The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
i’ve come across this site before, but today has been an already 5 hour session reading everything that has been posted and researching things on the side. first and foremost, i want to thank you all for your words, rants, and honesty. i stayed home from work today after breaking down in the bathroom, already dressed for work, because of my hair. a few posts made me cry, a few made me smile and all remind me that i am not alone. i, like a few of you, hate that i focus on my hair, but even though i try my damndest to not do so, it really does depress me. i know i will bounce out of it, but it’s only a matter of time before it comes back. today is the first day that i have ever not gone in to work because of the hair situation. here’s my story:

I have had alopecia universalis for 12 years now. It was very difficult in the beginning when my hair began to fall out. I was in college and devastated because I thought my life was over. I have now grown to accept myself and the way I look now. I know I would not be who I am today without this having happened, and I really like me! It does get better, but it is a process. A good support system and love from family and friends gets you through. Good luck to you all on your journey.
The topical sensitizers, diphencyprone or squaric acid dibutylester, have been used in those suffering from recalcitrant alopecia areata or those with more than 50% hair loss. The goal of treatment is to create an allergic contact dermatitis of the scalp. This alteration in the immune response occasionally is accompanied by hair regrowth. The efficacy of the topical sensitizers has been demonstrated in both young children and adults, but it probably works less than half the time. Recent success using oral janus kinase inhibitors, including tofacitinib, ruxolitinib, and baricitinib, have been shown to be efficacious in severe, extensive alopecia areata in adults, but long-term therapy has potential side effects. The durability of response to these medications is variable, and most patients experience recurrence of hair loss after discontinuation. Perhaps topical therapy with these types of drugs may be available in the near future.
Figure 2 is used with permission from Utah Valley Family Practice Residency Program.Figures 3 and 10 are used with permission from the Utah Valley Family Practice Residency Program. Figure 5 is used with permission from Mark Luba, M.D., Good Samaritan Family Practice Residency. Figure 6 is used with permission from Richard Usatine, M.D., UCLA. Figures 9 and 11 are reprinted with permission from the American Academy of Dermatology.
Each follicle produces hair for 2 to 6 years and then takes a break for several months. While the hair follicle is in its rest phase, the hair falls out. There are around 100,000 follicles on the scalp, but because each follicle rests at a different time and others produce hairs, hair loss is usually unnoticeable. More noticeable hair loss occurs when there is a disruption to the growth and shedding cycle, or if the hair follicle is obliterated and replaced with scar tissue.
I’m typing on my iPad so forgive the many mistakes I will make. Thank you so much fornrplying I’ve been wondering where u and Pilar are. And good for u for not visiting. Ive had my moments where I can stay away and eve feel good. I had all of my extensions removed and I think it has affected the way I feel. But bit feels so good for them to be gone! And in all honesty my hair is in even better shape than it was before I got them. My ends are not as wispy as they were. I wore them for two months and they really made me feel better but I could never wash my hair like I wanted and every time my husband touched my head he said when are u going to get these out! Anyway I’ve felt not as good since I had them removed. I like to hibernate but my husband is a social butterfly; I use to be……but we All know how this changes you! Please please let me know how the propecia works. If there are any side affects, etc….like weight gain, moodiness, gloating etc…..there is a lady bin our office on spire and I have been reading the horrific side affects it has and I’m wondering about propecia. I hope u r doing really good. U sounded really strong in ur post and I’m glad. And yes I am deeply depresses over this. I would so get a hair system but my husband is soooooo anti fake anything. Which drives me crazy. I just want to feel better. Have a blessed nite and thank u. Please keep in touch and thank u for replying I felt I would hear from u. Have u spoken to the doc since u ve been on pro?
As much as 30 percent of women will experience some sort of hair thinning, usually first noticed with age as a skinnier ponytail or a little more visible scalp peeking out. Thick hair screams “youth,” which makes thinning a tough pill to swallow. But there are many ways you can help slow down thinning and hair loss, from eating the right foods to cutting back on stress, even strategically styling your locks. Here, seven ways to stave off hair loss and keep your ‘do looking young and healthy for longer. 
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Several types of hair shaft abnormalities can lead to hair loss. These conditions cause strands of hair to thin and weaken, making them vulnerable to breaking. The hair loss doesn’t occur in the follicle but as a result of a break somewhere along the hair shaft, which is the visible part of a hair strand. This can result in overall thinning, as well as in many small, brittle hairs.
Family history will often tell the doctor what type of alopecia a person has. Occasionally, a punch biopsy may be necessary to determine the type of hair loss. Looking at plucked hairs under a microscope can help to tell the difference between alopecia areata and androgenic alopecia. Other tests might be done to check for autoimmune diseases like lupus that can accompany alopecia.
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.
The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.
About 2 years ago my hair started thinning. I thought it was because I was in college and stressed. At that point I started going what is known as “CG” in the curly hair world. I no longer color, flat iron, use sulfates and I rarely blow-dry and use silicones. I use shampoos and conditioners with beneficial ingredients, not fillers. After 1.5 years on this Curly Girl routine, I experienced some relief and noticed my hair getting thicker. That lasted a couple months and now I’m back to losing a ton of hair. One day I counted 160 hairs…that was on a decent day. I’m sure I’ve lost 2x that amount before. My hair is noticeably thinner, drier, and it knots. It NEVER use to knot. I think my hair has become finer too, but I’m not positive. It just feels more fragile.
I’m typing on my iPad so forgive the many mistakes I will make. Thank you so much fornrplying I’ve been wondering where u and Pilar are. And good for u for not visiting. Ive had my moments where I can stay away and eve feel good. I had all of my extensions removed and I think it has affected the way I feel. But bit feels so good for them to be gone! And in all honesty my hair is in even better shape than it was before I got them. My ends are not as wispy as they were. I wore them for two months and they really made me feel better but I could never wash my hair like I wanted and every time my husband touched my head he said when are u going to get these out! Anyway I’ve felt not as good since I had them removed. I like to hibernate but my husband is a social butterfly; I use to be……but we All know how this changes you! Please please let me know how the propecia works. If there are any side affects, etc….like weight gain, moodiness, gloating etc…..there is a lady bin our office on spire and I have been reading the horrific side affects it has and I’m wondering about propecia. I hope u r doing really good. U sounded really strong in ur post and I’m glad. And yes I am deeply depresses over this. I would so get a hair system but my husband is soooooo anti fake anything. Which drives me crazy. I just want to feel better. Have a blessed nite and thank u. Please keep in touch and thank u for replying I felt I would hear from u. Have u spoken to the doc since u ve been on pro? 

According to the International Society of Hair Restoration Surgery, since 2004, the number of female surgical hair restoration patients worldwide increased 24 percent. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head (genetically permanent hair zone) and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because those hair follicles take on the same characteristics as the hair in the area where it originated, the genetically permanent zone. Both approaches result in lasting outcomes. In order to know if you are a candidate, Dr. Yaker will go over your medical history and examine your hair and scalp. He will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.

When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]

Moreover, there are so many subtleties in hair restoration surgery that it's important to choose a physician who specializes in the field, not one who has added "hair restoration" to their menu of services along with other cosmetic surgical procedures, and performs a limited number of the procedures per week.  Experience counts, just like anything in life, and there are many of us in the USA who specialize exclusively in hair restoration, and treat only patients with thinning hair.  It's important to meet personally with your surgeon, and have an in-person evaluation, and a micro-analysis of your scalp to receive the highest level of care possible.  
When your hormones get out of whack as a result of thyroid disease, your whole body can feel off-kilter. Your weight, your mood, and even your thinking, can be affected, and you may have a host of other physical symptoms too. Hair loss is a common side effect of thyroid disease, but it's not a permanent problem as long as you get the treatment you need.
My ob-gyn gave me spirnolactone (?). I like the idea of finding an endocrinologist. I am changing insurance companies right now so as soon as I get sorted, I’ll be making an appointment for sure! I know there is something wrong with me, I lose hair by the handful daily. I’m hoping hair club will at least allow e to build some of my confidence back up while I try to find out what is really going on.
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
In answer to which doctor should I see for my hair loss, my opinion is that you should probably see both. Most doctors don’t know enough about hair loss as it is, so seeing doctors in different specialties may actually help you get a better, more accurate diagnosis. I am sure there are various conditions of hair loss that might be better served by seeing one more than the other. Perhaps a dermatologist would be better suited in determining if the cause was an infectious skin condition such as ringworm or scaring alopecia, and an endocrinologist may be better at diagnosing hormone related hair loss. The truth is, any doctor whether it is an endocrinologist, dermatologist, or general practitioner with a strong interest and knowledge in hair loss can make a proper diagnosis and work with you on the the treatment they think will produce the best results. The operative words here are “interest and knowledge.”

I am 31 years old and I been loosing my hair (in the front) for 3 years now. I have seen different 4 different gynecologists and the one I have now she took blood work and other tests and the when all the tests came back everything was fine. I am trying to find a dermologist in my area that accepts my insurance. I just want to know what caused the hair loss and what can be done. It is embarrassing to even go out, when I do go out I make sure that I have a hat on. ????????
You are what you eat – and that’s true for your hair as well. A diet containing mostly whole foods, especially the skin of plants such as cucumbers, potatoes, peppers, and even bean sprouts are rich in the mineral silica and contribute to hair strength. Foods like lean meats are high in iron and are essential to the protein-based, building blocks of hair growth.

Interesting. After reading these posts, I called a dermatologist in the Houston, TX area asking for an appt. and whether he prescribes medication for hair loss in women. I mentioned Spironolactone. He told the nurse that he does not, and that it can actually cause hair loss. This is exactly the frustration we all experience. You hear a different opinion from each Dr. and don’t know what the right answer is. If anyone knows of a good endocrinologist in Houston, please let me know. I’ve been losing hair for about 5 yrs (now 39 yrs) and have to use hair-loc extensions just to feel confidence when in public. I did not see much about Propecia in these posts. Have any women taken it w/ much success?
Dermatologist: The short answer is a doctor who specializes in the diagnosis and treatment of problems related to the skin, its structure, functions, and diseases, as well as its appendages (nails, hair, sweat glands). The longer definition (as defined by wikipedia) Dermatologists are physicians (Medical Doctors, M.D.) or Doctors of Osteopathy (D.O.) specializing in the diagnosis and treatment of diseases and tumors of the skin and its appendages. There are medical and surgical sides to the specialty. Dermatologic surgeons practice skin cancer surgery (including Mohs’ micrographic surgery), laser surgery, photodynamic therapy (PDT) and cosmetic procedures using botulinum toxin (‘Botox’), soft tissue fillers, sclerotherapy and liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses and treatment of skin disease in children. Immunodermatologists specialize in the diagnosis and management of skin diseases driven by an altered immune system including blistering (bullous) diseases like pemphigus. In addition, there is a wide range of congenital syndromes managed by dermatologists.

Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
Hi! Any recommendations for doctors that care about or specialize in hair loss in South Carolina (or NC or GA for that matter–I can travel.) I am very glad to have found this site. I am 3 months into using 5% Rogaine and taking 50 mg of Spiro. I have noticed a decrease in shedding but no regrowth.Very very very stressful problem to have. So nice to have ideas and support here.
I have been losing my hair over this past year but within the last 6 months it has changed texture and still falling out! Now my hair is very coarse and kinky! For 42 years I had long straight-as-a-board hair and now I look like a poodle! Every time I comb or brush my hair handfuls of hair comes out! My hairdresser, gyno, GP and 3 dermatologists have told me it was normal to lose this amount of hair! Many contribute it aging but I find that hard to believe. Finally, my most recent derm said I was low in iron and said that might be a factor. Now, I’m going in to see if I might be anemic. My gyno ran the same tests and said all seemed normal! It’s the most frustrating and stressful event, especially when everyone tells you things are “normal”! Has anyone experienced their hair texture changing over a short period of time? Thanks-
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration. 

in between all these years, i also tried some homeopathic methods. i read dr. andrew weil’s book on health and used to take 2000mg of alpha-linolenic acid either by evening primrose oil, grapeseed oil or borage oil. it didn’t regrow my hair but i do feel that it helped stall it. only problem is that after a year or so it stopped working for me, but it may help some of you out. there’s a connection, according to dr. weil, between alpha-linolenic acid and hair. i’ve also used homemade rosemary water and washed my hair with it, but it only helps with making me smell like the bush it comes from.
Most people naturally shed about 50 to 100 hairs a day, but sometimes men and women can shed much more, leading to thinning hair, hair loss, and over time, baldness. The causes of this hair loss can be a result of hormones, underlying medical conditions, and even certain medications like antidepressants, high-blood pressure medications, and NSAIDS (non-steroidal anti-inflammatory medications). Sometimes, hair loss is purely genetic and can run in families.

But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth, in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains, adding, “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”

I too have problem with hair loss. I had seen a dermatologist that charged me $85 just to pull my hair and told me nothing wrong with me. I told her my hair normally fall off a lot when I wash me hair, but she insisted that my hair is healthy. She spent approximately 5 minutes with me. From that experience, I don’t go see anybody else about my hair, bad experience. That was 10 years ago. I am not 43 years old. I just don’t trust the doctors any more. I still have problem with my hair so if any of you know a recommend/good caring doctor(s) in Houston Texas, please let me know. Thank you.


I want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.
"Dr. Yaker is ABSOLUTELY AMAZING! He is innovative, highly professional, incredibly skilled and extremely passionate about hair restoration. His bedside manner is one of complete dedication and compassion with genuine care for his patients and their needs. He strives for excellence in everything he does, and it's evidenced by his loyal client following and their satisfaction with their incredible outcomes. I'd recommend him to anyone & everyone interested in hair restoration or transplantation."
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
Eyebrows unfortunately is a different ball game, that is skin transplantation from skin at the back of your head where your hair grows. This means that you would have to trim your eyebrows for the rest of your life. The cost for this surgical treatment is $5000, and again covered by Care Credit. Not sure if I want to do this. I am very light blond. I may just consider permanent eye brow tatoe. I have seen beautiful work – cost around $500.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

I want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.
Each follicle produces hair for 2 to 6 years and then takes a break for several months. While the hair follicle is in its rest phase, the hair falls out. There are around 100,000 follicles on the scalp, but because each follicle rests at a different time and others produce hairs, hair loss is usually unnoticeable. More noticeable hair loss occurs when there is a disruption to the growth and shedding cycle, or if the hair follicle is obliterated and replaced with scar tissue.
Topical immunotherapy (i.e., contact sensitizers) is the most effective treatment option for chronic severe alopecia areata (Table 5).6 Response ranges from 40 to 60 percent for severe alopecia areata, and reaches approximately 25 percent for alopecia totalis and alopecia universalis.6 Because of potentially severe side effects, only clinicians who have experience with these agents should prescribe them.
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss. 

During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
Ludwig Scale: This is the most common classification for female pattern hair loss. There are 3 stages (ranging from mild hair loss to extensive, severe widespread thinning) and in each stage hair loss occurs on the front and top of the scalp with relative preservation of the frontal hairline. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.
A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.

The best fix by far for replacing lost hair is a transplant. Back in the day, docs used plugs that resembled cornrows (definitely not natural looking). Today, guys have more options. You can go for “the strip method” where a doctor surgically removes a strip of hair from the back of your head, dissects every hair graft under a microscope, and then plants the individual grafts onto hair-thin areas of your scalp with tiny incisions.


A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
Thank you so much ladies, I am grateful I was able to find this website. Can anyone suggest a Doctor in the South Florida Area ( West Palm Beach, Ft. Lauderdale, Hollywood or Miami)? I have seem countless of Doctors in the past 20 years; felt like none really cared or took an honest interest. The last Doctor I visited didn’t even bother to see me in person, she just called me on the phone and told me nothing can be done, use Rogaine if you want, she said. Needless to say my condition is serious. After this I am at the point of giving up but if I could find a Doctor that really cares I am willing to try again. Any advise is welcome. Thanks again.
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin's surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman's hair loss.

I do not believe birth control pills nor rogaine to be an appropriate long lasting answer for hair loss. I do not want to be on drugs for a length of time. Luckily, I have researched how the answer possibly lies within your lifestyle. What you eat, How much you exercise, how much sleep you get and stress you have. As for hormone-caused hair loss, the adrenal gland produces a 1/4 tsp of hormones per year. If you go slightly under or over that amount, a hormone imbalance is the result. If you use table salt, or are on a low-salt diet…you may be negatively affecting your hormones.
Interesting reading all the stories, I had great hair until 15 years ago,and then the texture of my hair drastically changed. It be became “dead hair” wirery. I call it it my chicken feathers just taking its time to fall out which it has done over a long period of time, but I now have bald spots on the sides and thinning in my bangs. I started buying wigs years ago knowing that this was something that was inevitable. I’ve had all the tests and tried all the products, nothing..just curious if anyone else has had the “dead hair” issue

Physical stress can also be a cause for hair loss. Any kind of physical trauma surgery, a severe illness, an accident, even the flu can lead to temporary hair loss. This can trigger a type of hair loss known as Telogen effluvium. Hair loss usually gets noticeable 3-6 months after the trauma but once your body recovers, your hair would start growing back again.
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Triamcinolone acetonide (Kenalog), 0.1 mL diluted in sterile saline to 10 mg per mL, is injected intradermally at multiple sites within the area to a maximum dosage of 2 mL per visit.6 The main side effect, atrophy, can be minimized by not injecting too superficially and by limiting the volume per site and the frequency of injection (no more often than every four to six weeks).6 Because spontaneous resolution often occurs in patients with alopecia areata, assessing treatment response can be difficult. Intralesional steroids should be discontinued after six months if no improvement has been noted.

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