Do you need to keep getting Kenalog injections regularly for maintenance once hair grows back from alopecia areata?

Question

Hello hairloss Experts. Once hair grows back from a small patch of alopecia areata via treatment of Kenalog injection. Does the person still need to get injections regularly for maintenance? Or will the hair fall out again if kenalog injection is stopped?

Jeff Donovan, MD, PhD · Answer

There is one other option you are omitting from your list. And that is the possibility that hair grows back with injections and then one can put a pause on injections for anywhere from a few months to a few years to a few decades. Treatments for alopecia areata are generally continuous with very, very advanced forms of alopecia areata. But treatments are not necessarily lifelong for those with smaller areas of alopecia areata (what is termed patchy or mild alopecia areata). For many individuals with mild alopecia areata (such as 1-3 small patches or circles of hair loss), hair can grow back with treatment and then treatments can be stopped for a period of time. It does not always need to be continued. Now it could be that steroid injections or some other treatments are needed again for some individuals in 4 months or for some 8 months or for some 4 years - but many can go a long, long time without needing treatment (and without having hair loss). It is difficult to predict perfectly who will be able to pause or stop treatments and keep their hair and who will need to keep going with treatment. But a general rule is helpful : the more severe the hair loss that was present when starting out with treatment the greater the chance that ongoing treatment will be needed. The less severe that the hair loss was when starting out with treatment, the less likely that someone will need treatment long term and forever. But these a general rules and not 100 % accurate in everyone - but fairly accurate still. A patient with a coin shaped area of alopecia usually will be able to pause treatments for an extended period of time. Stopping treatment once hair grows back in this situation usually does not just cause new hair loss. A patient with complete hair loss on the scalp and body (called alopecia universalis) usually needs to continue treatment lifelong and stopping treatment comes with a very high chance of hair loss.

Darice W. Fadeyi, MD · Answer

Generally speaking, if you’re fortunate to have regrowth after kenalog injections into a lesion of alopecia areata, those injections are tapered off and stopped. Then the area is monitored. The reason for this approach is that continual steroid injections can lead to atrophy and scarring of the area which ultimately will inhibit or arrest the maintenance of healthy follicles.

Do you need to keep getting Kenalog injections regularly for maintenance once hair grows back from alopecia areata?

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Do you need to keep getting Kenalog injections regularly for maintenance once hair grows back from alopecia areata?

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