Efficacy of Trichloroacetic Acid in Patients with Alopecia Areata: A Clinico-Histopathological Study

The study involved 40 patients with alopecia areata who were treated with 35% trichloroacetic acid (TCA) over three sessions. The results indicated that 75% of patients showed improvement, with 20% achieving a complete response, 15% a good response, and 10% an excellent response. The treatment was found to be more effective in patients with active alopecia, with a 100% response rate in 14 patients, compared to a 61.5% response rate in 16 patients without active alopecia. Clinical, trichoscopic, and histopathological examinations showed a reduction in lymphocytic infiltrates, an increase in the number of hair follicles, and no significant adverse changes in skin structures. Despite the study's limitations, including a small sample size and short follow-up, TCA was deemed a safe and effective treatment for alopecia areata, suitable for children and for treating large areas of the scalp, including alopecia totalis.