Intralesional betamethasone versus triamcinolone acetonide in the treatment of localized alopecia areata: a within-patient randomized controlled trial

Background: Intralesional triamcinolone acetonide is the treatment of choice for localized alopecia areata. Betamethasone is a corticosteroid that can be used for intralesional infiltration, but there is little evidence in the literature to indicate its effectiveness in this condition.

Objective: To assess the safety and effectiveness of the use of different doses of intralesional betamethasone, triamcinolone acetonide for the treatment of localized alopecia areata.

Methods: A within-patient double blind (patient and examiner) randomized controlled trial was performed. We recruited 12 patients with alopecia plaque divided into four quadrants. Each quadrant, after randomization, received an intralesional injection with one of the following treatments: triamcinolone acetonide 2.5 mg/ml, betamethasone 0.375mg/ml, betamethasone 1.75mg/ml, or 0.9% saline (placebo). The intervention was repeated in the same quadrant every 4 weeks, totaling 3 sessions. Visual evaluation of the results were performed.

Outcome assessment:
Three independent examiners performed photographic analysis of each patient at 4, 8 and 12 weeks, selecting the quadrant with greater repilation in relation to the others.