A Self-control Study Of Alopecia Areata Treating With Carbon Dioxide Fractional Laser Combining With Topical Corticosteroid Versus Plum Blossom Needle Combining With Topical Corticosteroid

Alopecia areata（AA）is a common non-cicatrical hair loss disease in dermatology.Some can resolve themselves,but the other with severe disease can’t,even lasting for many years.AA only affects patients’external image,but it can bring serious psychological burden to patients and reduces their quality of life.Etiology of AA is unknown,and there are many treatments for AA,but no effective treatment.In recent years,it has been reported that it is effective to treat alopecia areata by using fractional laser to form drug delivery channel in the skin.Plum blossom needle is the commonly used method that outside cure treats alopecia areata in traditional Chinese medicine,also can injure the natural barrier of skin,be helpful for the absorption of medicine.ObjectiveThe purpose of this study was to to compare the efficacy,safety and recurrence of CO₂ fractional laser versus plum blossom needle on AA.Meterials and MethodsBy the method of self controlled trials,forty-eight patients completed the treatment process,and 65 pairs of alopecia areas were treated by CO₂ fractional laser and plum blossom needle respectively.After treatment,all the alopecia areas were treated with topical prednisolone.The subjuects of plum blossom needle group received 12 treatments once a week.The subjects of frational laser group received six weekly treatments at one week interval（10-20m J）.The patients were followed up for 3 months after finishing the treatment.The patients were followed up for 3 months after finishing the treatment.The efficacy,dermoscopic findings,pain scores,other adverse reactions and recurrence of the two groups were compared.Eight patients were investigated for the efficacy of different energies of fracional laser（10,15 and 20m J）.Results1.The significant efficacy rate of CO₂ fractional laser group was 66.2%and the effective rate was 98.5%;The significant efficacy rate of the plum blossom needle group was 61.5%and the effective rate was 92.3%.The effective rate and the significant efficacy rate of are higher than the plum blossom needle group.The difference was not statistically significant（P>0.05）.2.The improvement time,excellence time,cure time,appearance time of vellus hair and terminal hair of the alopecia areas treated by CO₂ fractional laser were earlier than the alopecia areas treated by plum blossom needle,and the difference was statistically significant.（P<0.05）3.（1）The significant efficacy rate of alopecia areas treated with different energies of fracional laser（10m J,15m J and 20m J）were 54.0%（25/65）,84.4%（32/65）and 12.5%（8/65）respectively with obvious difference between them（P>0.05）;（2）Eight patients was compared by self control.The significant efficacy rate of 15m J was 87.5%,which was higher than that of 10m J（50.0%）and 20m J（25.0%）.But there was no statistical difference（P>0.05）.4.The pain scores of the CO₂ fractional laser group（1.97±1.60）were lower than those of the plum blossom needle group（2.73±1.82）,and the difference was statistically significant（P<0.05）.5.The satisfaction rate of the CO₂ lattice laser group was 75.4%,and that of the plum blossom needle group was 36.9%.The difference was statistically significant（P<0.05）.6.The recurrence rate of CO₂ fractional laser group was 14.0%and that of plum blossom needle group was 32.5%,and the difference was statistically significant（P<0.05）.Conclusion1.CO₂ fractional laser is one of the treatments for alopecia areata,which is as effective as plum blossom needle.2.CO₂ fractional laser,which makes hair repainting faster,is more effective,more comfortable,less time cost and more acceptable to patients.It is more suitable for alopecia areas with low hair coverage,as well as patients with inconvenient follow-up.The cheaper treatment,plum blossom needle,is more suitable for alopecia areas with high hair coverage.Moreover,it is suitable for patients with convenient follow-up.3.Using the 15m J energy of CO₂ fractional laser to treat alopecia areata may provide superior clinical effectiveness.