Journal of Asia Pacific Aesthetic Sciences

ABSTRACT: Intralesional triamcinolone acetonide (ILTA) is a well-established treatment for localized alopecia areata (AA). However, reports on the recommended dosage of ILTA, particularly in the Malaysian context, remain limited. We present the case of a 32-year-old Chinese woman who presented with sudden-onset patchy hair loss over the biparietal and frontal scalp regions, with no family history of alopecia or underlying systemic illness. Clinical examination revealed localized non-scarring alopecia, with normal laboratory findings and no evidence of scalp infection. A diagnosis of localized AA was made. The patient was treated with ILTA at a concentration of 5 mg/mL, administered as multiple 0.1 mL intradermal injections spaced approximately 1 cm apart, using a 34-gauge, 1.5 mm needle and a 1 mL syringe. Sterile saline was used as a diluent to reduce discomfort, and topical lidocaine cream was optionally applied prior to injection. At three weeks, the patient demonstrated significant hair regrowth, accompanied by an improvement in the Severity of Alopecia Tool (SALT) score from 21% to 3–4%, along with high patient-reported treatment satisfaction. This case highlights the rapid efficacy and good tolerability of ILTA at a concentration of 5 mg/mL in the management of localized AA.