Treatment options for alopecia spot with scalp atrophy (indent)? (photos)

Question

Would topical corticosteroid, low level laser therapy or 2 % Nizoral shampoo help with a newly formed alopecia spot with scalp atrophy (indent)? Started Minoxidil January 15 2021 for female pattern hair loss. Blood work all normal. Alopecia spot developed 3 months ago? Unable to see a dermatologist until July.

Jason Emer, MD · Answer

You need a formal evaluation to see what type of hair loss you may have. when you have hairless its best to do a full hormonal workup for internal optimization plus scalp biopsies or scrapings to rule out any stress related, inflammatory, autoimmune or infectious causes of hair loss. In general most people with early hair loss have telogen (stress related) and/or androgenetic (normal aging) and both can be treated with in office treatments like steroid injections, PRP/acell, Exosomes and at home treatments like oral medications, oral vitamins like Viviscal, topical exfoliating sprays like Restorsea, and weekly growth factors like anteagemd.  See an expert for an evaluation. If hair loss is significant it may requires hair transplant (follicular unit translation).

Jeff Donovan, MD, PhD · Answer

This is an interesting question. I would need more information to really offer anything substantial. If the ident occurred because you had a PREVIOUS steroid injection in that area the simple answer is keep going with minoxidil and see the dermatologist. However if the area is itchy and the indent occurred WITHOUT any sort of injection into that area in the past, you need a biopsy to rule out scarring alopecia. Again, I need a lot more information in this case but I am concerned this may not be a typical alopecia areata spot. There is likely some component of androgenetic alopecia here given the miniaturization that is seen. However there is an inflammatory component and one needs some experts on board to determine if this is related to psoriasis, scarring alopecia, seborrheic dermatitis or minoxidil use. Please see an expert.

William Rassman, MD (retired) · Answer

This appears to be a spot caused by alopecia areata. I would try to accelerate the appointment with your dermatologist.

Treatment options for alopecia spot with scalp atrophy (indent)? (photos)

Answers (3)

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