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These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.
Is it possible to forward a photograph?
I will attempt to answer your question without a photograph. Please realize that if I receive a photograph, I might alter my diagnosis and treatment plan.
This sounds to me like alopecia areata. This can affect the beard area without affecting the scalp. This is caused when the lymphocytes in the skin begin to attack the hair follicle. The lymphocytes release chemicals called cytokines. The cytokines basically paralyze the hair follicles. Fortunately, the cytokines do not kill the hair follicle so the hair (usually) eventually returns. We do not know why the lymphocytes do this, although studies indicate that this is genetic, though there may not be a family history.
Alopecia areata is what is considered an auto-immune disease, like pernicious anemia, addison's disease, lupus, diabetes, so your physician should be on the look out for other auto-immune disease. However, the vast majority of patients with alopecia areata do NOT have other conditions.
The most successful treatment is injections of cortisone into the circles. Topical corticosteroid creams and Protopic ointment or Elidel cream can also be used either by themselves if you are afraid of needles, or in conjunction with injections.
When the hair comes back, it may come back white. The pigment producing cells in the hair follicle take awhile to become activated so the hair will eventual return to its normal color.
I hope that helps and as I said, I would be happy to look at a photograph or too.
Feel free to get back to me with other questions.
thanks for your advice the another problem is it grooving and spreading to other part of the face is there anything I can stop that ? please also see attached pictures!!!
Thank you for the pictures. I am pretty sure that this is alopecia areata. Did the physician who prescribed an anti-fugnal cream do this on the basis of a positive lab test or his/her clinical impression?
I cant not send the pictures despite I have tried many time. web site doesn't accept them
I did receive the pictures. Thank you. Were you able to read my comments?
I think they are all the same diagnosis. Alopecia Areata.
If there was a positive fungal culture, then I am wrong and it is a fungus. A fungus would also be a possibility, but that can be easily tested for.
I am sorry doctor for the misunderstanding I mistakenly press the poor service button. Excellent service thank you very much.
I have seen the gp two days ago, he is also sure about alopecia areata he prescribed SYNALAR JEL. base on your experience; do you think that will be helpful?