DOI: 10.14457/tu.the.2018.719
title: The efficacy of laser & light-based therapies in alopecia areata: a systematic review & meta-analysis

description: Background: Alopecia Areata is a common recurrent non-scarring type of autoimmune skin disease that attacks hair follicles causing not only scalp hairlessness but also on the face and sometimes on other parts of the body. Laser and light therapies had been long in existence as effective and safe second replacement treatments in the management of alopecia areata. Excimer laser is most commonly used devices in many studies and has mostly revealed convince outcomes recently. Nevertheless, additional data is necessary so as to prove the benefit of pulsed infrared diode and fractional laser therapies. Objectives: 1) To evaluate the efficacy of laser therapies and light-based therapies for Alopecia Areata, 2) To estimate the differentiation between laser and light-based therapies versus intralesional corticosteroid treatments by means of efficacy 3) To compare the complications rate associated with lasers, light-based therapies and intralesional corticosteroids 4) To determine the recurrent risk associated with laser and light-based therapies. Materials and Methods: A systematic literature review was carried out of computerized databases MEDLINE via PubMed, the Cochrane Central Controlled Trials Registry and Scopus databases were explored and all the eligible studies with clinical trials were included. This study primarily emphasized on how effectiveness of laser therapies and light-based therapies in hair regrowth in different measuring outcomes by means of comparison with control (no treatment) and how much proportion of good treatment response with intralesional corticosteroids. The overall response rate was investigated by grouping all studies in this meta-analysis applying random effects model and calculating odd ratio (OR) and proportions. All data were analyzed with Review Manager and STATA version 14.0. Results: Fifteen clinical trial articles encountered the inclusion criteria and were involved in this study. Laser and light-based therapies were found to be effective even in patient with severe and recalcitrant alopecia areata. Limitations: There were certain degree of variations in severity of disease, treatment interventions, duration of treatment, comparative features, variable treatment protocol, and outcome assessment which conduced to difficulty in standardizing the outcome data to analyze overall and subgroup effects. Conclusions: Laser & light-based therapies are secure and beneficial replacement therapies, useful as an adjuvant method. Laser therapies and light-based therapies achieved significantly higher efficacy than no treatment group and among them, excimer seems to be preferred form. Complications and recurrent rate were low. Furthermore, clinical evaluation of device setting and universal measurement of hair regrowth outcomes is necessary to determine standardized treatment protocols. And in order to simplify the outcome and consequence of laser therapies & light-based therapies as narrative treatments, further large-scale clinical trials with longer duration of treatment should be encouraged.