Why shiny, soft bald patches do not respond to medication?

Question

Hello doctor,

I have bald patches all over my head. They look shiny and soft with no evidence of the presence of hair follicles. So I went to a skin doctor. She suggested using Minoxidil 5 percent. But still, there is yet to be any improvement. Please help me. I had Covid-19 around one and a half years back. And took my first Covid-19 vaccination around a year back. The problem started after the Covid-19. I noticed this problem after tonsuring my head.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

It is alopecia areata of scalp. It is a self-limiting disorder characterized by areas of asymptomatic, non-inflammatory hair loss commonly involving the scalp. Autoimmune disease hair loss occurs in patches. In addition, it can be associated with a thyroid disorder. Around 80 percent of people have regrowth of hair during the first year of hair loss. Some show complete recovery; in others, the regrowth never takes place. Topical and oral steroids are the mainstay of treatment, and intralesional steroids can be used. Intralesional steroid injection Kenacort can be given once in three weeks. Systemic steroids have been found useful in the recent onset of disease.

Do you have any of the following:

History of fungal infection in the past?
Autoimmune disorder?
Thyroid issues and vitiligo?
On certain medications?
Itchy scalp?
Recent onset?

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

My advice:

Consult your specialist doctor, talk to them, and take medications with their consent.

Apply Mometasone (Mometasone furoate) lotion in the evening for ten days on the bald patches.
Wash scalp with Ketoconazole and Salicylic acid medicated shampoo on alternate days for ten days.
Apply Tenovate (Clobetasol) cream at night for 30 days on the bald patches.
Intralesional steroid injection will also help.

Thank you.