DO ILS (INTRALESIONAL STEROID) HELP WITH HAIR LOSS? FIND OUT HERE

ILS injection efficacy varies based on the client category addressed. Patients with less than 75 % hair loss, youngsters, and those who have had hair loss for a shorter time are likely to have the best results. Patients with severe Alopecia Areata (AA), fast advancing disease, and an existing phase lasting longer than two years do not respond well to ILS. ILS works much better for patients who have exclamation point hairs and a positive hair pull test since these indicate continuous follicle inflammation. As AA is known to undergo spontaneous remission, evaluating the effectiveness of ILS in this disease is problematic.

Literature-Based Evidence:
Although ILS has been used to address AA for more than 50 years, there have been no clinical trials published. Porter and Burton found that intralesional injections of triamcinolone acetonide and its less soluble variant, triamcinolone hexacetonide, resulted in hair regrowth in 64 and 97 % of AA sites, correspondingly. At 12 weeks following 3 injections of triamcinolone acetonide by using a Porto Jet needle-free device, 52 of 84 patients (62%) experienced hair regrowth, compared to one of 15 (7%) control participants treated with isotonic saline. According to Chang et al, 6 out of 10 patients with AA affecting over 50% of the scalp reacted well to ILS. According to an experimental trial conducted in Saudi Arabia, 63% of patients who received monthly triamcinolone injections experienced complete regrowth.

Administration Method:
For adult patients with less than 50% scalp involvement, an Intralesional steroid, preferably triamcinolone acetonide, would be the first treatment. Concentrations ranging from 2.5 to 10 mg/mL are acceptable, although for the scalp, 5 mg/mL (maximum volume of 3 mL each session) is the ideal concentration. 2.5 mg/mL can be applied to the eyebrows and face (0.5 mL for each eyebrow). For application on the scalp, a quantity of 10 mg/mL with a maximum total of 2 mL, or 5 mg/mL with a maximum total of 4 mL has also been reported. A 0.5-inch long, 30-gauge needle is used to infuse triamcinolone acetonide intradermally in numerous 0.1-mL injections at 1-cm spacing. Due to the lack of leakage between the syringe and the needle, BD insulin (1 cc) syringes are an excellent option. As a diluent, sterile saline is chosen over Xylocaine since the latter stings more. To reduce pain from injections, a topical anesthetic can be administered 30 to 60 minutes before treatment. It will be effective when treating brows. A needle-free tool (such as DermajetTM) can also be used to deliver ILS. Between patients, the tool should be cleaned.
Every 4 to 6 weeks, the therapies are repeated. The first signs of regrowth usually appear in 4 to 8 weeks. The ILS must be stopped if there is no change after 6 months of treatment. Glucocorticoid resistance in some AA patients may be caused by reduced production of thioredoxin reductase 1 in the outer root sheath. Children under the age of 10 are generally not treated with ILS injection due to the pain at the injection sites.

Side Effects:
Pain, shrinkage of skin and hair follicles, telangiectasia, hypo/depigmentation, and Cushingoid characteristics are also common side effects of ILS therapy due to systemic administration. A transient hair loss is the most prevalent side effect. This can be addressed by avoiding injections with a large amount per injected location, injections that are too frequent, or injections that are too superficial (intra-epidermal). The occurrence of atrophy must not result in the treatment being stopped. Re-injecting portions of denting, if avoided, is enough to reverse the atrophy. ILS' ultrasonic evaluation of cutaneous atrophy found that the atrophy is transitory and that the skin subsequently regains its original density.
Higher ILS levels have been linked to transient follicular atrophy. If ILS is being used close to the eyes, such as when repairing brows, there is a risk of cataracts and higher pressure inside the eye. Anaphylaxis has been reported in a patient who had intralesional triamcinolone acetonide for the Alopecia Areata treatment.

Conclusion: ILS is excellent for hair loss that is uneven, consistent, and restricted in nature. This treatment is not recommended for Alopecia Areata (AA) that is fast progressing or for alopecia totalis/Universalis. For the majority of patients, ILS is still the recommended therapy option.

Why Revitalis:

Revitalis, the best hair clinic in Mumbai, strives to provide fresh life and vitality to its clients. Our purpose is to treat patients with dignity and respect while providing high-quality medical care. At Revitalis, we believe that cosmetic treatment is more than just a medical procedure; it is a work of art that requires both artistic and medical understanding, as well as decades of professional experience. DR GEETANJALI SHETTY MD (the top hair specialist in Mumbai) leads the practise, which offers solutions to all hair problems, including Intralesional Steroid injection to prevent hair loss and enhance hair strength and resilience. It also offers a variety of pharmacological, laser, and surgical treatments to assist you to overcome baldness and hair loss.

Reference:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002419/