Randomised controlled study for comparing the efficacy of tretinoin 0.05% cream alone versus tretinoin combined with microdermabrasion in adult patients of alopecia areata
Abstract
Background: Alopecia areata is non-scarring autoimmune disease. It is characterized by discrete patches of non-scarring hair loss and may involve scalp, eyebrows, eyelashes, beard, axillary hair and pubic hair. Therapeutic armamentarium is expanding with detailed elucidation of patho-mechanisms and emergence of new drugs like janus kinase inhibitors.
Methods: An interventional prospective study was conducted on the patients which were randomized into two groups (19 patients each) by lottery system, patients of group A were treated with tretinoin 0.05% cream whereas in group B patients microdermabrasion (MDA) was performed at baseline, 3rd, 6th, 9th and 12th weeks in addition to the application of tretinoin 0.05% cream daily.
Results: The mean GPI% in Group A was 6.26±5.13 and group B was 32.63±15.29% which is significantly higher at the end of 2 weeks (p=0.001). At 8 weeks, mean GPI in group A was 10.95±6.79 and in group B was 51.42±12.42 which was also significantly higher (p=0.026) as compared to group A. Similarly mean VAS in group A at 2 weeks and 8 weeks (0.62±0.51 and 1.1±0.67) and in group B was (3.27±1.53 and 5.16±1.26) which was significantly higher with difference in p value at 2 weeks between the two groups was p=0.001 and at 8 weeks was p=0.017. There was significant change in GPI and VAS at 8 weeks, in group A as compared to group B.
Conclusions: This study revealed that tretinoin was more effective than the combination with MDA.
Keywords
Full Text:
PDFReferences
Safavi K. Prevalence of alopecia areata in the First National Health and Nutrition Examination Survey. Arch Dermatol. 1992;128:702.
Amin SS, Sachdeva S. Alopecia Areata: an update. J Pak Asso Dermatologists. 2013;23:209-20.
Kuldeep CM, Singhal H, Khare AK, Mittal A, Gupta LK, Garg A et al. Randomised Comparision of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide and Tacrolimus Ointment in Management of Localised Alopecia Areata. Int J Trichol. 2011;3(1):20-4.
Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British Association of Dermatologists’ guidelines for the management of alopecia areata. Br J Dermatol. 2012;166:916-26.
Perera E, Yip L, Sinclair R. Alopecia Areata. Hair Ther Transplant. 2014;4:118.
Wang E, Joyce SS Lee, Tang M. Current Treatment Strategies in Pediatric Alopecia Areata. Indian J Dermatol. 2012;57(6):459-65.
Gill H, Andrews S, Sakthivel S, Fedanov A, Williams I, Garber D et al. Selective removal of stratum corneum by microdermabrasion to increase skin permeability. Eur J Pharma Sci. 2009;38(2):95-103.
Guttikonda AS, Aruna C, Ramamurthy DV, Sridevi K, Alagappan SK. Evaluation of Clinical Significance of Dermoscopy in Alopecia Areata. Indian J Dermatol. 2016;61(6):628-33.
Lacarrubba F, Dall’Oglio F, Rita Nasca M, Micali G. Videodermatoscopy enhances diagnostic capability in some forms of hair loss. Am J Clin Dermatol. 2004;5:205-8.
Inui S, Nakajima T, Itami S. Significance of dermoscopy in acute diffuse and total alopecia of the female scalp: Review of twenty cases. Dermatology. 2008;217:333-6.
Mane M, Nath AK, Thappa DM. Utility of dermoscopy in alopecia areata. Indian J Dermatol. 2011;56:407-11.
Peter D, George L, Pulimood SA. Trichoscopic features of various types of alopecia areata in India: Application of a hand-held dermoscope. Australas J Dermatol. 2013;54:198-200.
D’Ovidio R. Inflammatory Alopecia: A Hidden Cause of an Announced Surgical Failure. The Importance of Koebner Phenomenon in Trichology. Hair: therapy Transplantation. 2012;01(01).
Baldwin HE, Nighland M, Kendall C, Mays DA, Grossman R, Newburger J. 40 years of topical tretinoin use in review. J Drugs Dermatol. 2013;12(6):638-42.