Background: Intralesional injection of corticosteroids has widely been used for the t,reatment of alopecia areata. The pair produced during the repeated multiple injection procedures is an actual therapeutic obstacle in both adult and child patients. Buffering of the local anesthetics is known to reduce the pain. Objective : The purpos; of this study was to evaluate the degree of pain reduction and hair regrowing effect by the use of buffered lidocain-triamcinolone acetonide suspension(BLT) compared with nonbuffered lidocairi triamcinolone acetonide suspension(LT) in the intralesional injection of alopecia areata. Methods : We evaluat d the degree of pain reduction by the use of BLT compared with LT in the intralesional injection in 40 cases of alopecia areata. The pain was ineasured by patients verbal pain score from zerc to ten and simultaneously observed if there were be any differences in hair regrowing bet,ween the two groups. Results : 1. Remarkable reduction of the pain du~ring the inject,ion was noted by the buffering agent and the pain was further reduced by the vertical insertion of the needle. The pain score of BLT was 1.5 by vertically inserted injections and 2.4 by ~30 degree angle injections while the pain score of LT was 4.4 by the vertical and 5.6 by t.he 30 degree, Z. The mean time for appearance of regrowing hairs was 3.6 weeks in the BLT area and 4.0 weeks in the LT area. The use of BLT area showed a statistically faster response than the LT area. Conclusion : The use ot BLT is recommended not only by it,s remarkable effect on pain reduction but also by its sigriificantly accelerated hair regrowing effect in the trea~tment of alopecia areata. (Kor J Dermatoi 1997;35(1): 41-48)