Is Intralesional Methotrexate an Effective Alternative to Intralesional Triamcinolone in Alopecia Areata? Findings From a Randomized Controlled Trial

This randomized controlled trial involving 40 participants compared the effectiveness of intralesional methotrexate (MTX) and triamcinolone acetonide (TrA) in treating alopecia areata (AA). The study found that TrA significantly reduced the Severity of Alopecia Tool (SALT) score by an average of 54.36%, indicating effective hair regrowth, while MTX showed an average increase in SALT score, suggesting less effectiveness. Patients reported higher satisfaction with TrA, and adverse effects were minimal and similar between the groups. The findings suggest that TrA should remain a first-line treatment for limited patchy AA due to its greater efficacy and patient satisfaction, while MTX may be considered for combination therapies. Further research with larger sample sizes is needed to better understand MTX's efficacy in AA treatment.