Hair Restoration Blog

Q:

I am a 26 year old female and felt like the world was mine, and then this happened and now I would rather hide, so I understand about feeling like a freak. But I think we all have to remember that we have nothing to be ashamed of This disease is more widespread than we think and people are more understanding than we give them credit for. We can all still live long and happy, if a little self consciously. Since getting AU, I have heard of so many people who have friends or family with this disease - there are a lot of us, and we are still lovable, attractive, successful and admired. We may look different but if we can overcome the self-imposed stigma of it, I think it will just serve to make us stronger.

Speaking as a woman, let’s give our daughters, sisters and mothers a good example for self-respect, and show them how to be fearless, how to overcome obstacles and show them that women are more than long shiny hair and a media approved image.

I know I am young and have not yet suffered with this disease as long as any of you, so it is likely easier for me to say these things. I just hope to remain this optimistic and not let it get the better of me. We are all more than our hair. And if being bald and shapely or hairy and fat is the choice, I choose to keep my body healthy on the inside instead of just looking it on the outside.

Thanks to all of you, I wish you all the best and just remember, you are more than your hair and do not accept feeling like a freak! Remember the people that love you when you are at home and hairless for all to see, what they see in you is what you truly are, not the you that has to wear a wig so people don’t stare or the one who has come to hate the wind.

A:

I like your attitude.  Treatment of Alopecia Universalis (AU) could be difficult or impossible in some cases.  You have to come to my office and talk to some of my patients who think the world has come to an end because they are losing their hair.

This is what I always say to my patients: It is important to try to look your best. If you have the option to change your appearance for the better, do it as much as possible, but for the part that you cannot change, accept it.  Learn to use it to your advantage and learn to love it.

Q:

I would like to ask Dr. Mohebi about hair stem cell research. If you can explain what it is, how long has it been in research, and in what phase it is at this moment? I’m 31and notice that I had AU, around the age of 29-30. At the time I was going through a lot of stress that made me feel like I’ve brought this on myself. I was taking treatment injections for my eyebrows to see if I can at least save my eye brows. Well, I got tired of the injections, and just left it in the hands of the Creator. Are there eyebrow and eyelash replacement that can be obtain and if so where? I just had a little girl and I really want to take some decent pictures with her and it bothers me at times that I can’t even do that, so I can relate to all who are going through the up’s an down’s and the fight within and without to BEAT-AU, and others. I guess only time will tell.

A:

Hair stem cell research is becoming very promising for treatment of many types of hair loss. Phase 3 of the study on hair multiplication was started about 3 years ago and it is still ongoing. The purpose of phase three study of any new treatment modality is to prove that there are no long term side effects on the volunteer patients who undergo any new treatment. Hair stem cell technology seems to be a real therapeutic option for many types of hair loss conditions for the next 5 to 10 years.

Having said that, some details about the process of hair multiplication is not quite clear yet. There is not much information released on the quality of multiplied hair and we are not quite aware about the final cost of the procedure. When it comes to AU (Alopecia Universalis) we cannot know for a fact that hair multiplication is the answer to this condition considering the mechanism of AU and the fact that the patient’s own immune system tends to destroy hair follicles.

It is likely that multiplied hair follicles have the same antigenic properties so they could be recognized by the immune system and destroyed the same way that the native hair was initially. A combination of some sort of anti-immune treatment and transplanting multiplied hair might be the answer, but we cannot know for sure before they are investigated thoroughly in the future.

I am a 26 year old female and felt like the world was mine, and then this happened and now I would rather hide, so I understand about feeling like a freak. But I think we all have to remember that we have nothing to be ashamed of This disease is more widespread than we think and people are more understanding than we give them credit for. We can all still live long and happy, if a little self consciously. Since getting AU, I have heard of so many people who have friends or family with this disease - there are a lot of us, and we are still lovable, attractive, successful and admired. We may look different but if we can overcome the self-imposed stigma of it, I think it will just serve to make us stronger.

Speaking as a woman, let’s give our daughters, sisters and mothers a good example for self-respect, and show them how to be fearless, how to overcome obstacles and show them that women are more than long shiny hair and a media approved image.

I know I am young and have not yet suffered with this disease as long as any of you, so it is likely easier for me to say these things. I just hope to remain this optimistic and not let it get the better of me. We are all more than our hair. And if being bald and shapely or hairy and fat is the choice, I choose to keep my body healthy on the inside instead of just looking it on the outside.

Thanks to all of you, I wish you all the best and just remember, you are more than your hair and do not accept feeling like a freak! Remember the people that love you when you are at home and hairless for all to see, what they see in you is what you truly are, not the you that has to wear a wig so people don’t stare or the one who has come to hate the wind.

A:

I like your attitude.  Treatment of Alopecia Universalis (AU) could be difficult or impossible in some cases.  You have to come to my office and talk to some of my patients who think the world has come to an end because they are losing their hair.

This is what I always say to my patients: It is important to try to look your best.  If you have the option to change your appearance for the better, do it as much as possible, but for the part that you cannot change, accept it.  Learn to use it to your advantage and learn to love it.

Dear doctor,

I am a 38 old married woman from Bangalore. I have 2 children (13 years daughter and 9 years son) . I was having alopecia areata problem since I was 10 years old. But I used to get hair back in a year. Like this, hair was falling and getting back was happened 3-4 times. But hair was very lengthy and very beautiful when I got married. After that during second pregnancy I started loosing hair.

After delivery I lost all my hair and became bald including eyebrows, eyelashes and body hair.I was very lean. I took Allopathy medicines in kurnool(AP) like steroids. I got my hair back and became fat. I stopped the medicines gradually as per doctor’s advice. I lost my hair again after stopping medicines. After that I tried homeopathy(Bathra’s) and ayurvedic. No use by these. After that I have tried intra regional steriods(injections). I can see a few hair,but if I stop medicines, they started falling again.

1 year back I got affected with Chikun Gunya. I met rheumatologist in Bangalore. He again suggested some steroids(wysolone) and Azoran(immunosuppresents) for both severe leg pains and alopecia universalis. I have seen a very good progress and got hair back. But those new hairs are very soft and not strong. He reduced the dose of Wysolone(1/2 of 5 mg) and maintaining the azoran -50mg 3 tabs per day. After reducing wysolone again  I am getting so many bald patches.

I recently met my doctor and he again increased the dose of wysolone to 10 mg. I think this is neverending process. I have almost lost the hope and fed up with all these tests, treatments and side effects and unnecessary spending of money. I was very lean and my weight was 50 kgs at the time of second delivery.

Now I am 85 kgs.I am fighting with this desease  since 10 years. Presently I am using the medicines suggested by rhemotologist.I am having brittling nails and will get headache some times. Every 2 months once I will take blood and urine tests before consulting doctor. The reports are showing more ESR. No other problems for now. I have taken thyroid test and found hypothyroidism. Now taking thyroxin tablets for that.
Family background: My mother is having Diabetes and Thyroid problems.

Please suggest any permanent solution for my problem. Please help me out of this problem…..

Thanks

A:
Alopecia Areata or its more aggressive alopecia universalis, in which patients experience whole body hair loss, is an autoimmune disorder. Autoimmune reaction is an abnormal response from the immune system that attacks certain organs or cell lines and causes malfunction on that system.  In alopecia areata (AA), patients may have involvement of some other body organs such as thyroid disease or other appendages of skin such as nails and hair.

It seems like your alopecia areata was activated by pregnancy and led you to get alopecia universalis. A precipitating factor can be found in 15.1% of patients with alopecia areata and include major life events, febrile illnesses, drugs, pregnancy or trauma but no clear conclusions can be drawn. Despite these findings, most patients with alopecia areata do not report a triggering factor preceding episodes of hair loss.

Your thyroid disease could be part of the same autoimmune disorder that affected your hair and skin.  Eight percent of people with alopecia areata have thyroid disease; this is higher than the incidence of thyroid disease in the general population which is 2%. Despite the correlation between alopecia areata and thyroid disease, treating the thyroid disease does not generally remedy the alopecia areata.

The outcome of alopecia areata is unpredictable. Some people lose hair in only small patches. Others may have more extensive involvement like you. Alopecia capitis or alopecia totalis is the loss of 100% of your scalp hair and alopecia universalis is the loss of 100% of body hair. These last two conditions are rare and more difficult to treat. In the majority of patients with smaller involvements of alopecia areata, the hair will re-grow completely within about 1 year without any treatment.

More serious involvements need to be closely followed by a dermatologist or a rheumatologist. Treatment might not be permanent and complete.  If immunal-suppressive treatments are being used, close monitoring to the treatment and correcting the course of treatment based on the initial response is the key to the following treatments.

Parsa Mohebi, MD

Q:

Two weeks back i have just noticed while shaving i have a round patch on my upper lip where there is no hair which is very strange because i have seen last two weeks back i have perfect hair. so can you please advice me what to do? and what was the problem for losing the hair and it looks like burnt.
Thanking you in advance

A:

Patchy hair loss without any other symptoms or skin conditions is usually a sign of Alopecia Areata (AA). The form of alopecia areata that we have described in several posts in the past can be seen almost anywhere on the body where hair may grow. This disorder usually presents itself as patchy or coin shaped balding spots.

Alopecia areata is an autoimmune disorder that could be seen alone or with other types of autoimmune disorders that can involve the thyroid gland. In alopecia areata hair follicles are attacked and destroyed by the immune system in limited areas causing patchy balding spots.

Recovery can be spontaneous in most cases and usually no treatment is required. See my article on treatment of alopecia areata. Some doctors may decide to treat the hair loss lesions of alopecia areata rather than waiting for spontaneous clearance especially when the lesions are exposed or patients cannot deal with them for a few months. Treatment may include a variety of lotions or injection of long acting steroids into the lesions.

Hair transplant surgery is not an option when there is any chance of alopecia areata. If you transplant hair into the balding patches of alopecia areata, your body may react against the transplanted follicles. Transplanted hair can be destroyed the same way the native hair follicles were affected by the disease.

The balding spots of alopecia areata can occasionally involve the whole head. That condition is called Alopecia Capitis. It could even extend to the whole body and cause the patient to lose some or all of his or her hair. This condition is called Alopecia Universalis. However, the outcome of the patients with typical alopecia areata is usually good and recovery is complete in most patients. I highly suggest that you see a good dermatologist to confirm the diagnosis and treat the condition if needed.

Q:

I have 2 round spots of hair loss on my neck. I also have ridged fingernails with a history of thyroid disease that is now treated. The hair loss spots are shinny with no hair on them with the size of a quarter. I have read online a lot about alopecia areata, but I also heard that alopecia areata could be just general thinning of the hair. Is there any particular test that I can do to evaluate my condition and to make sure my hair loss condition is alopecia areata and nothing else?

Thank you.

A:

Your description matches alopecia areata (AA), but there are some other and generally rare conditions which can resemble alopecia areata. Hair loss spots caused by alopecia areata may be found in groups or individually. The other signs such as nail pitting and ridging are not universal, but if seen with hair loss patterns typical of alopecia areata can support the diagnosis.

Thyroid disorder can also be part of an autoimmune syndrome- along with alopecia areata. A physician can confirm the diagnosis by checking the appearances of the lesions at the site of the hairloss. No other tests are needed to confirm the diagnosis of alopecia areata.

Alopecia areata usually resolves spontaneously without any treatment. In severe cases, or in alopecia universalis, medical treatment might be needed. However, hair transplant is not the proper treatment for alopecia areata; patients may lose transplanted hair or transplanted hair may never grow.