Fractional carbon dioxide laser in combination with topical corticosteroid application in alopecia areata

Objectives: This study aims to evaluate the effectiveness and safety of combining fractional carbon dioxide (CO 2 ) laser treatment with topical corticosteroid application in the management of alopecia areata (AA). Material and Methods: This prospective uncontrolled trial was conducted at a tertiary care center on 37 patients diagnosed with AA who had not received any form of treatment for at least 2 months before the study. Results: The treatment demonstrated significant efficacy in promoting hair regrowth. After the second session, 40.62% of patients showed regrowth of vellus hair, and by the fourth session, 62.50% exhibited sparse pigmented terminal hair. By the sixth session, 43.75% achieved regrowth of terminal hair in clusters, and 34.37% achieved complete regrowth. By the eighth session, 50% of participants reached a stage where no further treatment was required, and 28.12% had complete regrowth of terminal hair. The results showed significant statistical improvements, with p = 0.0020, 0.00463, and 0.00146 after the fourth, sixth and eighth sessions, respectively. Gender differences in treatment response were observed, with male patients showing a higher early response, although this was not statistically significant. Comorbidities, including hypertension and diabetes mellitus, did not significantly alter treatment outcomes. Conclusion: The study demonstrated significant improvements in hair regrowth over the course of eight treatment sessions, with a notable proportion of patients achieving complete regrowth or satisfactory outcomes. The results suggest that this combined therapy is particularly effective for patients with localized AA.