Hair loss & dents in scalp due to steroid injections. What can I do to resolve this? (Photos)

Question

After covid, my hair started to shred in massive chunks and you could see my scalp. I was told I had Telogen Effluvium and maybe one tiny spot of alopecia. Had steroid injections in my scalp for hairloss and noticed my body didn’t react well to them. I now have dents in my scalp and little round, red circles of hairloss. I read the hair can regrow but there are no explanations on what I need to do to accomplish regrowth. What do I do to remedy this? This made my hairloss so much worse!

Dana Goldberg, MD · Answer

I’m sorry to see your reaction to the steroid. In some cases, steroids can thin and stretch the skin. If this is the case, once your hair loss is stabilized, you can cut out the hairless skin. Alternately, you could consider hair transplant from the back of the scalp.

Hopefully, though, you can get some hair regrowth in the meantime. One option is PRP injections or exosome injections. This is an office procedure that can encourage hair growth and has very little risk.  It can be done several times with improvements in hair thickness and new growth seen in most patients.

Matt Tahsini, MD · Answer

Hello, and thank you for your question. Sadly, steroid injections can lead to atrophy on the scalp and also scars. Due to this, I suggest you do not get more steroid injections. Please make an appointment with a reputable dermatologist to see if you indeed have TE or any other condition. Best of luck to you.

Dr. T

Dr. T

Darice W. Fadeyi, MD · Answer

Hi and thank you for your question. I suggest you see a board certified dermatologist in order to get this evaluated. An experienced professional should be able to determine whether telogen effluvium (TE) is indeed present and, if so, whether other conditions are at play simultaneously. I do not treat TE with steroid injections since this is not an inflammatory process. You describe “dents” and worsening of your hair loss. Unfortunately, aggressive or frequent steroid injections can lead to atrophy and poor perfusion of the scalp and scarring of follicles. This is called steroid atrophy. It is essential that you avoid further steroid injections and give your scalp time to recover before resuming them IF they are indeed warranted at all. Persisting with steroid injections into atrophic patches can lead to permanent alopecia in those areas.

Hair loss & dents in scalp due to steroid injections. What can I do to resolve this? (Photos)

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