Intralesional Injection of Triamcinolone Acetonide, Methotrexate, and Vitamin D in Treatment of Alopecia Areata: A Narrative Review

The narrative review concludes that intralesional methotrexate (MTX) and vitamin D3 are potentially more effective and safer alternatives to triamcinolone acetonide (TrA) for treating localized alopecia areata (AA) in adults. Both treatments showed significant hair regrowth and reduction in AA-specific trichoscopic characteristics, with generally mild and manageable side effects. Specifically, 60% of patients experienced minor discomfort during injections, 33.3% in the vitamin D3 group and 43.2% in the control group had pinpoint bleeding, and 13.3% of the vitamin D3 group had vasovagal episodes.