308 nm-Excimer light together with topical betamethasone valerate in treating alopecia areata

Excimer light was reported to be effective in treating alopecia areata (AA), as it induces T-cell apoptosis, however its combination with topical steroids in the management of AA still needs to be investigated. The study objectives were to determine the efficacy and safety of combining 308 nm-Excimer light and topical steroid versus either Excimer light or topical steroid alone in treating AA. Thirty AA patients were included, each patient had at least three patches, patches in each patient were randomly classified in to 3 groups. Group I patch: was treated by topical steroid only. Group II patch: was treated by Excimer light only. Group III patch: was treated by topical steroid and Excimer light. The response for hair growth was assessed at the baseline, week 8, week 12 then at 3months after the last session using a hair regrowth scale and trichoscopy. Any encountered adverse effects were recorded. All treatment groups showed significant improvement at the end of the study compared to the baseline, although hair regrowth was significantly better in group III where 60% of patches showed > 50% hair regrowth. All treatment groups showed significant decrease in black dots (BD) (trichoscopic sign of activity), and increase in signs of improvement (upright growing and pigtail hairs). However, BD and exclamation mark hair (EMH) were significantly reduced in the mixed therapy group compared to the other two groups. We concluded that excimer light is an effective and safe treatment option for AA, particularly when combined with topical steroid.