How Effective Is Intralesional Injection of Triamcinolone Acetonide Compared with Topical Treatments in Inducing and Maintaining Hair Growth in Patients with Alopecia Areata? A Critically Appraised Topic

The document critically appraised the effectiveness of intralesional triamcinolone acetonide (ITA) compared to topical treatments for alopecia areata (AA) by reviewing 12 studies, including controlled clinical trials and cohort studies. It found that ITA could induce hair regrowth, particularly in patchy AA, but the response was often temporary with higher relapse rates and adverse effects like skin atrophy. Methodological flaws such as lack of randomization and blinding, small sample sizes, and lack of control groups weakened the evidence. Adverse effects were noted in up to 24% of cases. The document concluded that more rigorous research, including a large, multicenter randomized controlled trial (RCT), was needed to establish ITA's efficacy and safety.