Reply to Dr. Greenwald: Treating Alopecia Areata with Intralesional Injections and Topical Minoxidil

In a letter to the editor, Dr. Jim Baral detailed his experience treating a 2½-year-old girl with alopecia areata using a combination of intralesional injections of 2.5% triamcinolone acetonide, betamethasone dipropionate ointment, and 3% minoxidil applied topically twice a day. Over the course of several visits from April to August 1986, the patient showed hair regrowth in the affected areas as well as unexpected hair growth on the forehead, nape of the neck, and sacroiliac area, with the latter exhibiting a tail-like effect. Dr. Baral also mentioned similar experiences with other patients, including identical twins and a male patient, who developed hair growth in non-scalp areas after using topical minoxidil. He noted that 3% minoxidil is made from 180 tablets dissolved in 70% propylene glycol and 30% alcohol. Dr. Baral's observations suggest that remote hair growth from topical minoxidil application is not unusual in his experience.