Trichloroacetic acid 35% as a therapeutic line for localized patchy alopecia areata in comparison with intralesional steroids: Clinical and trichoscopic evaluation.

Background: Intralesional corticosteroids (ILCs) is the first‐line therapy for patients older than 10 years having patchy alopecia areata, however some patients do not respond effectively. Aims: To evaluate the efficacy of a chemical peel trichloro acetic acid (TCA 35%) in comparison to ILCs. Patients/Methods: Twenty‐two patients with two patches of alopecia areata were included. Two treatment modalities with ILCs and topical TCA 35% were performed in two randomly selected patches. Three sessions were done, 3 weeks apart and were followed‐up for three months. Evaluation was done using Mac Donald Hull and Norris grading system and by counting trichoscopic parameters in each patch. Results: Both ILCs and TCA 35% treated patches showed measurable improvement with no statistically significant difference between the results of the two modalities (p>0.05) at different times of the study. Yellow dots, black dots, exclamation marks and dystrophic hair were all reduced by 100%, 82.0%, 100% and 88.3% in ILCs treated patches and by 70.4%, 69.1%, 100% and 75.0% in TCA treated patches, respectively. Conclusion: Topical TCA 35% is an effective and safe treatment for the treatment of AA without serious side effects, despite the slower response when compared to ILCs. [ABSTRACT FROM AUTHOR]