Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing to us.
I can understand your concern as alopecia areata can be cosmetically unpleasant.
So you have alopecia areata of eyebrows and beard area not responding to intralesional steroid alone and that is why oral XXXXXXX pulse therapy with betnesol was started.
Had you visited my clinic I would have started you on
1)oral levamisole 150 mg( tablet dicaris) on two consecutive days in a week( say Monday, Tuesday)
2)oral betnesol forte, according to body weight. Continue with 5 mg on two consecutive days( say Thursday Friday). Steroids yield best results when taken in morning and should be taken after breakfast.
3) topically apply minoxidil solution 5 percent two times in a day and steroid salicylic acid solution( topisal) in night.

Please follow these suggestions atleast for a month and get back for follow up to me. Do not expect immediate results. Hair growth usually begins in patches as fine discoloured hair which later on gains thickness and color. Do not stress yourself or panic. You will definitely have response. Steroids would induce hair growth and prevent progression of lesion.
Also please remain under your doctor's follow up. Once good response is achieved, steroids should not be stopped abruptly rather tapered gradually. Please keep this in mind while discontinuing the treamtent.
Hope this helped.
Take care

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Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing back.
1) Dicaris or levamisole is an immunomodulator. Alopecia areata is an autoimmune ds that is one's own immunity acts against self. So levamisole is added to modify the same. Now this drug alone may not offer much result. Hence combine it with steroid.
2) Going by your weight, ideal dose for you is 12 mg/week ie 6 mg on two consecutive days. So definitely you should increase the dose, if not 6 mg atleast 5. Only precaution is to take it in morning after breakfast. Also it should be taken under doctor's supervision. Another caution is tapering the dose. ideally steroids are reduce by 0.5 mg to 1 mg per week once response is achieved.
3) no diet changes are required. Alcohol has no correlation to same. But definitely a healthy nutritious diet would help. Please continue with amexidil and as advised topisal also( follow the prescription in my previous post)

Hope this helped.
Take care

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Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi XXXXXXX
These medicines can be continued safely for four to five months. So please continue with the same. The only caution is taking oral steroids after break fast and not stop them abruptly.
Steroid and dicaris together will promote hair growth and prevent progression of disease as well. Also continue with topical minoxidil and steroid salicylic acid solution( topisal is a potent steroid use it in small quantity for two to three weeks then shift to milder one like diprovate s lotion)
Please be stress free and be patient as well as compliant with treatment. At least two to three mnoths time is required for response
Also remain under your doctor's follow up.

Hope this helped.

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Brief Answer:
Do not take intralesional steroid.

Detailed Answer:
Hi XXXXXXX
Thanks for writing track.
Right now as you are on oral steroids and topical steroids, there is no point taking intralesional steroid. You may discontinue its use. Just continue with oral steroids and topical medicines atleast for two months and then depending on response we may modify the treatment.
Hope this helped.
Take care

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