Identification of Novel Step-Up Regimen of Intralesional Triamcinolone Acetonide in Scalp Alopecia Areata Based on a Double-Blind Randomized Controlled Trial

The study investigated the optimal concentration of intralesional triamcinolone acetonide (TA) for treating localized alopecia areata (AA) on the scalp. Conducted as a double-blind randomized controlled trial with 105 patients (168 AA patches), the trial compared hair regrowth and side effects across four groups: 10, 5, 2.5 mg/mL TA, and normal saline (NS). Results showed that all TA concentrations led to better hair regrowth than NS (P < .001). However, the 10 mg/mL group had the highest incidence of atrophy and telangiectasia. The study concluded that starting with 2.5 mg/mL TA is advisable for limited scalp AA, with the option to increase the concentration based on clinical and dermoscopic responses.