Liquid nitrogen cryotherapy in the treatment of alopecia areata : an Egyptian study

Abstract EN

Introduction Alopecia areata (AA) is a common cause of nonscarring alopecia that occurs in a patchy, confluent or diffuse pattern.

It may involve loss of hair from some or all areas of the body, usually from the scalp.

The aim of this study was to evaluate the effect of cryotherapy in the treatment of AA.

Patients and methods Through a nonrandomized and nonblinded study, 17 patients with 20 recalcitrant patchy AA lesions were recruited at the outpatient dermatology clinic, Assiut University Hospital, between August 2014 and September 2016.

The lesions were treated with liquid nitrogen cryotherapy spray once weekly for 6 weeks.

The lesions were sprayed for 2–3 s, until it became slightly frozen.

After the frozen area was thawed (∼3–5 s), a second spray was done in the same manner.

The lesions were assessed by direct scalp observation for the size and hair regrowth and by taking photographs.

The therapeutic response of the lesions to cryotherapy was evaluated in relation to the age of the patients, the size of the lesions, and the duration of the disease.

Results A positive therapeutic response was noted in 13 (65%) lesions.

By studying the clinical response to cryotherapy in relation to the age of the patients, we found that 53.8% of the lesions which responded to cryotherapy were in patients aged more than 30 years compared with 46.2% in patients aged less than 30 years.

Lesions less than or equal to 3 cm have shown a better clinical response than those of more than 3 cm (76.9%).

The clinical response of AA lesions was better (84.6%) when the disease duration was less than 6 months.

Conclusion Superficial cryotherapy with liquid nitrogen is a therapeutic option with a good treatment outcome.

It has the privilege of being simple, convenient, short‑term and office‑based technique, especially in mild to moderate recalcitrant AA.