QDoes intralesional kenalog work for androgenetic alopecia?

This is a great question because in my practice, I have inherited patients from non-board-certified dermatologist practitioners being treated for androgenetic alopecia with intralesional Kenalog injections. I wondered if I missed something in residency because, especially as someone with androgenetic alopecia themselves, I have never come across this as a potentially beneficial intervention. Intralesional Kenalog does work well for other causes of alopecia including alopecia areata, lichen planopilaris, and discoid lupus but I have not found any literature supporting its effectiveness for androgenetic alopecia in my review of the literature. 

Sometimes explaining this to patients is a challenge because the etiology of androgenetic is complex and multifactorial.¹ I explain that androgenetic alopecia is most associated with how certain hair follicles respond to fluctuations in forms of testosterone over time. I do see that other forms of alopecia, particularly telogen effluvium, often unmask androgenetic alopecia patterns at an earlier age and this may be from where the disconnect comes.

Reference:

1. Starace et al. Am J Clin Dermatol. 2020