A RANDOMIZED COMPARATIVE STUDY OF INTRALESIONAL INJECTION VERSUS MICRONEEDLING- ASSISTED DELIVERY OF PLATELET RICH PLASMA AND TRIAMCINOLONE ACETONIDE IN ALOPECIA AREATA OF THE SCALP

Abstract

Background Alopecia Areata is a chronic autoimmune disorder characterized by non-scarring hair loss with significant psychological impact. Intralesional corticosteroids remain the standard therapy for localized disease, while regenerative modalities such as Platelet-Rich Plasma and microneedling have recently gained attention. Aim To compare the efficacy and safety of intralesional injection versus microneedling-assisted delivery of platelet-rich plasma and Triamcinolone Acetonide in scalp alopecia areata. Materials and Methods This randomized comparative interventional study included 30 patients with scalp alopecia areata who were equally allocated into two groups. Group A received intralesional injections of PRP with triamcinolone acetonide, while Group B underwent microneedling-assisted delivery of PRP with triamcinolone acetonide. Four treatment sessions were administered at 3-week intervals. Clinical response was assessed using Severity of Alopecia Tool (SALT) score, hair regrowth assessment, patient satisfaction score, and adverse effects. Statistical analysis was performed using SPSS version 26. Results Both groups showed significant improvement in SALT scores after treatment. The mean SALT score in Group A reduced from 18.6 ± 6.4 to 6.8 ± 3.7, while in Group B it reduced from 19.1 ± 5.9 to 8.9 ± 4.2 at 12 weeks. Excellent hair regrowth (>75%) was observed in 60% of patients in Group A and 46.7% in Group B. Procedural pain was significantly lower in the microneedling group (VAS 3.9 ± 1.3) compared to the intralesional group (VAS 6.7 ± 1.1). Skin atrophy was noted only in the intralesional group. Conclusion Both treatment modalities were effective in scalp alopecia areata. Intralesional therapy showed slightly superior efficacy, whereas microneedling-assisted delivery demonstrated better tolerability and lower pain scores. Microneedling-assisted delivery may serve as a useful minimally invasive alternative for patients’ intolerant to repeated injections.