Steroid Injection

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Overview

Steroid injection is a hair loss treatment that’s often used for alopecia areata (patchy hair loss) and scarring alopecia, in which corticosteroid solution is injected into bald patches on the scalp to stimulate hair regrowth. The treatment is usually given every 4 weeks, and some people will see the results after only one or two sessions. While the average number of treatment times is 3-4, some may have to repeat the sessions for up to 6 months until the hair regrowth is complete.

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davda

What are some recommended creams or lotions for promoting healing in the recipient area after a FUE procedure?

I am now six weeks post-op and still experiencing redness in my recipient area. Are there any effective creams, ointments, or lotions that you can recommend to help alleviate this issue? Thank you.

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Latest Reply: 19 Sep 2023

. Dr. Ilker Apaydin

jesina

Could the use of steroids for bodybuilding potentially impact the health and growth of my transplanted hair?

I'm 28 years old and have been dealing with male pattern baldness (MPB), resulting in significant hair loss on the top of my head. It's been a month since I had a hair transplant, and the transplanted hair was taken from the donor area, which is DHT-resistant. I'm considering using steroids for body

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Latest Reply: 1 Oct 2023

. Dr. Serkan Aygin

1972to1976best

Is it possible to experience swelling years after a hair transplant?

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Latest Reply: 1 Oct 2023

. Dr. Ali Emre Karadeniz

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Dr. Sherif Wakil

Aesthetic Plastic Surgeon

London, United Kingdom

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Dr. Muhammed Haluk Hatipoglu

Hair transplant Surgeon

Istanbul, Turkey

12 years of experience

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Everything About Steroid Injection

By Medical Content Team | Medically Reviewed by Dr. Thierry Cahuzac

Published on 6 Feb 2023 | Last updated on 10 Oct 2023

Fact-checked

Introduction

While medications like minoxidil (rogaine), PRP therapy, and hair transplant options get all our attention when trying to manage hair loss, numerous other options often get overlooked. One such alternative to promote hair growth is a steroid injection. Corticosteroids provide a range of health benefits and are commonly used to treat joint pain and other musculoskeletal conditions. But interestingly enough, they can help with hair fall too. However, they treat only specific types of hair loss, such as alopecia areata, lichen planopilaris, and discoid lupus erythematosus. Steroid injections offer many advantages over conservative options and can save both time and money.

Keep on reading to find out more about steroid injections for hair loss.

How Does A Steroid Injection Work To Treat Hair Loss?

Besides genetic and environmental reasons, inflammation also plays a significant role in male (female) pattern baldness. Certain types of hair loss, however, are primarily caused by inflammation, auto-immune conditions, or both. Lichen planopilaris, for example, is a chronic inflammatory condition of the skin that affects nearly 1 to 7 percent of middle-aged women and causes hair loss. Alopecia areata, on the other hand, is an auto-immune disorder in which your immune system attacks the hair follicles and leads to patchy hair loss.

Interestingly, a steroid's two most important functions are inhibiting inflammation and suppressing the immune system. Hence, their use in inflammatory and auto-immune conditions such as sciatica, various types of arthritis and back pain is widespread. Similarly, these same features of a steroid also benefit people with an inflammatory or autoimmune type of hair loss. A steroid injection decreases inflammation or counteracts the action of the immune system on the scalp, prevents hair follicle damage and promotes hair growth.

Who Can Benefit From Steroid Injections?

While inflammation might be involved in hair loss for most people, a steroid injection does not work for everyone. It treats only select types of hair loss, especially those with chronic inflammatory or auto-immune conditions. So a steroid injection may benefit people with:

Alopecia areata of the scalp, usually those with less than 50 percent of the scalp area
Alopecia areata of the eyebrows or beard
Lichen Planopilaris
Frontal fibrosis alopecia — a form of lichen planopilaris that causes progressive hair loss at the front and sides of the scalp
Hair loss caused by discoid lupus — some people with lupus erythematosus (a very common autoimmune disorder) develop round (discoid) lesions on the scalp, which scar their hair follicles and cause permanent hair loss.
Folliculitis decalvans — a rare but chronic inflammation that results in scarring hair loss.

However, a steroid injection does not work for people with male (female) pattern baldness or other conditions that do not involve .

What Is The Procedure Of Steroid Injections For Hair Loss?

Steroid injections are very easy to perform and don’t require much time. It does not even require anesthesia and can be easily performed in a doctor’s office. The steps of the procedure are as follows:

The doctor uses antiseptic to clean the skin of your scalp or any other required place.
They draw about 3ml of corticosteroid (triamcinolone acetonide solution) in a small syringe and use a very small (30 gauge) needle for injection.
Then the hair specialist injects about 0.1 to 0.2 mL of solution roughly 1 cm apart.
Depending upon the size of the patch, the doctor repeats the process to cover the entire area. For example, a 5 x 5cm patch may require 10 to 15 small injections.

Overall, the skin patch may require as few as two injections to as many as 80 or even 90 during one session. There is only slight discomfort, that too very short-lived. That is why it does not require anesthesia. However, your doctor can also use topical anesthesia to reduce pain.

How Is The Recovery Like?

Steroid injections for hair loss is a minimally invasive, nonsurgical procedure -- meaning it does not involve any significant incision. As a result, the recovery is fairly quick and is free of any significant side effects caused by the procedure. The steroid itself, however, may cause adverse outcomes.

In addition, you may not notice any improvement in your hair for a month or more. It not only takes time for the injection to suppress inflammation or the immune system, but the new follicles also take time to grow into healthy hair. For example, in one study involving 101 people with Alopecia Areata, 80.2 percent of the participants saw an improvement in their hair growth in a median time of 3.2 months.

Furthermore, you will need two to three such sessions every four to six weeks to maintain the effects of the steroid on the immune system. So consult your doctor to discuss more about the recovery and if you are a candidate for this treatment option.

Are There Any Risks Associated With Steroid Injections?

Some of the risks of steroid injections carry include:

Small bleeding points at the injection sites
Discomfort, soreness or pain, which usually resolves within hours
Mild headache, which goes away on its own or with common medication
Thinner, paler and more wrinkled skin in the weeks following the injections. But these problems, too, go away with time
Acne-type skin pimples or rashes may appear in the treated area
The face may become red or puffy

In addition, steroid medication may get absorbed into the bloodstream and cause systemic side effects. While these side effects are uncommon, it is important to know that steroid injections are required every four to six weeks and in the long run, you may begin to experience some side effects. For example, you may experience diabetes, bone thinning, high blood pressure, vision problems, menstrual cycle disturbances and a temporary reduction in immune functions.

How Much Do Steroid Injections Cost?

The cost of getting steroid injections for hair loss varies significantly from place to place and the experience of your doctor. Typically, a corticosteroid injection for alopecia areata can cost $25 to $100 or more per session. Thus, two to three sessions of steroid injections may cost anywhere between $200 to over $1000. However, the good news is the cost is less than other treatment options, such as oral or topical medications, PRP and hair transplants.

Are Steroid Injections Effective?

Steroid injections effectively treat patchy hair loss caused by chronic inflammation or auto-immune conditions. Doctors have successfully treated people with alopecia areata with the corticosteroid triamcinolone acetonide for over 50 years now. As a result, plenty of evidence supports using steroid injections for hair loss. For example, a 2009 study published in the Journal of Drugs in Dermatology showed that intralesional triamcinolone acetonide is a safe and effective treatment for patients with extensive alopecia areata.

The authors of a 2015 study compared the effects of cryotherapy and steroid injections and found steroid injections to be more effective at treating alopecia areata. Similarly, a 2022 study suggests that steroid injections are safe and effective in treating severe or active alopecia areata. Likewise, the literature is also consistent with steroid injections for the treatment of other inflammatory and auto-immune causes of hair loss, such as lichen planopilaris.

Thus, steroid injections are an effective yet inexpensive, side effects-free way of treating patchy hair loss. However, talk to your doctor or a hair specialist. They not only provide in-depth information about the process but also determine the procedure that would best suit your needs.

FAQs

Are Steroid Injections Better than Topical or Oral Steroids?

Yes, steroid injections have fewer side effects than topical steroids, far less than oral. In addition, steroid injections cost less than topical or oral steroids. Furthermore, some oral medications for treating alopecia areata can cost even more than steroids. For example, the first FDA-approved systemic treatment for severe alopecia areata: the oral tablet baricitinib (Olumiant), costs around $2500 to $5000 per month (13).

Does Insurance Cover Steroid Injections For Hair Loss?

No. Unfortunately, many insurance companies consider hair loss treatments cosmetic procedures, not medical necessities. So insurance might not cover the treatment for these types of hair loss. For example, a multi-institution retrospective review found the insurance coverage denial rate to be 97 percent (14). However, talk to your insurance provider to see if they cover the treatment expenses for your condition.

When Should I Get Steroid Injections?

You should get steroid injections within the first month of developing a patch of alopecia areata. It will help quieten the immune system and prevent further increases in the patch size. However, you can get a steroid injection whenever you feel comfortable.