Background: Alopecia areata (AA) is an autoimmune condition that causes non-scarring hair loss. Although several therapy options exist, many have considerable adverse effects and/or low efficacy. This encourages the ongoing creation of innovative treatments. Objective: to evaluate the efficacy of N-acetyl cysteine (NAC) combined with microneedling (MN) versus microneedling (MN) alone in treating alopecia areata. Patients and methods: The comparative study of the intervention included fifty patients clinically diagnosed with AA and confirmed through dermoscopy. These patients were split into two groups. Group I (25 patients) underwent treatment with N-acetyl cysteine combined with microneedling (NAC-MN), and Group II (25 patients) underwent treatment with microneedling (MN). The patients were assessed utilizing the Severity of Alopecia Tool Score (SALT), the Hair Regrowth Scale (RGS), and dermoscopic evaluation. Results: The SALT score became statistically significantly lower after treatment compared to before treatment in Group I (NAC-MN) (P value < 0.001) than in Group II (MN) (P value < 0.035). Group I (n=15), which had 60% hair regrowth, had a statistically significantly higher Hair Regrowth Score (RGS 5) compared to group II (n=5), which had 20% regrowth (P value |
