Corticosteroid Injection Treatment for Alopecia Areata

Corticosteroid treatments are one of the most popular treatment methods for alopecia areata. Corticosteroid's can be applied to the affected area in many different ways. One way of corticosteroid application is through injection. Dermatologists often recommend injecting corticosteroids if a topical application of corticosteroids fails to bring about results.

The effect of corticosteroid injection

Corticosteroid treatments can be applied in a number of different manners. Each method of application, be it injection, oral, or topical, has different levels of success and potency. Locally injected doses of corticosteroids are the most effective method. Injecting doses locally can suppress local autoimmune reactions that coincide with alopecia areata. Suppressing the local immune reaction allows for hair follicles to resume their normal growth cycle. In addition the cortisone removes confused immune cells further allowing hair to grow. The effect of corticosteroids works to temporarily encourage hair growth. If the patient abruptly stops using this treatment, there could be a chance that a relapse in the original condition can occur.

There are two main types of corticosteroid injections. Each with a different level of potency and side effects.

Application of treatment

The corticosteroid injection is applied locally into the bald patch(s) or into the muscle for systemic treatment. The concentration of the steroid in the injection is often low, and can be gradually increased with subsequent applications of the corticosteroid injection. The exact dose of the treatment is determined by the patient’s age, health, and the severity of the disease. Typical systemic corticosteroid doses can range from a low 5mg to 20mg a session. Doses between 20mg and 30mg a session are considered to be extremely high doses. For local injections, typical doses start at 0.1ml of triamcinolone acetomide and incrementally rise with every subsequent treatment

The corticosteroid injections are administered by a medical professional. One single injection to several injections can be applied, per session, depending on the severity of the hair loss and the pain tolerance of the patient in receiving treatment. The injections are spread out, typically about 1cm apart. Treatment sessions are repeated every 4 - 6 weeks, and gradually tapered off as results start to surface.

Results of treatment

This form of treatment works best when treating small to medium sized patches. Larger amounts of hair loss typically won’t benefit from this treatment. One study conducted corticosteroid treatments using triamcinolone acetonide. The study treated patients over a span of 6 months with those who have hair loss affecting less than 50% of their scalp. The study concluded that about 60% of the patients responded positively to the treatment. Most published studies do indicate that the majority of cases of alopecia areata can be treated with locally injected corticosteroids. Studies also point out that this treatment is not as effective for patients who have suffered greater than 50% scalp hair loss and those who have been living with the diagnosis for 2 or more years.

The success rate of the systemic corticosteroid injections varies a little more than Intralesionally treated injections. There is a lack of data to decisively predict the success rate of systemic corticosteroid injections. But it is generally accepted that the systemic treatment and local treatments both share similar properties in results. The majority of those who have benefited from systemic steroid injections have been those with less than 50% scalp hair lost and where the disease is less than 2 years old. There is however some studies that do indicate that the oral systemic corticosteroid treatment works better than the injection, for people whom a systemic treatment option for alopecia areata is more practical.

Initial signs of hair growth can occur within 1- 3 months. The hair can initially grow back discolored and in fuzzy patches. But the re-growing hair will turn back to its normal color and density eventually, usually within 6 months.

Side effects

The most obvious side effect of injecting corticosteroids is pain. Perhaps less than a side effect, pain is just part of the process of receiving this treatment. Other side effects depend on the dose and frequency of the treatment. Some possible side effects include slight discoloration of the skin or sometimes even tissue damage to the skin.

Systemic steroid injection treatments are more prone to side effects because of the widespread coverage that a systemic application of corticosteroids results in. The side effects of systemic corticosteroid injections can be serious if the treatment was administered incorrectly. The side effects can become serious if the concentration of steroids is too much and the treatment is applied too frequently, resulting in the steroid being absorbed by the wrong target. For example too much of a concentration could enter the blood stream or be absorbed into various bodily organs which could lead to other side effects.

Conclusion

Corticosteroid injections are the most widely used form of treatment for alopecia areata and one of the most effective. Using corticosteroids is best for those who simply want to fill in their bald patches caused by alopecia areata. As this treatment option does alleviate alopecia areata related symptoms it does not address the root problems causing it.

Locally injecting corticosteroids have been found to be the most successful treatment option. Small to medium sized matches are best treated by local steroid injections. Especially in cases where the patient’s alopecia is less than 2 years old and where the condition affects less than 50% of the scalp. As long as the treatment is applied by a medical professional and the doses and frequency of the steroid are controlled, side effects can be limited. It is best to consult your doctor or dermatologist when seeking corticosteroid treatments.