Dr Lam's Hair Restoration Forum

Hi Dr. Lam,


My hair loss started ever since I took Roaccutane 20mg for 4 months. My hair loss is diffuse and I believe I suffer from diffuse alopecia areata. I have symptoms like scalp itchiness, mild pain and sore spots which come and go constantly and it shed the worse when this symptoms flake out. I am pretty sure that this is not MPH because both side of my parents family does not suffer from MPH and my hair loss is diffuse and shed everywhere rather than just frontal and crown shedding and it started only after I took Roaccutane. I have spoked to my doctor and had blood test done but he couldn't figured out what was wrong and he was pro accutane who doesn't believe that accutane could cause hair loss. I would like to know if there is any way to diagnose diffuse alopecia areata? I really hope you could help me on this. Many thanks.



Max

Alopecia areata can be most accurately diagnosed by a scalp biopsy. However, alopecia areata as a disease is not typically related to a drug product. it is usually an immune-related disease process in which T cells are attacking the hair follicle. Patchy loss (if that is what you are experiencing) could be fungal or other related causative factors (view my video on patchy hair loss).

Drug related hair loss is usually either an anagen or telogen hair loss (you can read about those types in the respective sections of this website). usually anagen hair losses occur shortly after the onset of taking a medication that would slow down proliferation of hair growth like chemotherapy and you would typically see abnormal breaks in the hair. Telogen loss typically occurs months after an insult and hair sheds at a much lesser extent since we only have about 10% of hairs at any given time in telogen except in certain cases like MPB in which telogen could be as high as 20%.

Bottom line is that I am not a dermatologist or an internist. Sometimes you need the help of both to get the right answer. The dermatologist would investigate local scalp/hair issues, and the internist would look at hormone related issues (testosterone, thyroid, ferritin, etc.). Hope that helps.
Best,
SML

Dear, dr.lam

i've been having alopecia areata for alomost 7 months. it's happened after stop taking roaccutane..

It's definitly from taking roaccutane.

koo

please see a dermatologist. i really wish i could be of help. i am a surgeon not a derm. if you live in dallas, i can recommend someone to you. however, if you have been on accutane, i assume a derm prescribed it to you?
best,
sml