Fractional Carbon Dioxide Laser versus Cryotherapy in the Treatment of Alopecia Areata: A Pilot Comparative Study

Abstract Alopecia areata, one or more round bald patches appear suddenly, most often on the scalp. It can affect males and females at any age. The exact mechanism is not yet understood and there is not yet any reliable cure for alopecia areata. Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Superficial cryotheray is introduced as a possible treatment for Alopecia Areata with minimal side effects and being less painful. In addition, fractional CO2 laser is introduced as a effective option in AA treatment. Aim of the Study the current study aimed to assess the efficacy and safety of FCO2 laser in comparison to cryotherapy in the treatment of AA. Patients and Methods this study included 22 patients (with patchy AA (at least three patches) of both sexes. Patients were subjected to full history taking, complete general and dermatological examination then digital photography and dermoscopic examination were performed. The three patches in each patient were divided according to therapy used; one patch was treated with Fractional CO2 laser, second one was treated with superficial cryotherapy and the third was left without treatment as control. Results Regarding FCO2 laser treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. In addition, SVHs count showed significant increase after treatment compared to before treatment. Concerning cryotherapy treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. Also, there was as increase in the TH and SVHs count after treatment in comparison to before treatment, but the results were statistically insignificant. Conclusion Both cryotherapy and fractional CO2 laser therapy are safe and effective modalities in the treatment of AA with superiority for FCO2 laser.