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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
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My son aged 27 has developed a bare spot on his scalp overnight.

Resolved Question:

My son aged 27 has developed a bare spot on his scalp overnight. We have an appointment later today at the GP , but from what I have read it looks like Alopecia areata. My question is : what is the likelihood of his developing more than one patch and over what timeframe ?Or could it just be an isolated spot?
Thankyou for your help.
Terry
Submitted: 3 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 3 years ago.

dermdoc19 :

These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.

dermdoc19 :

Hello

dermdoc19 :

Thank you for your questions.

dermdoc19 :

If you would care to send a picture, I would like to confirm the diagnosis.

dermdoc19 :

If you gently pull the hair around the spot and hair falls out this is pretty good evidence the bare area will enlarge. There is about a 30% chance that this is not isolated and he will develop new spots. If there is a family history of this the odds increase. It is unlikely that he will develop alopecia totalis since this is usually quicker in onset. Patients with this usually present to the docotr with significant hair loss.

dermdoc19 :

If he has a history of eczema it will be harder for the hair to regrow.

dermdoc19 :

I have to step out...do you have further questions/

dermdoc19 :

He can add Rogaine to whatever treatment his doctor initiates.

dermdoc19 :

Usually intralesional injections into the bald spot...or cortisone. Topical cortisone or Topical Protopic ointment.

dermdoc19 :

I hope that helps and please let me know if you have further questions.

Customer:

We have just been to see a nurse - doctor not available - and she said she thinks it is alopecia and has prescribed a shampoo in case it is fungal related. I explained that he has had some stress recently ( he is deaf so needs me to interpret) and she said that this may be the cause but to take the shampoo for a couple of weeks possibly to eliminate it as a cause and then to see a specialist if necessary. Should my son also take the Regaine you recommend ?

dermdoc19 :

I see no harm in Rogaine. It has sown to help. By the way, shampoos are only of ancillary benefit for a fungus of the scalp since an oral anti-fungal such as Lamisil or Griseofulvin is required. We generally use a shampoo to help decrease spread to others. She must think it is alopecia areata.

Customer:

Ok thankyou. Do you feel it would be an advantage for me to get him to a specialist soon or to see if the current treatment with shampoo and Rogaine will improve things over the next two weeks which is the period the shampoo is scheduled for.

dermdoc19 :

I don't think there is any urgency.

dermdoc19 :

Rogaine helps, but the problem with it, is that when you stop using it the hair will fall out, unless it has been treated with another modality.

Customer:

Ok I think that is all I need at the moment. He doesn't have a family history of this and doesn't suffer from eczema so fingers crossed that this patch is isolated. Just finally, what do you think the likelihood is of his growing back naturally and how long might it take?

dermdoc19 :

Difficult to determine how long....but usually 4-6 months by itself without treatment,.

dermdoc19 :

Most cases do grow back on their own. Treatment only speeds up the process.

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