When is steroid injection into the skin recommended for alopecia areata?

A dermatologist may consider intralesional steroid injections for one or more clearly defined patches of alopecia areata. The medicine is placed into the affected skin to reduce local immune activity around hair follicles. The decision depends on the patch pattern, duration, scalp or facial location, age, and previous treatment.

Small injections are placed across the affected patch, with care taken to avoid unnecessary exposure of nearby skin. Hair regrowth, when it occurs, is gradual and not assured. Temporary soreness can follow treatment; thinning or a lighter area at an injection site is possible, particularly if medicine reaches too deeply or the dose is too strong.

Attend planned reviews so the clinician can compare the patch and check the skin. Protect exposed scalp from sun, avoid picking or rubbing the area, and mention new patches, eyebrow or eyelash loss, nail changes, or symptoms affecting other body sites. Tell the clinician about infections, medicines, pregnancy, and previous steroid reactions.

Seek prompt review if hair loss spreads quickly, involves eyelashes or eyebrows, or is accompanied by scalp pain, scaling, pus, or marked redness. Contact the clinic about persistent skin depression, pronounced colour change, or worsening pain after an injection.

Ask whether the patches are suitable for injections, how progress will be checked, what other treatment may be considered if patches multiply, and which local skin changes should be reported.