Kybella induced beard alopecia(delayed onset) (Photo)

Question

2018 - Kybella injections. 2022 - after stress and missed TRT doses, my beard hair thinned and turned blonde, but *ONLY* in the Kybella areas, covering ~40% of my total beard. 2023 - (~6 months ago) I started minoxidil twice daily and a 6-week on/off corticosteroid cream regimen; the hair thickened slightly but didn't regain color. The rest of my beard is black, making the patches noticeable even when shaven. This impacts my quality of life, I am offering a significant reward for help.

Mats Hagstrom, MD (license on probation) · Answer

I’ve been warning people to stay away Kybella treatments for a long time.
Since the product came on market.
Injecting chemicals, strong enough to create tissue necrosis is bound to have a long list of undesirable side effects and complications.
In the clinical trials to get this product approved by the FDA there was 20% facial nerve involvement.
 The treatment is inferior to the gold standard, which is liposuction by every measure.
The treatment is highly unpredictable and as you recognize, the chemical is not selective for just adipose tissue.
It causes damage to anything in its presence. i’ve seen individuals whose face was completely skeletonized by an unusual overreaction to normal dosing.
The product is also not accurate because of its unpredictable nature.
it would be helpful if you could outline the timeframe and pictures along the way.
If the treatment was done two years ago, and your hair follicles have not returned then they were probably destroyed from the treatment. The current regimen will induce fuzzy, thin hair growth, but it will probably not restore the primary beard follicles.
Obviously facial hair seems important to you.
If shaving daily is not a desirable option than the only treatment I can think of is individual hair grafts. 
This obviously is less than ideal, but could potentially give some resolution
I’m not sure where you’re located, but should you be close to Southern California then consider looking up Dr. Stefan Adair MD who is one of the most experienced hair restoration board certified plastic surgeons in the country.
Perhaps individual hair follicles could be harvested at the very periphery of your facial hair pattern to be used as individual graphs in the area of hair loss.
In plastic surgery the concept of “borrow from Peter to pay Paul” is pretty common
scalp hair will have different texture growth patterns, and potentially color.
This type of work is fairly complex and working with those who have extensive experience is very important.
As with all complex situations and generally all plastic surgery procedures, finding the right provider is generally the most important variable.
most hair loss work is done by dermatologist, but this type of treatments can be done by providers from different backgrounds.
at this point, I think you’ve maxed out and the medical treatment options so surgical options are probably the next thing depending on your level of motivation, etc.
Best,
Mats Hagstrom MD

Kybella induced beard alopecia(delayed onset) (Photo)

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Kybella induced beard alopecia(delayed onset) (Photo)

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