[35F] With diffuse and patchy hair loss and scalp issues

Patient Description

A 35-year-old female has been experiencing hair thinning for over a year, with recent progression to rapid hair loss. The hair loss is diffuse and accompanied by patchy circular bald spots. The patient reports an itchy, flaky scalp with whitish-grey scales and red patches. There is slight pitting on the thumbnails and joint pain, which is not new. The patient has a family history of autoimmune diseases and has been diagnosed with chronic idiopathic urticaria, B12 deficiency, and Hashimoto's. She is not currently taking any medications and stopped taking some about two months ago. Dandruff shampoo has not alleviated the scalp symptoms.

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Arora's Assessment

What might be happening

Your symptoms suggest a few possible conditions:

  1. Alopecia Areata: This is an autoimmune condition that causes patchy hair loss. It can be associated with other autoimmune diseases, like Hashimoto's, which you have mentioned.

  2. Psoriasis: The red patches and whitish-grey scales on your scalp could indicate scalp psoriasis, which is also linked to autoimmune conditions. It can cause itching and flakiness.

  3. Telogen Effluvium: This is a condition where stress or changes in your life can cause widespread hair thinning. It might be contributing to your diffuse hair loss.

Typical treatments for these conditions include topical corticosteroids for alopecia areata and psoriasis, and addressing any underlying stressors for telogen effluvium. Blood tests and a scalp examination by a dermatologist can help confirm these diagnoses.

What you can do

For Hair Loss and Scalp Issues:

  • Consult a Dermatologist: It's important to get a professional evaluation to confirm the diagnosis and discuss treatment options.
  • Gentle Hair Care: Use mild shampoos and avoid harsh treatments or styling that can irritate your scalp.
  • Stress Management: Practice stress-reducing techniques like meditation or yoga, which can help if stress is a contributing factor.

For Autoimmune Conditions:

  • Regular Monitoring: Keep up with regular check-ups for your Hashimoto's and B12 deficiency to ensure they are well-managed.
  • Healthy Diet: Maintain a balanced diet rich in vitamins and minerals to support overall health.

Consider using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

  • Worsening Hair Loss: If you notice rapid progression or new symptoms, seek medical advice promptly.
  • Scalp Changes: Any new or worsening redness, swelling, or pain should be evaluated by a healthcare professional.
  • Systemic Symptoms: If you experience new joint pain, fatigue, or other systemic symptoms, it may indicate changes in your autoimmune conditions.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

People Also Ask

What are the common causes of patchy hair loss and how can they be treated?

Patchy hair loss can be caused by conditions like alopecia areata, an autoimmune disorder, or scalp infections. Treatment often involves topical corticosteroids or other medications prescribed by a dermatologist.

How can I differentiate between dandruff and scalp psoriasis?

Dandruff typically causes white flakes and an itchy scalp, while scalp psoriasis presents with red patches covered with whitish-grey scales. A dermatologist can provide a definitive diagnosis and appropriate treatment.

What lifestyle changes can help manage autoimmune conditions like Hashimoto's?

Managing autoimmune conditions can involve regular monitoring by a healthcare provider, maintaining a balanced diet rich in nutrients, and possibly taking prescribed medications to manage symptoms.

How does stress contribute to hair loss and what can be done to mitigate it?

Stress can trigger or exacerbate hair loss conditions like telogen effluvium. Stress management techniques such as meditation, yoga, and regular exercise can help reduce its impact on hair health.

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