Ophiasis alopecia areata treated with microneedling

Alopecia areata (AA) is a T cell-mediated autoimmune disease resulting in the destruction of hair follicles. Ophiasis refers to a subtype of AA that presents as a symmetric, band-like hair loss pattern of the occipital, temporal, and parietal regions of the scalp. We present a case of a 58-year-old white man with AA, ophiasis pattern, who was treated with clobetasol 0.05% solution and four treatments of microneedling with triamcinolone over 6 months. He underwent gradual improvement, most notably on his left occipital scalp where his hair loss was most prominent, with near complete hair regrowth on his left occipital scalp. Microneedling with triamcinolone can be considered as a promising treatment in cases of ophiasis AA.