Intralesional betamethasone as a therapeutic option for alopecia areata

Melo, Daniel Fernandes; Dutra, Thaisa Bastos de Sousa; Baggieri, Vanessa Maria Amoreira Curty; Tortelly, Violeta Duarte

doi:10.1590/abd1806-4841.20187423

Cited by 9 publications

(15 citation statements)

References 5 publications

(8 reference statements)

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“… 26 An alternative option to TH for the intralesional treatment of AA is betamethasone (betamethasone dipropionate 5 mg/mL + disodium phosphate betamethasone 2 mg/mL). 18 A good response has also been reported with hydrocortisone acetate 25 mg/mL. 16 …”

Section: Pre-treatment Considerationsmentioning

confidence: 92%

“…This route of administration overcomes the epidermal barrier, making the drug available directly in the inflamed area. 16 , 17 , 18 Thus, it minimizes the possible adverse effects of systemic corticosteroid (CT) therapy, with greater drug penetration when compared with the topical route. 18 Patients with isolated alopecia patches, of small size (<3 cm), short duration, or occupying less than 25% of the scalp are the best candidates for intralesional infiltration.…”

Section: Pre-treatment Considerationsmentioning

confidence: 99%

“… 16 , 17 , 18 Thus, it minimizes the possible adverse effects of systemic corticosteroid (CT) therapy, with greater drug penetration when compared with the topical route. 18 Patients with isolated alopecia patches, of small size (<3 cm), short duration, or occupying less than 25% of the scalp are the best candidates for intralesional infiltration. 5 , 16 , 19 To date, no randomized clinical studies attested the effectiveness of this therapeutic modality.…”

Section: Pre-treatment Considerationsmentioning

confidence: 99%

“… 4 , 24 In Brazil, TAc is restricted to intraocular use and, therefore, the most widespread form has become triamcinolone hexacetonide (TH), its less soluble derivative and with a higher risk of cutaneous atrophy. 18 Classically, the concentration of 2.5–10 mg/mL of triamcinolone is used for the scalp and 2.5–5 mg/mL for the face and other body areas. 3 , 25 A pilot study showed that lower concentrations, such as 2.5 mg/mL, were as effective as higher concentrations and with a lower risk of atrophy.…”

Section: Pre-treatment Considerationsmentioning

confidence: 99%

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Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

Ramos¹,

Anzai²,

Duque‐Estrada³

et al. 2020

Anais Brasileiros de Dermatologia

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Background Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. Objective To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. Methods Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. Results/Conclusions Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.

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Section: Pre-treatment Considerationsmentioning

confidence: 92%

Section: Pre-treatment Considerationsmentioning

confidence: 99%

Section: Pre-treatment Considerationsmentioning

confidence: 99%

Section: Pre-treatment Considerationsmentioning

confidence: 99%

See 2 more Smart Citations

Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

Ramos¹,

Anzai²,

Duque‐Estrada³

et al. 2020

Anais Brasileiros de Dermatologia

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“…Finasteride, minoxidil, panthenol, and biotin have been used in scalp mesotherapy 8 . Regarding AA, main therapeutic guidelines consider intralesional corticosteroids, a type of mesotherapy, as first‐line therapy in adults with AA involving less than 50% of the scalp 9 …”

Section: Introductionmentioning

confidence: 99%

Use of vibrating anesthetic device reduces the pain of mesotherapy injections: A randomized split‐scalp study

Carvalho

Barreto

Weffort

et al. 2020

J of Cosmetic Dermatology

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Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients’ comfort.This is a randomized split‐scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self‐reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration‐assisted side was 8.0 ± 1.0 while pain score for the vibration side was 2.3 ± 1.5, for AGA (P < .001) and 7.4 ± 1.2 and 2.1 ± 1.3, respectively, for AA (P < .001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.

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Intralesional Steroids: When and How to Inject?

Pirmez

2019

Hair and Scalp Treatments

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Intralesional betamethasone as a therapeutic option for alopecia areata

Cited by 9 publications

References 5 publications

Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

Use of vibrating anesthetic device reduces the pain of mesotherapy injections: A randomized split‐scalp study

Intralesional Steroids: When and How to Inject?

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