Evaluation of fractional carbon dioxide laser alone versus its combination with betamethasone valerate in treatment of alopecia areata, a clinical and dermoscopic study

Alopecia areata (AA) is a non-scarring tissue-specific autoimmune disorder. Many therapeutic modalities are available for the treatment of AA, but none has yet proven to be uniformly effective. Fractional carbon dioxide (FRCO₂) laser has been introduced as a treatment modality for AA. The objective is to evaluate and compare the efficacy and safety of FRCO₂ laser in treatment of AA alone or in combination with betamethasone valerate cream. 30 patients were assigned to one of the following groups, Group A FRCO₂, Group B FRCO₂ plus betamethasone valerate cream or Group C (betamethasone valerate cream). Patients received eight laser sessions 2 weeks apart, treatment period was 4 months. A statistically significant decrease in SALT score, dystrophic hair and a statistically significant increase in terminal hair was observed in all groups. Patient satisfaction level and reduction in SALT score were significantly higher among FRCO₂ and FRCO₂ plus betamethasone valerate group. However, no statistical significant difference was found between FRCO₂ group and FRCO₂ combined with betamethasone valerate cream group. FRCO₂ laser is a safe and effective treatment modality for AA when used alone or in combination with betamethasone valerate cream. However, it was found superior to betamethasone valerate cream monotherapy.