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Intradermal minoxidil is used as an off-label treatment for patchy non-severe alopecia areata (AA) either alone or in combination with steroids; however, studies estimating its efficacy are still lacking. To assess the efficacy of intradermal delivery of minoxidil 5% alone and in combination with intralesional triamcinolone acetonide for treatment of patchy non-severe AA. One hundred patches in twenty patients with patchy non-severe AA, five patches for each patient, were included in this prospective intra-patient comparative controlled clinical study. Four comparative patches per each patient were randomly assigned to receive 4 sessions, at a 4-week interval, of one of the following treatments: intralesional triamcinolone acetonide, intralesional minoxidil 5%, combination treatment, or micro-needling. The fifth patch was observed as the negative control. Treatment outcomes were assessed at baseline, and 1 month after treatment ends. Minoxidil intradermal injection was nearly comparable to the micro-needling effect and its combination to steroids had no additive effect. Hair regrowth in response to minoxidil occurred earlier than the spontaneous recovery. Monotherapy of intralesional minoxidil is of limited efficacy in treating non-severe patchy AA, but it speeds the recovery.

Efficacy of intradermal minoxidil 5% injections for treatment of patchy non-severe alopecia areata