Alopecia totalis treated with 1064 nm picosecond Nd:YAG laser: A case report

Alopecia areata (AA) is an autoimmune disorder causing nonscarring hair loss. Alopecia totalis (AT), the severe form of AA, is usually refractory to many first-line treatments including topical and intralesional corticosteroids and topical immunotherapy. Systemic corticosteroids, ultraviolet light phototherapy, and immunosuppressants may be effective but can cause side effects and high recurrence rates after discontinuing treatment. Janus kinase inhibitors and numerous types of lasers, such as 308 nm excimer laser or light, low-level laser therapy, and fractional lasers have been explored for alternative treatment of AA over the past few years with beneficial effects. Herein, we presented a case of AT treated with the novel 1064 nm picosecond Nd:YAG laser (ps-Nd:YAG) (Cutera, Brisbane, CA, USA) under a split-scalp study. A 25-year-old woman presenting with AT for two years was treated with topical and intralesional steroid and the 1064 nm Nd-YAG picosecond laser on the right half of the scalp. The laser treatment interval was once a month. The left half of the scalp was treated with topical and intralesional steroids alone. After treatment for six times, the right half of the scalp had greater improvement than the left half of the scalp. 1064 nm picosecond Nd:YAG laser therapy may be an effective alternative adjuvant treatment for AT.