Why are the patches of hair I lot on my beard not growing back?

Hi,

Welcome to icliniq.com.

I have gone through the history provided from your end and have also viewed the image (attachment removed for the protection of patient identity) that has been provided. It appears to be alopecia areata.

Alopecia areata is a coin-shaped loss of hair that can appear on the scalp, mustache, beard and any areas of hair. They are an autoimmune condition where one's antibodies attack their own cells, causing hair loss. They may sometimes be associated with other autoimmune conditions like thyroid conditions and liver conditions and may also present genetically. They do not have to be necessarily present, though.

It usually causes coin-shaped hair loss in certain areas, which may grow if hair growth stimulation is done using multiple medications and procedures. It is not a dangerous problem. If left untreated, they may increase in size or form new patches. The follicles or roots are still present in the areas which only need stimulation from time to time.

They do not have a complete cure and may recur on and off depending on any triggers like stress, infections, or bodily stress like surgeries.

My advice :

1)Minichek F solution (Minoxidil+ Finasteride 5 % solution) may be used on the affected area in the morning. Use a very small quantity of one milliliter or less for all the areas and keep applying them on the clean and dry affected areas every morning for at least one year. They help with hair growth stimulation by increasing the blood circulation in the affected area and are not advised to be abruptly stopped as they may lead to hair loss due to a sudden cut off of the blood supply in that area.

They may be reduced in dosage eventually over the years and stopped. For example: if used daily for one year, they may be reduced to six days per week for the next year, then five days per week in the following year, and then maybe stopped eventually by reducing the number of days they are being used. This helps the hair follicles get used to the blood supply.

2) Tenovate cream (corticosteroid) may be used at night on the affected areas for three weeks in a very small quantity in a very thin layer only. They may be kept overnight and washed off in the morning. Do not use it on damp skin.

Tenovate is a corticosteroid and, therefore may be stopped after three weeks. Make sure to take a break of two weeks following the same and continue again for the next three weeks.

3) ILS procedure (intralesional corticosteroids procedure) may be done instead of using the Tenovate cream. In this procedure, Triamcinolone injections are taken in a very small dosage on the affected areas one centimeter apart. They are usually done within five minutes and it is a quick procedure at a dermatologist's clinic or hospital. They are usually done in sessions of three to four every four to six weeks, and they show fast and better results than using cream. If this procedure is done, the cream is not required to be used. Minichek F (Minoxidil+ Finasteride 5 % solution) solution may be used daily, even after the procedure.

4) Blood tests to rule out other autoimmune diseases may be done TFT (thyroid function test ) T3 and T4, LFT (liver function test), RFT (renal function test ), DHEAS (dehydroepiandrosterone sulfate), CBC (complete blood count), ANA (antinuclear antibody) test, and vitamin D3.

Thank you.