Brief Answer:
Alopecia Areata, Intra-lesional steroids
Detailed Answer:
Hi. thanks for posting your concern at XXXXXXX
I would keep a possibility of Alopecia areata. It is an autoimmune condition and commonly present as focal patches of hair loss, most commonly over the
scalp nut also on the beard, moustache or eyebrows or eyelashes. This is known as patch type OR focal alopecia areata
Alopecia totalis is when hair loss involves the entire scalp and
Alopecia universalis is when hair loss involves the entire body hair.
In Focal type of Alopecia Areata, most of times, hair regrows spontaneously within 1 year (as it happened first time round with you, 5 years ago). But people often seek treatment because the bald patches are unsightly and are easily noticeable to others.
Various treatment options in Focal type of alopecia areata in order of the choice of treatment:
--Intra-lesional
Triamcinolone acetonide is first line treatment in adults followed by other modalities like:
--Topical potent steroids
--Topical Minoxidil
--Topical Anthranalin
--Topical PUVA(psoralens +UVA therapy).
All of them are effective. However I prefer Intra-lesional steroid in my patients of Alopecia areata. It can be repeated after 3 -4 weeks and usually hair regrow after 2 injections, given 3 weeks apart.
Since you have been using
Diprosone, which is a potent
topical steroid and even after after 3 months (good enough trial) it does'nt seem to affect.
In such a case if I was your treating doctor I would have recommended switching to intralesional steroids which is anyways, my first choice.
take care
regards