Intralesional Botulinum Toxin A Injection for Recalcitrant Alopecia Totalis and Alopecia Universalis: A Randomized, Double-Blind, Placebo-Controlled Trial

The study investigated the efficacy of botulinum toxin type A (BT) in treating recalcitrant alopecia totalis (AT) and alopecia universalis (AU) in 20 patients. Each patient's scalp was divided, with one half receiving BT injections and the other half receiving saline. Clinical assessments were conducted over 4 months using the Severity of Alopecia Tool (SALT) score, scalp mapping, and photography. The results showed no clinical improvement in either AT or AU with BT treatment. The conclusion indicated that while BT may improve cephalalgia alopecia areata, it did not show efficacy for recalcitrant AT or AU, suggesting the need for further research to understand these differing outcomes.