Intralesional Methotrexate Versus Triamcinolone Acetonide for Localized Alopecia Areata Treatment

    TLDR Both treatments improved alopecia areata, but methotrexate caused more skin darkening, while triamcinolone caused skin lightening and thinning.
    This study compared the efficacy and safety of intralesional methotrexate (MTX) and triamcinolone acetonide (TrA) in treating localized alopecia areata (AA) in 50 adults. Both treatments significantly improved Severity of Alopecia Tool (SALT) scores over 6 months, with no significant difference between the two groups. Patient satisfaction was slightly higher with MTX (64.0%) compared to TrA (52.0%). However, the safety profiles differed: MTX was associated with hyperpigmentation in 32.0% of patients, while TrA was linked to hypopigmentation and atrophy in 8.0% of patients each. Both treatments required a similar number of sessions, suggesting that treatment choice should consider these distinct side effects.
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