Intralesional steroid is one of the accepted mode of treatment for alopecia areata. Whenever choosing a particular method one has to take different factors into consideration. What may be suitable for one individual may not be so for the other.
Since alopecia areata is not a life threatening disorder, I avoid medicines, which can have systemic side effects. Intralesional steroid injection given properly is safe. In general, I reserve this treatment for those cases where topical medication has failed, patient cannot hide them by changing the hairstyle and therefore it is leading to profound psychological problems.