Hair Restoration Blog

Q:

My daughter, aged 20, has recently become the victim of AU.  I am a doctor myself and understand the etiology.I would like to know if there are any reports on therapy using IV methylprednisolone and endoxon.

I would also like to know if there is any relation of AU WITH ERYTHROCYTOPENIA as my daughter is having Hb around 9-10% RBC COUNT OF 3.3 to 3.6 million.

A:

Yes, several studies have concluded which indicate use of high dose steroids as pulse therapy to improve the outcome of Alopecia Areata (AA) and its more severe forms Alopecia Universalis (AU) if used early on in the process of the disease.

The results of a study  performed on 66 people who suffered from severe alopecia areata were published in 2003 to show a positive response in patients; with Alopecia Universalis results were favorable in about 80% of patients.  There has been a high rate of relapse among the treated patients of the study, but a few have stayed clear of the disease following their first treatment. More information on this study can be found here: http://www.ncbi.nlm.nih.gov/pubmed/12746668

This study provides the best indication of pulse methylprednisolone therapy: first recent episode of extensive plurifocal alopecia areata. These results are less convincing in patients with a long term history of the disease or other advanced forms of alopecia areata.

There have been strong links to support autoimmune etiology for Alopecia Areata and its more severe form of Alopecia Universalis.  The disease has also been seen in other diseases that are autoimmune in nature.  It is not clear, however, why alopecia areata and other autoimmune diseases might be present concurrently in the same person.

There are some suggestions regarding the possible triggers for autoimmune attacks (i.e.- viruses, infection, medicines, sunlight, or other environmental factors) that can prompt the immune system in a extraordinary method to attack the body’s own tissues. Pernicious anemia, a serious form of anemia, is typically caused by autoimmune processes and has often been present in patients with Alopecia Areata or Alopecia Universalis.

I believe a thorough evaluation of your daughter for the causes of her erythrocytopecia is the first priority at this point.  Your daughter may have a systemic condition that aggravated both her skin and hematologic conditions which should be investigated by a qualified dermotologist in your area.

To see more information on hair loss caused by autoimmune and other diseases, please visit our Other Types of Hair Loss page.

Q:

Hello Doctor,

This is XXXX from India.
My sister is suffering from Alopecia Areata for last 11 years. We tried treating her disease with every thing we knew (Alopathy/ Homeopathy/Ayurved) but it’s of no use. May be because we didn’t have proper guidance. It will be great if you can kindly guide us how should we move forward to treat her.

Thank you in advance.

Regards,
XXXX

A:

Alopeica areata (AA) is an autoimmune condition of skin.  AA usually does not need any medical intervention and the lesions improve spontaneously.  However, at times the balding spots might be very difficult to treat.  Although there is minimal evidence that injections of steroids can change the process of this disease, many physicians treat the balding AA lesions with intramural injections of long acting steroids.  Topical medications including minoxidil may also be used in some cases.  There are several current studies being conducted on the use of irritating agents to possibly change the inflammatory process of the skin.  Use of irritating agents are still not in the main stream treatments of Alopecia Areata.

Hair transplantation is definitely not one of the options at this time, because newly transplanted hair may be going through the same balding process with the same mechanism.  My best recommendation is to find a qualified dermatologist in your area and continue with him or her through future treatments.  You must be patient in circumstances such as these and try to understand that a quick recovery may not be achieved in some patients.

Q:

Hi Doc! How are you?

I have question regarding my hair loss problem. I’ve noticed it just 3 weeks back. As I’ve been reading your infomercial regarding the causes of hair loss. I think I am categorizing my problem to Alopecia Areata where I have one circled affected areas on the right of my front hairline & 2 at the right side at the back of my head. Before that it was small and now it is becoming bigger day by day.

Hope you could help me to find a solution of my problem. Thanks a lot! Hope to hear from you soon!!!
More power!!!

A:

Alopecia areata (AA) in its typical form is easily distinguished from typical patterned male and female hair loss.  Obviously, you need to be examined by a hair specialist or a dermatologist to confirm the diagnosis.  Alopecia areata generally present itself with a patchy or circular (coin shaped) balding spot and could be seen in almost anywhere in the skin.  The lesions are confined to their primary spots with no sign of hair loss in neighboring areas.  Some authorities have recommended steroid injections to facilitate the improvement of the lesions.  However, spontaneous recovery is seen in most patients with no interventions.

In contrast, hair loss pattern in male or female patterned hair loss is more widespread with the hair miniaturization (thinning) advancing to the neighboring areas.  Hair transplantation is not indicated in alopecia areata while it could be the only permanent solution in most cases of patterned baldness.