Superficial cryotherapy effective as alternative treatment option for patchy alopecia areata: Study

Superficial cryotherapy is a novel cold-based treatment that has emerged as a potential therapy for patchy alopecia areata (AA). A recent pilot study published in the Journal of the European Academy of Dermatology and Venereology highlighted the promise of superficial cryotherapy by demonstrating significant hair regrowth in certain treatment protocols. This development could offer an alternative to the current standard treatment with triamcinolone acetonide (TA) injections.

The study explored the therapeutic effects of superficial cryotherapy by comparing two treatment durations (10 seconds and 20 seconds) and juxtaposing their outcomes with TA injections and a negative control. The results revealed that cryotherapy, applied for 20 seconds in two freeze-thaw cycles, led to noticeable hair regrowth, comparable to the effects observed with TA injections. Also, the shorter 10-second cryotherapy duration did not yield significant improvements when compared to the control group.

Analysis of the mechanism suggests that cryotherapy may stimulate hair growth by enhancing vascular endothelial growth factor (VEGF) levels while reducing pro-inflammatory cytokines. This combination of vasodilation and immune modulation might create an environment conducive to hair regeneration.

Controlling the precise cooling temperature at the scalp surface is technically demanding, limiting the consistency of results. Also, unlike TA injections, cryotherapy has yet to be tested in intrasubject split-lesion studies, a rigorous method that could offer more definitive comparative data.

Adverse events reported during the study were mild and self-resolving, adding to the appeal of cryotherapy as a less invasive option. Examples included temporary redness and mild discomfort, which dissipated without medical intervention.

While the 20-second cryotherapy protocol shows promise, the lack of significant results with the 10-second duration underscores the importance of optimizing treatment parameters for consistency and efficacy. Experts caution that while the pilot study marks an exciting step forward, larger and more comprehensive trials are required to validate these findings. Overall, cryotherapy represents a potential breakthrough in the treatment of patchy alopecia areata. Its ability to rival the efficacy of TA injections in preliminary studies offers hope for a less invasive therapeutic option.

Source:

Lee, H., Lee, J. W., Park, S., Park, H., Kim, G., & Kwon, O. (2024). Comparative analysis of temperature‐controlled cryotherapy versus intralesional triamcinolone acetonide injection for alopecia areata: An intrasubject split‐lesion pilot study. In Journal of the European Academy of Dermatology and Venereology. Wiley. https://doi.org/10.1111/jdv.20464