I'm a 29 y.o. female w/alopecia areata as diagnosed by scalp biopsy. I initially thought I had female pattern baldness as it is mostly diffuse but there are some patches about the size of a quarter. I also have some short white hairs growing in and I have a streak in the center of my head that's white. I'm getting kenalog injections & use Olux foam every other day, but I worry about the use of steroids & thinning skin. Would lasers be an option or no? Also, how accurate is a punch scalp biopsy?
Would Laser Hair Therapy Help with Someone with Alopecia Areata?
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Doctor Answers 5
Alopacia Areata Treatments
Very likely not. It sounds like you do have alopecia areata. Lasers would be useless in this case. You are getting all the correct treatments. The other treatment that you can add is minoxidil.
Chrissy, Alopecia Areata may correct itself with time but most of us don't want to wait until this happens. Steroid injections, done correctly, should not cause atrophy if the concentration of steroid is appropriate. Topical steroids, as you are using, is also a good addition or alternative. Other topicals such as Protopic or Elidel might also help as might several other therapies that most general dermatologists could prescribe. The fact that you have some new growth is always promising.
Laser not effective treatment for Alopecia Areata
Alopecia areata is caused by inflammation around the hair follicle which results in the hair shafts falling out. Most cases of alopecia areata are localized circular patches, but same patients experience a more diffuse version in which the scalp hair becomes very thin without any noticeable "bald" patches. In many patients, white hair appearing at sites of alopecia areata is encouraging as this may be "new" hair re-growing. The standard treatments are low dose intralesional kenalog injections and topical steroids. Laser does not have any role in reducing the inflammation around the hair follicles. It is very important to see a board certified dermatologist regularly while being treated for alopecia areata so the side effects of these steroids can be monitored and managed if and when they first appear.
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Alopecia areata: Diagnosis and Treatment...
The most effective treatments for patchy (early stage) alopecia areata are steroid injections, (kenalog), topical steroids and minoxidil.
A dermatologist skilled in the management of hair loss can follow for thinning of the skin and concerns from steroids. These are uncommon.
How accurate is a biopsy?
A biopsy is fairly accurate but not 100 % by no means. For the most part the diagnosis of alopecia areata is what we call a CLINICAL DIAGNOSIS, meaning that seeing with the eyes by carefully examining the scalp is the predominant method of making the diagnosis rather than a biopsy. Yes, a biopsy is helpful in challenging cases or challenging clinical presentations. Out of every 200 patients with alopecia areata I see, I might do a biopsy in 1. The mainstay of diagnosis is not biopsy.
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