Alopicia Areata or low testosterone?

Question

While my dermatologist visually diagnosed Alopicia Areata, I just had blood work (internist) confirming I have low testosterone - could that create a hair loss condition/misdiagnosis? If I started building testosterone, would that be my solution? Would it create issues with taking Propecia (which I do)? Would hate to think I'm jumping through hoops when it is a testosterone/more easily corrected solution (if my hair will grow back once normalizing levels). I really appreciate you help!

Jae Pak, MD · Answer

Alopecia areata has a certain pattern.  Genetic androgenic alopeica due to DHT (a byproduct of testosterone) also has a certain pattern.  If you think you have both (it can happen), ask your doctor.

Jason Emer, MD · Answer

If you have thinning hair you really need an evaluation to see if it is genetic or from another cause like stress or autoimmune.  If it is determined to be genetic there are many options and traditional treatments like rogaine foam and propecia pills can be used.  I have great success in my practice using injectable progesterone and prp to the scalp.  Postmenopausal women also benefit from spironolactone.  I suggest seeing a dermatologist with expertise in hair loss.  If it is autoimmune, the best initial treatments are steroid injections and topical rogaine.  Best, Dr. Emer.

Jeff Donovan, MD, PhD · Answer

Without seeing your scalp and knowing more about your history,  I can't comment specifically on your situation but here's a few general comments for anyone with alopecia areata and blood work showing low testosterone. Alopecia areata is said to be a "clinical" diagnosis, meaning it's generally quite easy to recognize. Patients with alopecia areata usually develop coin shaped areas of hair loss initially. This can lead to further areas of hair loss or it can grow back over time.  While it's possible for alopecia areata to be misdiagnosed, most cases are quite typical. In most cases (99% plus), there is no clear relationship between alopecia areata and low testosterone. For most people, the two would be unrelated. A physician can explore further whether there is any autoimmune adrenal issues causing low testosterone - but this is exceedingly rare. There has been one report in the medical journal of alopecia areata in a woman with low androgens. All in all, this is very, very unusual, and typically there is no relationship. REFERENCE OF INTERESTBaron J, Zabel J. Przegl
Dermatol. 1989 Mar-Apr;76(2):133-6. [Alopecia
areata in a woman with marked hypoandrogenism]. [Article
in Polish].

William Rassman, MD (retired) · Answer

It also has some genetic inheritance with it in some people. There are two issues with AA, the first is the dermatologic treatment which obviously requires a deermatologist and I will not go into this here. The second issue is the cosmetic treatment of this disease which is best treated with Scalp Micropigmentation which shows up well on our website. See below in web reference

Alopicia Areata or low testosterone?

Answers (4)

Answer: Alopecia Areata is an autoimmune disease

Answer: Alopecia Areata is an autoimmune disease

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Everything you need to know about Hair Loss Treatment

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Alopicia Areata or low testosterone?

Answers (4)

Answer: Alopecia Areata is an autoimmune disease

Answer: Alopecia Areata is an autoimmune disease

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Recommended reading

Everything you need to know about Hair Loss Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.