Therapeutic Effect of Superficial Cryotherapy on Alopecia Areata: A Prospective, Split-scalp Study in Patients with Multiple Alopecia Patches

BACKGROUND: Alopecia areata (AA) affects anagen hair follicles resulting in non-scarring hair loss. Since its introduction, superficial cryotherapy has been used as one of the meaningful treatment modalities for AA. OBJECTIVE: The purpose of this study is to clarify the therapeutic efficacy and safety of superficial cryotherapy for treatment of AA. METHODS: In 19 patients with multiple bilateral AA patches on their scalp, superficial cryotherapy was performed on the right side, every 2 weeks. Prednicarbate 0.25% solution was applied twice a day to both the treated and the control sides. Clinical improvement was estimated using the Severity of Alopecia Tool (SALT) score by 3 different dermatologists, along with the changes in terminal and vellus hair count and hair thickness analyzed by phototrichogram. RESULTS: After 4 months of treatment, mean terminal hair count on the right scalp was 1.6-fold increased (p=0.005), while mean terminal hair count on the left scalp showed no significant change (110.1% increase, p=0.285). Mean SALT score decrease on the right was 4-fold greater than that on the left (40.7% and 9.6%), without statistical significance (p=0.282). Mean vellus hair count and mean hair thickness did not show significant changes after superficial cryotherapy. No remarkable adverse event was observed. CONCLUSION: Superficial cryotherapy is an efficacious treatment modality with advantages of simplicity and noninvasiveness. It can be considered as a meaningful therapeutic modality for AA, especially when the disease status is limited to minimal to mild, or the conventional AA treatment is not applicable.

A Retrospective Study of the Effect of Superficial Cryotherapy on Alopecia Areata / 대한피부과학회지

BACKGROUND: There are some reports that superficial cryotherapy of alopecia areata could be an effective mode of treatment with many advantages. OBJECTIVE: We retrospectively evaluated the efficacy and side effects of superficial cryotherapy in patients with alopecia areata. METHODS: We retrospectively reviewed the clinical records of 153 patients with alopecia areata, who had been treated with superficial cryotherapy for more than 4 weeks, during the twelve years since 1993. We then evaluated the efficacy of superficial cryotherapy and its relationship with various clinical factors and side effects. Superficial cryotherapy using liquid nitrogen spray for 2~3 seconds was applied to the alopecic patches, and repeated three or four times per session. Positive therapeutic response was defined as the regrowth of terminal hairs. RESULTS: The results are summarized as follows: Positive therapeutic responses were noted in 105 (68.6%) of 153 patients reviewed. Patients who responded, vellus hair appeared within 4 weeks of treatment, terminal hair within 7 weeks, and a marked recovery was achieved within 12 weeks. A relatively good response rate was obtained in those patients who had less than 4 weeks of treatment, and the area of treatment was less than one fourth of the total scalp area, or less than two alopecic patches. On the other hand, those over 50 years of age and with more than 3 weeks of treatment interval seemed to have a relatively poor response rate. Other factors were not significant. There were no significant side effects, except slight pain, swelling and erythema. CONCLUSION: Superficial cryotherapy in patients with alopecia areata can be an effective treatment modality. It is a simple and convenient method, and has relatively good therapeutic response with less side effects. Therefore, we propose the superficial cryotherapy as a first-line treatment for patients with a milder form of alopecia areata, especially in children who are vulnerable to therapeutic side effects and pain.

Superficial Cryotherapy of Alopecia Areata in Eyebrows / 대한피부과학회지

Alopecia areata is a common skin disease with diverse modalities of therapy. The eyebrows are one of the target sites of alopecia areata and may be the only affected site. We report our recent experiences of superficial cryotherapy with liquid nitrogen to promote eyebrow hair growth due to alopecia areata. According to our results, superficial cryotherapy of alopecia areata in eyebrows can be an effective mode of treatment.