Fractional Laser Therapy May Present Therapeutic Alternative in Chronic Alopecia Areata

alopecia areata beard
Young man with Alopecia areata on his beard.
For patients with chronic alopecia areata, fractional laser treatment may present a therapeutic alternative.

The clinical effectiveness of ablative fractional 2940-nm erbium:yttrium-aluminum-garnet (Er:YAG) laser for the treatment of alopecia areata has been supported by study data published in Dermatologic Therapies. In a pilot study of patients with refractory alopecia areata, Er:YAG laser was associated with significant hair regrowth after 3 treatment sessions.

This single-center, prospective, observational cohort study enrolled 25 patients with a clinical diagnosis of alopecia areata involving the scalp and/or beard. Patients were consecutively enrolled at a medical center in Turkey from 2017 to 2019. All patients had failed to respond to prior topical or systemic treatments. Enrollees were each given 3 sessions of fractional Er:YAG laser therapy at 4 to 6 week intervals. Clinical photographs were taken at baseline and 1 month after the last session. The primary outcome was percentage change in Severity of Alopecia Tool (SALT) score, determined through photographic evaluation of hair regrowth. “Complete” regrowth was defined as a 90% improvement in baseline SALT score (SALT90). Patients were also asked to rate their satisfaction with the laser treatment on a 5-point scale, with higher scores indicating greater satisfaction.

All 25 enrollees completed 3 treatment sessions. Median participant age was 31 (range, 19-55) years, and the majority (76%) of participants were men. Mean regrowth rate at 1 month was 17.4%±3.5%. Among patients with patchy scalp involvement (n=16), mean regrowth was 27.8±31.3%. Of these 16 patients, 1 had complete regrowth (SALT90), 3 had partial regrowth (SALT50-SALT90), 6 had minimal regrowth (≤SALT50), and 6 had no regrowth (≤SALT20). In patients treated for beard involvement (n=5), mean regrowth was 39%±34.2%. Of 7 patients with alopecia universalis, however, just 1 had any hair regrowth. Overall degree of satisfaction was moderate (mean score 1.84±2.21). Adverse events were mild, with all patients reporting transient erythema and 2 participants reporting folliculitis.

The majority of the study cohort (62.5%) experienced at least a 50% improvement in baseline SALT score after laser treatment. For those with alopecia universalis, however, therapy was largely ineffective. Larger studies are necessary to confirm the safety and efficacy of this treatment option for patients with alopecia areata.

“Our results suggest ablative fractional 2940-nm Er:YAG laser might be a good therapeutic alternative for patients with chronic alopecia areata, especially patchy alopecia areata of the scalp and beard,” the investigators concluded.


Tanakol A, Oba MC, Uzuncakmak TK, Askin O, Kutlubay Z. Treatment of alopecia areata with 2940-nm fractional erbium:yttrium-aluminum-garnet laser [published online July 7, 2020]. Dermatol Ther. doi: 10.1111/dth.13978