A Retrospective Study of the Effect of Superficial Cryotherapy on Alopecia Areata

Hong, Seung Phil; Jeon, Soo Young; Oh, Tak Heon; Lee, Won Soo

Abstract

BACKGROUND: There are some reports that superficial cryotherapy of alopecia areata could be an effective mode of treatment with many advantages.
OBJECTIVE
We retrospectively evaluated the efficacy and side effects of superficial cryotherapy in patients with alopecia areata.
METHODS
We retrospectively reviewed the clinical records of 153 patients with alopecia areata, who had been treated with superficial cryotherapy for more than 4 weeks, during the twelve years since 1993. We then evaluated the efficacy of superficial cryotherapy and its relationship with various clinical factors and side effects. Superficial cryotherapy using liquid nitrogen spray for 2~3 seconds was applied to the alopecic patches, and repeated three or four times per session. Positive therapeutic response was defined as the regrowth of terminal hairs.
RESULTS
The results are summarized as follows: Positive therapeutic responses were noted in 105 (68.6%) of 153 patients reviewed. Patients who responded, vellus hair appeared within 4 weeks of treatment, terminal hair within 7 weeks, and a marked recovery was achieved within 12 weeks. A relatively good response rate was obtained in those patients who had less than 4 weeks of treatment, and the area of treatment was less than one fourth of the total scalp area, or less than two alopecic patches. On the other hand, those over 50 years of age and with more than 3 weeks of treatment interval seemed to have a relatively poor response rate. Other factors were not significant. There were no significant side effects, except slight pain, swelling and erythema.
CONCLUSION
Superficial cryotherapy in patients with alopecia areata can be an effective treatment modality. It is a simple and convenient method, and has relatively good therapeutic response with less side effects. Therefore, we propose the superficial cryotherapy as a first-line treatment for patients with a milder form of alopecia areata, especially in children who are vulnerable to therapeutic side effects and pain.