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My 14 year old daughter has alopecia totalis. Who should she see?

By Anonymous November 15, 2016 - 10:12pm
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My daughter was diagnosed initially with Alopecia Areata. Then one month later was completely bald. We have seen dermatologists in the same practice who tell us conflicting things and another one at a different practice that suggests different treatments. I really believe it was caused by her prozac which she has been on for years but about 2 1/2 months before she started losing her hair the dose was increased. She is now off prozac and now on luvox. Kenelog injections into scalp dissoved fat in scalp and no longer being performed, she was prescribed mens rogain twice a day and latise for her scalp until the lead derm told her not to use latise as it isnt a recommended treatment. And suggested kenelog IM amd metrotrexate v.s. zeljanz. Our family doctor ran labs and all came back ok including thyroid. He is reluctant to encourage using the recommended tx by her dermatologist because of potential side effects in such a young girl that hasn't even gone through puberty yet. Instead he is recommending she see a pediatric endocrinologist. I know you can't give advise but can you please direct me to any valid studies that would give insight into what an appropriate treatment would be? We live in a rural town with limited resources so we are desperate for expert advise and guidance. Thank you!!!

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Hello Anonymous,

Welcome to EmpowHER. Thank you for reaching out to our community with this issue. I am so sorry to hear about this and will do my best to provide information that may guide you.

Alopecia Totalis (AT) is one of a group of three main conditions. Those three are Alopecia Areata, Alopecia Universalis, and of course Alopecia Totalis. AT is an autoimmune disorder which results in the total loss of hair, but only on the scalp. It is somewhat of an intermediary condition between Alopecia Areata which is patchy scalp hair loss. Alopecia Universalis extends to total body hair loss.

AT usually appears in two types: One being a fairly sudden and complete loss of all head hair. The other being a slower form which originates as Alopecia Areata (patchy loss) and advances to complete scalp hair loss. In this sense it is sometimes tied to Alopecia Areata (patchy loss), but not all the time.

It comes about as a result of an autoimmune disorder which causes your immune system to attack your hair follicles. In most cases there is small chance of hair recovery, however there have been cases of complete restoration as well. Consider it a genetic auto immune condition that has an unknown trigger, and which can sometimes be “un-triggered” for unknown reasons. They are still researching why hair follicles are the target of the autoimmune activities.

Anonymous, based on this information from HairLossTalk, I question the link to Prozac.

The main Alopecia Totalis treatments are therapies which focus on immunomodulation, such as glucocorticoid injections, anthralin, or glucocorticoids taken orally. We have heard reports from some that years of steroid therapy can put the condition into remission. Years of steroid therapy is not always enjoyable however, as there are side effects. It is important to comment that Rogaine (Minoxidil) is not effective for those with Alopecia Totalis. Some treatments which have been considered include Methotrexate, a treatment for autoimmune disorders, and corticosteroids have been proposed as treatments.

Anonymous, since AT is thought to be an autoimmune disorder, I think you should schedule a consultation with a rheumatologist.

Keep us updated,

November 16, 2016 - 7:18am
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