Excimer Light versus Combination of Tacrolimus and Excimer Light in the Treatment of Alopecia Areata

Background. Alopecia areata (AA) is a nonscarring alopecia that can affect any hairy area of the body. Excimer light at 308 nm with immunosuppressive effects is recommended as a promising management method for AA. Objectives. To assess the efficacy and safety of excimer light at 308 nm alone versus a combination of tacrolimus 0.1% and excimer light in the treatment of alopecia areata. Methods. Forty patients with AA of the scalp were divided into two groups, group A was treated with an excimer lamp twice per week for three months, and group B was treated with a combination of tacrolimus 0.1% and an excimer light. The efficacy of the treatment was evaluated by the SALT score and serum T-regulatory cells at the baseline, after 3 months from the baseline, and after 6 months from the beginning of treatment. Results. In group (A), the median SALT decreased from the baseline (13.15) to (6.15) 3 months after the baseline and further decreased after 6 months of follow-up to (3.3). While in group (B), the median SALT score was decreased from the baseline (11.15) to (0.5) after 6 months from the beginning of treatment. After 3 months, there was improvement in Treg function in both groups A and B (4.98 ± 1.02, 5.50 ± 0.84), respectively. There was a significantly higher improvement in group B (85.19 ± 8.55) than group A (70.05 ± 9.95). Dermoscopic findings reveal decreased signs of activity in group B more than group A. Conclusion. The combination of excimer light and tacrolimus is more effective than excimer light alone in treatment of AA.