, Intra-lesional steroids
Hi. thanks for posting your concern at XXXXXXX
I would keep a possibility of Alopecia areata. It is an autoimmune condition and commonly present as focal patches of hair loss, most commonly over the scalp
nut also on the beard, moustache or eyebrows or eyelashes. This is known as patch type OR focal alopecia areata
is when hair loss involves the entire scalp and Alopecia universalis
is when hair loss involves the entire body hair.
In Focal type of Alopecia Areata, most of times, hair regrows spontaneously within 1 year (as it happened first time round with you, 5 years ago). But people often seek treatment because the bald patches are unsightly and are easily noticeable to others.
Various treatment options in Focal type of alopecia areata in order of the choice of treatment:
--Intra-lesional Triamcinolone acetonide
is first line treatment in adults followed by other modalities like:
--Topical potent steroids
--Topical PUVA(psoralens +UVA therapy).
All of them are effective. However I prefer Intra-lesional steroid in my patients of Alopecia areata. It can be repeated after 3 -4 weeks and usually hair regrow after 2 injections, given 3 weeks apart.
Since you have been using Diprosone
, which is a potent topical steroid
and even after after 3 months (good enough trial) it does'nt seem to affect.
In such a case if I was your treating doctor I would have recommended switching to intralesional steroids which is anyways, my first choice.