch square area of AA on scalp. Double layer MD (horizontal + vertical) done with high negative pressure crystal abrasion. This removed sebum plugs from mouth of follicular openings, stimulated hair growth by strong irritation, pulling hair roots vertical, and helped for uniform distribution of ILST.
Criteria: Patients of 5-50 years of age, both sexes, with only non-scarring alopecia included. Patients with unhealthy skin of scalp due to eczema, fungus or other infections and scarring alopecia excluded.
Results: With this combination treatment (MD+ILST), the regrowth of hair is fast, full and very uniform. With alone ILST, The growth is slower, less uniform and like bushes distributed with areas of no-grow.
MD alone also effective but the hair growth is less uniform, slower than the combination treatment but can be useful for young children and diabetics. Hair growth usually obvious after third session. Usually enough growth in 4-5 sessions.
Recurrence rate is approximately 30%. 40% of these patients had recurrence after 4-6 months of stopping treatment. Another 40% of these had recurrence after 6-12 months. About 10% of these had some recurrence every 1-2 years during last 4 years and another 10% of them recovered partially and did not recover on all patches.