Eyelash Alopecia - steroid to stimulate growth?

Question

Hello. I've suffered with AA since I was a kid. It started out with Alopecia Universalis and all of my hair fell out. After 13 years my hair and eyebrows regrew, but eyelashes are having a hard time to come out. Can a steroid shots in eyebrows stimulate the growth? Is getting them on your face unbearable? Is there a chance my eyelashes will grow or shoul i give up?

Jeff Donovan, MD, PhD · Answer

I’m glad to know your scalp and eyebrow hair density has improved. There are several options for a situation like this and you’re going to want to sit down with a dermatologist. Eyelash injections are possible but that’s something generally only done by an ophthalmologist and few ophthalmologists have alot of experience treating alopecia areata. So you would be going to a doctor that does not have alot of experience in the disease itself and how to monitor. But it’s an option- especially if you are still being monitored by a dermatology specialist. The dermatologist can oversee the main plan and the eye doctor can be called upon to help. Any injections around the eyes needs close monitoring for side effects. Your doctors can advise all the side effects that are possible with eyelash injections. The most common treatment however is not eyelash injections- it’s the use of something like Latisse (bimatoprost). This has evidence of helping patients with alopecia areata - provided the patient has some eyelashes to begin with on day 1 of treatment. If there are zero eyelashes, this treatment does not work so well. Eyelash serums of various kinds also help. Th ese have not been studied as well as Latisse but they most certainly do something (at least in some patients). Latisse and serums and steroid injections do not help all patients with lash loss but they do help many. The other option if the lash loss is really troublesome is to use systemic options to turn down the entire immune system a bit more. These options have even more side effects but can be quite helpful. Whether you will need them a few months or a few years or forever is unknown but this is something that you’ll also want to discuss with your doctors and your own medical team. Systemic options include JAK inhibitors, methotrexate and other systemic immunosuppressants. These are important discussions so be sure to book an appointment with your doctor. Because you are not my patient, I don’t know enough information about your story to guide you one particular way or another.

Matt Tahsini, MD · Answer

Hello and thank you for your question. Any time you’re dealing with your eyes you need to take extra care and go to a reputable doctor.  There are a few options but I think you either need to see  a dermatologist or ophthalmologist for advice on what is best for you. Good luck to you.
Dr. T

Eyelash Alopecia - steroid to stimulate growth?

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Eyelash Alopecia - steroid to stimulate growth?

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