Intralesional steroids (steroid injections)

Intralesional steroids, or steroid injections, are steroids that are injected just underneath the skin using a fine needle. Small amounts of steroid are injected roughly 1cm apart. When used to treat alopecia areata, the injections are given into the patch of hair loss and at the patch margins. For scarring alopecias such as frontal fibrosing alopecia or LPP, the injections are generally directed at the active margins of patches where the hairs are still present. The aim is to reduce inflammation around the hair follicle.

The treatment may be repeated several times over a number of months. This type of treatment is usually only used on smaller areas of hair loss and not typically offered to those with extensive hair loss such as alopecia totalis or universalis. 

Intralesional steroids are unlikely to be offered by GPs and will most likely be provided within a dermatology setting. There is a risk of skin-thinning or indents on the scalp.

Intralesional steroids might be prescribed to patients with the following alopecia types:

alopecia areata, frontal fibrosing alopecia (FFA), lichen planopilaris, central centrifugal cicatricial alopecia (CCCA).