Successful Response to a Combination of Intralesional Methotrexate and Fractional CO2 Laser in Refractory Alopecia Areata: Case Report

The document presents a case report on the successful treatment of two patients with refractory alopecia areata (AA) using a combination of intralesional methotrexate (IL-MTX) and ablative fractional CO₂ laser (AFCO₂L). Both patients, a 38-year-old woman and an 18-year-old patient, experienced complete hair regrowth after failing to respond to other treatments. The treatment involved 15 mg of IL-MTX every 2-3 weeks, preceded by AFCO₂L, and showed a synergistic effect without increasing adverse events. The study highlights the potential of this combination therapy in treating AA but notes the need for further research due to the small sample size and lack of long-term follow-up. The authors also mention that the use of systemic corticosteroids could have influenced the results, and they call for more studies to determine the optimal dosing and frequency of IL-MTX. The research was ethically conducted, with patient consent, and no conflicts of interest were reported.