Fractional CO₂ Laser and Minoxidil in the Treatment of Alopecia Areata, A Comparative Study

Alopecia areata (AA) is a chronic inflammatory disease that affects the hair follicles and sometimes the nails. It usually presents as a single or multiple patches of hair loss on the scalp, but any hair-bearing skin can be involved. AA treatment depends on the severity and extent of the disease.

To evaluate the efficacy of combined fractional CO₂ (FCO₂) laser with topical minoxidil 5% solution versus topical minoxidil 5% solution alone in the treatment of AA.

The study included 150 patients with AA. The patients were collected from outpatient clinics of the Dermatology and Venerology Department, Tanta University Hospitals. Patients were divided into three groups; 60 patients were treated with topical minoxidil 5% solution, 60 patients were treated with FCO₂ laser combined with topical minoxidil 5% solution, and the third group of 30 patients represented the control group treated with topical saline.

Compared to the placebo group, there was a statistically significant improvement in hair growth in the combination group and minoxidil group. In the combination group, 80% of patients showed excellent improvement, 13.3% of patients showed very good improvement, and 6.7% of patients showed good improvement. In the minoxidil group, 53% of patients showed excellent improvement, 40% of patients showed very good improvement, and 6.7% of patients showed good improvement after 3 months of therapy. Side effects were minimal and transient in both groups.

Topical minoxidil 5% solution either alone or in combination with FCO₂ laser could be considered a safe and tolerable method for AA treatment.