Unresponsive Alopecia Areata Treated Successfully with Liquid Nitrogen Cryotherapy: A Study of Five Patients

Introduction: Alopecia Areata (AA) is one of the most common form of hair loss seen in dermatology. Treatment failures can occur with almost every conventional therapy, either singly or in combination. Aims and Objectives: To study the clinical profiles and management outcome of Liquid Nitrogen Cryotherapy (LNC) for the treatment of unresponsive cases of AA. Materials and Methods: A prospective study was conducted on five patients who showed no response to conventional topical treatment for six months. The subjects were enrolled in the study after written consent. Clinical photographs were recorded at each visit. Patients were given 3-5 sittings of LNC at 2 week intervals. Each session consisted of dual freeze thaw cycles of 15 seconds each, with a cryospray technique following application of topical anaesthetic cream. Suitable antibiotics and anti-inflammatory agents were prescribed post-operatively for five days. The clinical response was evaluated by using regrowth scale at 4th week and 8th week. Final end point evaluation of patient post 3 months after the last treatment session was done to observe sustained regrowth of hair. Results: Five patients were recruited, out of which three patients showed an excellent response, 1 each had a satisfactory response and a fair response respectively. Commonly seen adverse effects were slight pain, erythema, edema, erosion, crusting, dyspigmentation/hypopigmentation, which were transient and did not require withdrawal of treatment. Conclusion: Liquid Nitrogen Cryotherapy is a cheaper, easily available with transient adverse effects and can be worth trying in unresponsive Alopecia Areata.