Hair Restoration Blog

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.

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.