Suggest treatment for hair loss
Need more information
Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query and I have also looked at the picture.
In the picture it looks to me like a case of Pseudopelade
I would like to gather some more information from you in order to be able to guide you better.
If I am not wrong you seem to have naturally curly hair and you have probably taken hair straightening treatment.
-Does it affect only the central part width or it is more diffuse?
-Do you take regular hair treatments like hair straightening/relaxers?Braiding etc?
-Were the bald patches preceded by some skin lesions?Or scaling?
-Can you upload a clear digital recent picture?
Yes I regularly braid my hair I do relax it but not as much since I started balding.
No, one day a friend was doing my hair back in my early 30's and she told me it looked kind of thin at the top and one day there was a very short area of my hair about 2 inch and the texture was very different as if it were dying and that is where the balding began, now its on the left side all of a sudden there is a short are of hair like it just broke off.
Yes I can but it can't be today my hair is braided but will be taking it out ..the area in the middle is now completely bald and other areas around my crown, but i will upload it as soon as I can...do you think I need a hair transplant or is there still hope, mind u, the hair i do have is growing like crazy..go figure..Please help me.
This type of Alopecia can present in patients who use a variety of traumatic haircare techniques, including chemical and physical straighteners, traction, braiding, hair extensions, hair gluing, chemical curls etc
There might also be another contributing factor in addition to the above ones like Female pattern androgenetic alopecia, as you say.
I would suggest that you stop practicing traumatic haircare techniques any further. I would suggest a scalp biopsy to determine the exact etiology.
Hair loss treatment
Pseudopelade OR patch(es) of Cicatricial alopecia is an end result , Traumatic hair care techniques being one of the causes of pseudopelade. These techniques, like the ones mentioned above, particularly braiding can lead to cicatricial alopecia due to constant pulling and traction on the hair.
Moreover, Hair straightening can be very damaging to the hair and even when performed correctly, can result in loss of up to 20% of the tensile strength of virgin hair. It results in physical damage to the hair with loss of proteins and moisture resulting in dry, brittle hair. Many patients experience hair fall and breakage.
I was just speculating that androgenetic alopecia may be a contributing factor but in your case it does'nt seem to be, because in androgenetic alopecia there is hair thinning and hair shedding mainly from the front and crown of the scalp which is gradual and initially the patient notices increased part-width and later there is diffuse thinning but there are never bald patches except in very late stages. As far as I can see from the picture you have quite thick hair everywhere which goes against androgenetic alopecia. Even the preserved hair in the crown near the bald patches are quite thick, unlike that seen in androgenetic alopecia.
First and foremost, I would suggest that you stop with straightening and braiding techniques, which would arrest further progression.
If the bald area has already scarred (Cicatricial alopecia) then obviously it will not regrow new hair. However hair transplant is an option
So if I were your patient you would not administer those cortisone injections I hear about?
Oh what is the difference between you and a Trichologist? I know i spelled that wrong.
Hair fall treatment
I can understand your concern regarding the bald patches, specially being a woman.
Cicatricial patches of alopecia are totally devoid of hair follicules (which are normally visible as openings on the scalp skin), are smooth, shiny with slightly wrinkled epidermis and may be slightly depressed as compared to surrounding normal skin.
A Biopsy would be confirmatory
I would suggest you to apply a topical minoxidil 2% solution, twice daily.
I would also start you on oral steroids, preferably pulse steroids in a dose of 32 mg methylprednisolone on 2 consequtive days in a week (e.g every saturday and sunday) for 8-12 weeks.
I would also like to put you on an oral biotin supplement.
Trichology is a sub speciality of dermatology. I am a dermatologist and I am specialist in conditions affecting skin , hair and nail.
I would suggest that you seek an appointment with a dermatologist or a trichologist for a confirmatory diagnosis, skin biopsy and appropriate management,
Methylprednisolone is a steroid. It is basically given to control and inflammatory cause for underlying cicatricial alopecia/pseudopelade. If you remember, I told you that traumatic hair care techniques is just one of the cause, there are others e.g Lichen XXXXXXX pilaris, pseudopelade of brocq. In your case trumatic hair care techniques seem to be the most likely cause, however other causes need to be ruled out too, therefore I stressed upon the need for a skin biopsy.
Methylprednisolone if taken in pulse form(just 2 consecutive days in a week for 8-12 weeks) does'nt produce the so called side effects of steroids like weight gain etc as compared to when it is given as, daily oral steroids.
It is the only drug that works if at all, for all the underlying causes of pseudopelade (specially if there is an underlying inflammatory cause like lichen XXXXXXX pilaris). It might not restore the lost hair but it would stop further progression for sure.
You wont get it online. You need to take a prescription from a dermatologist.
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