Study of the efficacy of carboxytherapy in alopecia

J Cosmet Dermatol. 2018 Dec;17(6):1275-1285. doi: 10.1111/jocd.12501. Epub 2018 Feb 20.


Background: Management of alopecia areata (AA) and androgenetic alopecia (AGA) is often challenging. The use of carboxytherapy may be a novel therapeutic option for such cases.

Objective: To evaluate the clinical efficacy and safety of carboxytherapy in alopecia areata and androgenetic alopecia.

Patients and methods: This study was conducted on 80 patients with alopecia divided into two groups; Group I included 40 AA patients (Group IA received carboxytherapy and Group IB control received placebo), and Group II included 40 AGA patients (Group IIA received carboxytherapy and Group IIB control received placebo), and followed up monthly for 3 months. They were evaluated clinically (by assessment of Severity of Alopecia Tool (SALT) score in group I, and Sinclair scale and Norwood-Hamilton scale in group II), by dermoscopy and digital dermoscopy at each visit.

Results: Group IA patients showed significant clinical improvement in SALT score and dermoscopic improvement after carboxytherapy and at the end of follow-up period with significant reduction in dystrophic hair, black dots, yellow dots, and tapered hair coinciding with significant emergence of regrowing hair. Group IIA patients showed significant clinical and dermoscopic improvement after carboxytherapy with significant increase in hair density measured by digital dermoscopy. However, regression of these results was observed during the follow-up period but was still significantly better than before treatment. There were statistically significant improvements in clinical score, global assessments, dermoscopic, and digital dermoscopic findings in both group IA and group IIA received carboxytherapy in comparison with group IB and group IIB received placebo injections, respectively.

Conclusion: Carboxytherapy seems to be a promising therapeutic option for patchy AA and could be helpful as an adjuvant therapy of AGA but more than 6 sessions are required and adjuvants are recommended for maintenance of the results.

Keywords: alopecia areata; androgenetic alopecia; carboxytherapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Alopecia / drug therapy*
  • Alopecia / pathology
  • Carbon Dioxide / therapeutic use*
  • Cosmetic Techniques*
  • Dermoscopy
  • Female
  • Humans
  • Injections, Intradermal
  • Male
  • Treatment Outcome
  • Young Adult


  • Carbon Dioxide