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Steroid Injections for Hair Loss: Effectiveness, Risks & Benefits
Dr. Michael May (FRCS)
Medically reviewed by
Dr. Michael May (FRCS)
Updated on May 16, 2024

If you are wondering how effective steroid injections for hair loss are in treating alopecia areata,  you are likely one of the 2% of the worldwide population who is experiencing this hair loss condition [1]. The good news is that intralesional steroid injections were found to improve symptoms in over 60-80% of cases of mild and moderate alopecia areata [2][3]. However, they are less efficient in treating its severe forms, such as alopecia totalis.

While steroid injections are primarily used to treat alopecia areata, they can also help reduce inflammation and improve the symptoms of other autoimmune scalp conditions, such as frontal fibrosing alopecia or discoid lupus. Furthermore, they are sometimes prescribed to treat common scalp problems, such as lichen planopilaris or scalp psoriasis [4].

Of course, like most medications, steroid injections can also have unwanted side effects. Depending on the type of medication used, you may be experiencing symptoms such as pain and bruising, infection, scalp folliculitis or scalp atrophy [5][6]. People who are sensitive to corticosteroids or have other health conditions may suffer even more severe reactions. However, your trichologist will help you weigh the benefits of this treatment against its risks.

Keep reading this article to find out all you need to know about:

  • What steroid injections are and how they work to treat hair loss
  • How effective steroid injections are in treating various types of alopecia
  • Whether steroid injections can cause hair loss
  • The unwanted side effects of steroid injections for hair loss.
Table of Contents

What are steroid injections for hair loss?

The most common type of steroid injections used to treat scalp conditions which cause hair shedding is called intralesional corticosteroid injections (although the intramuscular variety can sometimes be prescribed [7]). These are steroid medications which are injected directly into the affected regions on your scalp.

Corticosteroids (which should not be confused with the anabolic steroids that make your muscles grow) are a type of anti-inflammatory medication which can improve the symptoms of autoimmune conditions and other types of localised hair loss caused by scalp inflammation.

How do steroid injections work to reduce hair loss?

When you are experiencing an autoimmune disorder that causes hair loss, your white blood cells are attacking your hair follicles. This is achieved through an inflammatory response generated by your immune system.

Normally, this kind of response involves several types of cells working together to destroy microorganisms which can make you sick, such as viruses or bacteria [8]. However, in autoimmune conditions, your immune system “mistakes” your hair follicles (and sometimes, other kinds of cells in your body) for harmful microorganisms and targets them instead. When your hair follicles are damaged by inflammation, they can no longer produce hair.

Steroid injections play a role in regulating your immune system and reducing inflammation [5]. Thus, they prevent your white blood cells from attacking your hair follicles and also help relieve inflammation symptoms, such as redness, swelling, itchiness, pain or a burning sensation on your scalp.

How effective are steroid injections for hair loss?

The effectiveness of steroid injections for hair loss depends on several factors:

1. The type of condition they are treating

While steroid injections can be very effective in treating alopecia areata and other auto-immune and/or inflammatory scalp conditions, they do not have any effect against different, non-inflammatory types of alopecia, such as androgenetic alopecia (also known as male or female pattern hair loss) or telogen effluvium.

2. The type of corticosteroid used

There are different types of injectable corticosteroid medications, each with specific uses. Research has found that certain concentrations of steroids called betamethasone dipropionate and triamcinolone acetonide may be the most efficient in treating alopecia areata [20][1].

3. The extent of the hair loss

When it comes to treating alopecia areata, steroid injections are generally effective against mild or moderate hair loss, which affects under 50% of the scalp. However, while more research is needed to confirm this, there is also a study which found that intralesional steroid injections can also reduce symptoms in 6 out of 10 patients with severe alopecia areata (between 50% and 99% hair loss) [21].

4. The patient’s individual response to treatment

Each person has their own biological characteristics (e.g. age, health condition, immune response), and lifestyle choices (e.g. smoking, diet, alcohol intake) which can impact their response to injectable corticosteroids.

What types of hair loss conditions can steroid injections treat?

Here are the main hair loss-inducing conditions that steroid injections are most often prescribed for and the medications’ efficiency in treating them:

Alopecia areata

Alopecia areata on the scalp

Symptoms for alopecia areata include the following:

  • Round, smooth patchy hair loss
  • Often, pitted and brittle nails
  • Small, broken hairs that look like exclamation marks
  • Yellow or black dots on the scalp

Intralesional corticosteroid injections have been found quite effective in treating alopecia areata, especially in mild or moderate forms.

Depending on the type of steroid used, one study found hair regrowth in 97%, respectively 64% of the two groups who received different steroid injections [9].

Another study performed on 290 patients with alopecia areata revealed that 61% of them went into remission after receiving 1-2 intralesional steroid injections [10].

A different clinical trial revealed that 82% of its 127 patients with limited alopecia areata experienced an over 50% improvement in hair growth after steroid injections.

Furthermore,  patients with moderate to extensive alopecia areata also saw 25%-50% hair growth after 6 months of intralesional corticosteroid injections [2]. These findings are confirmed by another, similar study on 120 patients with the same condition, where intralesional corticosteroid injections had an 83.3% hair regrowth efficiency rate [10].

However, be aware that while steroid injections can stop alopecia areata from spreading and even regrow hair, this does not imply the condition is permanently cured. While in 30-50% of cases, it is known to go into remission within 12 months even without treatment, it can often have several relapses over the years [11][7].

Lichen planopilaris

Lichen planopilaris

Symptoms of lichen planopilaris include the following:

  • Smooth patches of hair loss
  • Swelling and redness
  • Rough scaling around the edges
  • Itchiness and tenderness
  • Scalp burning

Several literature reviews have found intralesional corticosteroid injections efficient in treating lichen planopilaris lesions, as they can reduce inflammations substantially[12][13].

One study showed that injections with systemic corticosteroids led to full remission in 83% of 73 patients with generalised lichen planopilaris [14].

However, some authors caution that this treatment is more invasive than other options, such as oral medication (which can be as effective [14]). That is because it can cause scalp denting or atrophy [12].

Frontal fibrosing alopecia

Frontal Fibrosing Alopecia

Symptoms of frontal fibrosing alopecia include the following:

  • Mostly encountered in women
  • Frontal balding
  • Redness, itching and tenderness in the affected area
  • Bumps on the scalp
  • Rosacea-like rash

Intralesional corticosteroids are the first line of treatment for frontal fibrosing alopecia.

One study performed on 130 patients who experienced this condition revealed that 83% of them showed a positive clinical response to intralesional corticosteroids. 34% of the total number of patients achieved improvement, 49% achieved stabilisation and 5% continued disease progression (data was unavailable for the remaining 16%) [15].

The efficacy of steroid injections in the treatment of frontal fibrosing alopecia was also confirmed by other, smaller studies [16].

Discoid lupus

Discoid lupus

Symptoms of discoid lupus include the following:

  • Discoid (round) lesions on the scalp
  • Scaling and redness around the affected area
  • Possible scarring or skin discolourations after the lesions are healed

When the first line of treatment for discoid lupus skin and scalp lesions – topical steroids (such as steroid creams) – fails, intralesional steroid injections can prove efficient in some cases.

A study performed on 28 patients with face and head lesions caused by discoid lupus revealed that 46% of the patients experienced full remission of their lesions and another 46% experienced considerable improvements after 1-9 intralesional corticosteroid injections [17].

This confirmed the findings of observational studies which had also noted positive results of steroid injections in treating discoid lupus lesions which resisted topical steroid treatment [18].

However, since few clinical trials have been conducted on this matter,  more research is needed to ascertain these results.

Scalp psoriasis

scalp psoriasis

Symptoms of scalp psoriasis include the following:

  • Thick, reddish plaques of skin
  • Silvery flaking
  • Dry, cracked skin
  • Itchiness, tenderness and burning on the scalp.

While topical steroids are the first line of treatment for scalp psoriasis, some researchers think that steroid injections can also provide benefits when used together with topical treatments [19].

While this approach has shown promise in treating psoriasis of the limbs [4], no studies have yet been performed to determine the efficacy of corticosteroid injections on scalp psoriasis [19].

hair loss on the crown

What are the risks of steroid injections?

Scalp atrophy induced by intralesional corticosteroid injections [1]

While steroid injections are generally considered safe [10], some patients may experience the following unwanted side effects (this list can vary with the type and concentration of the injected steroids) [1][5]:

  • Local pain and discomfort
  • Minor bleeding or bruising
  • Infection at the injection site
  • Scalp acne
  • Scalp folliculitis
  • Scalp atrophy (thinning) or dents
  • Scalp discolouration at the injection site
  • If the patient has diabetes or high blood pressure, temporary increases may occur in their blood sugar or blood pressure.
Do steroid injections cause hair loss?

Do steroid injections cause hair loss?

No, steroids do not cause hair loss when they are injected into your scalp to treat alopecia. The link between balding and steroids usually stems from the fact that the anabolic kind (the ones certain athletes take to increase their muscle mass more rapidly) can indeed trigger male pattern baldness or female-pattern baldness. However, corticosteroids are different substances, which do not have the same effect.

While there are certain steroids (e.g. Prednisolone) which have hair thinning listed among their unwanted side effects [22], these are not used for intralesional injections. The medication types, concentrations and doses used for treating scalp conditions are generally considered safe and are not known to make your hair fall out.

Steroid injections vs topical or oral steroids?

Steroid injections vs topical or oral steroids

Topical and oral steroids can also help reduce inflammation and improve the symptoms of certain kinds of alopecia. However, the main benefits of intralesional steroid injections are that they ensure better penetration than topical ones, while at the same time, being more targeted than oral ones. This helps them reach the affected area faster and reduces side effects to the rest of your body.

While intralesional steroid injections are the first line of treatment for alopecia areata [2], topical steroids are usually prescribed first in treating scalp problems such as psoriasis or dermatoses, as they are less invasive, while injections are offered after topical treatments have failed.

Since steroid injections break the skin, the risk of certain local side effects, such as pain, bruising, infection, or thinning of the scalp (scalp atrophy) is also higher.

How long after steroid injections does your hair stop falling out?

How long after steroid injections does your hair stop falling out?

The amount of time before you start seeing results from your steroid injection treatment can vary with the condition you are treating, the type of corticosteroids you are using and your body’s response to the medication.

Since treatment sessions are usually spaced 4-6 weeks apart, it can take a few weeks of steroid injections before you can expect to see improvement in your hair loss. One study conducted on alopecia areata patients reported that it took 2-4 weeks to see the emergence of new hair after intralesional injections with each of 2 different steroids [9], but that can vary. Alopecia UK states that it generally takes 4-6 weeks before you can start seeing results [23].

However, if you have seen no improvement after 6 months of steroid injection treatment, the medication is likely not working for you [2].

How much do steroid injections for hair loss cost?

How much do steroid injections for hair loss cost?

While prices may vary, a session of steroid injections for hair loss usually costs between £100 and £500 in the UK. The treatment for alopecia areata includes, on average, 3-4 sessions, so you can expect to pay somewhere between £300 and £2000 for a full course of steroid injections.

Your GP may prescribe steroid injections for certain conditions, such as sciatica, or arthritis. However, it is unlikely that you can get alopecia areata treatment on the NHS. When used to improve the symptoms of conditions that cause hair loss, steroid injections are registered as having cosmetic purposes, and their cost is generally not supported by the NHS. Fortunately, you can still get them in private hair clinics.

Are you looking for hair loss treatment?

If you are experiencing hair loss that does not improve with home care or over-the-counter treatments, it is time to book a consultation with an experienced trichologist. They will perform specific tests to determine the cause of your hair shedding, such as a dermoscopy, a scalp biopsy or blood tests for hair loss.

Once you have a confirmed diagnosis, they will recommend the best and safest course of action for your specific condition. Whether that may involve topical, injectable or oral steroids or other effective, evidence-based forms of treatment, you can rest assured that your hair and scalp will be in the most competent hands.

Steroid Injections for Hair Loss: Effectiveness, Risks & Benefits, Wimpole Clinic

  1. Alopecia areata: What’s new in the epidemiology, comorbidities, and pathogenesis?
  2. Intralesional Steroids for Alopecia Areata
  3. Alopecia areata
  4. Update on Intralesional Steroid: Focus on Dermatoses
  5. Steroid injections
  6. Intramuscular Corticosteroid Therapy in the Treatment of Alopecia Areata: A Time-to-Event Analysis
  7. Intramuscular Corticosteroid Therapy in the Treatment of Alopecia Areata: A Time-to-Event Analysis
  8. Inflammatory responses and inflammation-associated diseases in organs
  9. A comparison of intra-lesional triamcinolone hexacetonide and triamcinolone acetonide in alopecia areata
  10. Comparative study of intralesional steroid injection and cryotherapy in alopecia areata
  11. Alopecia Areata: Burden of Disease, Approach to Treatment, and Current Unmet Needs
  12. Lichen planopilaris
  13. Oral lichen planus: comparative efficacy and treatment costs—a systematic review
  14. Individualizing treatment and choice of medication in lichen planus: a step by step approach
  15. Frontal fibrosing alopecia: efficacy of treatment modalities
  16. A Retrospective Analysis of Efficacy and Safety of Intralesional Triamcinolone Injections in the Treatment of Frontal Fibrosing Alopecia Either as Monotherapy or as a Concomitant Therapy
  17. Treatment of chronic discoid lupus erythematosus with intralesional triamcinolone
  18. Review of treatment for discoid lupus erythematosus
  19. Scalp Psoriasis: A Literature Review of Effective Therapies and Updated Recommendations for Practical Management
  20. Best dilution of the best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults
  21. Treatment of severe alopecia areata with intralesional steroid injections.
  22. Highlights of prescribing information
  23. Common Treatments for Alopecia Areata
Dr. Michael May (FRCS)
Medically reviewed by Dr. Michael May (FRCS)Updated on May 16, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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