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Dr. Bob
Dr. Bob, Medical Doctor
Category: Dermatology
Satisfied Customers: 5306
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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I recently got what looks like a dry spot in the back of my

Customer Question

I recently got what looks like a dry spot in the back of my head on the hair/scalp. I saw my primary doctor for it and he thought it was some kind of bacteria that was stopping the hair from growing. I was then recommended "Athlete's foot cream-Antifungal cream." I was supposed to try that out for 2 weeks and apply the cream twice a day (Morning/night), and see if the hair grew and improved after. Did not help and no good results, in fact the bald spot grew larger than before. So, he recommended to me to use a prescription drug for the bacteria to eliminate it internally because he thought the body was attacking itself from the inside and causing the hair loss. I refused and told him to recommend me to a dermatologist and see if he would get better diagnosis. The issue is I can't see one until a couple months from now because thier totally booked in my area. I just wanted to ask if you might now what it could be? Thanks.
Submitted: 10 months ago.
Category: Dermatology
Expert:  Dr. Bob replied 10 months ago.

This appears to be alopecia areata, a condition that affects about 2% of all people at one time in their lives or another. It is considered an autoimmune disease, in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the structures from which hairs grow. This can lead to hair loss on the scalp and elsewhere.

Expert:  Dr. Bob replied 10 months ago.

In most cases, hair falls out in small, round or oval patches about the size of a quarter. or silver dollar. In many cases, the disease does not extend beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the scalp (referred to as alopecia areata totalis) or complete loss of hair on the scalp, face, and body (alopecia areata universalis).

Expert:  Dr. Bob replied 10 months ago.

While distressing for many, alopecia areata is not a life-threatening disease. It does not cause any physical pain, and people with the condition are generally healthy otherwise.

Expert:  Dr. Bob replied 10 months ago.

The course of the disease varies from person to person. Most likely your hair will regrow with or without treatment, but it may also fall out again at a later date. No one can predict when it might regrow or fall out. Some people lose just a few patches of hair, then the hair regrows, and the condition never recurs. Other people continue to lose and regrow hair for many years.

Expert:  Dr. Bob replied 10 months ago.

There are several treatment options that a dermatologist can discuss with you, but none are foolproof. If medications and creams are ineffective, steroid injections into the scalp underlying the affected area may help to reduce inflammation and stimulate hair growth.

Customer: replied 10 months ago.
I've had a relative of mine with the same condition and he was prescribed some kind of liquid or ointment medication applied twice daily for about a month and hes went away soon after. I don't know the name of the prescription, but is their such one? what would you best recommend to me that is least lethal but yet effective than the anti-fungul cream.
Expert:  Dr. Bob replied 10 months ago.

This condition frequently runs in families. He may have been treated with a steroid ointment (e.g. lidex, triamcinolone, desonide). These ointments also suppress inflammation and often help the hair follicles to recover.

Customer: replied 10 months ago.
How is this steroid ointment applied, By hand or injected? Would I have to get it prescribed or can it be found over the counter.
Expert:  Dr. Bob replied 10 months ago.

It is a presciption medicine that is rubbed in by hand twice daily. If one strength doesn't work, a more potent version can be tried. If the creams don't work then injections may be tried.

Customer: replied 10 months ago.
Which one should I try first?
Expert:  Dr. Bob replied 10 months ago.

I would ask your doctor about Lidex (fluocinonide). This is a moderate potency steroid (anti-inflammatory). In my experience the ointment works better than the cream, but is greasier. Either should help, but you may not see improvement for several weeks or months due to the slow growth of hair.

Customer: replied 10 months ago.
Should I only apply it to the bold spot area or can it be applied all over? It seems like my hair got thinner all over, especially in the back area from the first pic.
Expert:  Dr. Bob replied 10 months ago.

Try it on the affected area only. If your hair is falling out all over, there may not be much that you can do...though a dermatologist will have some suggestions for things to try. Also be sure to get basic blood tests, including your thyroid levles and CRP level (a non-specific marker of inflammatory conditions).

Customer: replied 10 months ago.
Anything else you might recommend?
Expert:  Dr. Bob replied 10 months ago.

Try to avoid sleeping on your back. This adds pressure to the affected area and traction on the remaining hair follicles. If necessary, tie a tennis ball into the back of your pajama top to avoid rolling onto your back at night.

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