Can Hair Regrowth Occur in Bald Spots with Fine Hair Growth?

Can a balding person with fine hair regrow their hair?

I have been experiencing hair loss for almost a year.
I have seen a dermatologist, used medicated shampoos, and taken prescribed medications, but there has been no significant improvement.
The dermatologist has advised me to see an endocrinologist because I have developed acne on my scalp.
I would like to know if this is indeed related to my endocrine system.
The doctor also mentioned that my hair loss is due to alopecia areata, which can be caused by excessive stress, long-term sleep deprivation, and irregular lifestyle habits.
However, my hair loss started after I moved away for university, and I do not often stay up late.
Although I return home during summer and winter breaks to work night shifts, these periods are only short, lasting one to two months.
I have noticed that my hair loss is more severe during the school year, while it is less noticeable when I am working.
The most affected area is the occipital region, where my head rests on the pillow.
Could my hair loss be due to an unclean pillow? My hair loss does appear to be in circular patches, with several spots, but the bald area at the back is more elongated and quite large.
The bald spots can be somewhat itchy; is this normal? Some of the smaller patches have regrown to the point where they are no longer noticeable, but the larger patches currently only have fine hair growing back.
Aside from the bald areas, the rest of my hair is long and healthy.
My hair loss can be concealed, and I have stopped taking medication for a while, but I continue to use the medicated shampoo.
I have noticed that if I do not use this shampoo, my scalp becomes very flaky, resembling snow, and it itches a lot, especially around the temples and hairline, where there are large flakes of dandruff.
However, if I use the medicated shampoo, this issue does not occur.
The doctor advised me to wash my hair with my regular shampoo first before using the medicated shampoo.
I currently wash my hair twice a week.
I have found that this medicated shampoo seems to require a treatment regimen; if I go too long without washing, my dandruff and scalp itchiness return.
I have asked the doctor about this condition, and they mentioned it could be similar to tinea.
Is there a permanent solution for this, or do I have to continue using the medicated shampoo to manage it? I wash my hair daily because it is oily, and if I skip a day, it becomes very greasy.
I would like to know if my hair loss can improve naturally without medication, and if there is a possibility for my hair to regrow.

Lala Xiong, 20~29 year old female. Ask Date: 2017/11/16

Dr. Wu Yuxin reply Dermatology

Your question seems to lack a specific focus; it is advisable to seek medical attention to confirm the issue.

Reply Date: 2017/11/16

More Info

When it comes to hair regrowth in areas where fine hair has started to grow, there are several factors to consider, especially given your history of hair loss and the treatments you've undergone. It sounds like you're experiencing a complex situation involving potential hormonal influences, stress-related hair loss, and possibly scalp conditions that could be contributing to your symptoms.

Firstly, the presence of fine hair in bald spots is a positive sign. It indicates that the hair follicles in those areas are still active and may be capable of producing thicker hair over time. However, the rate and extent of regrowth can vary significantly from person to person, depending on various factors such as genetics, overall health, and the presence of any underlying conditions.

Your dermatologist's suggestion to consult with an endocrinologist is particularly relevant. Hormonal imbalances can significantly affect hair growth and loss. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal issues can lead to hair thinning or loss. If your hair loss is indeed linked to hormonal changes, addressing these underlying issues may help improve your hair growth.

Regarding your concerns about the cleanliness of your pillow and its potential impact on hair loss, while it's essential to maintain good hygiene, it's unlikely that a dirty pillow is the primary cause of your hair loss. However, if your scalp is itchy and you notice flakes, this could indicate a scalp condition such as seborrheic dermatitis or fungal infections like tinea capitis (ringworm). These conditions can lead to inflammation and hair loss, so it's crucial to address them appropriately.

The fact that you have been using medicated shampoos and have noticed a reduction in dandruff and itchiness is a good sign. Medicated shampoos often contain active ingredients like ketoconazole, selenium sulfide, or zinc pyrithione, which can help control fungal growth and reduce inflammation. It's essential to follow your dermatologist's advice regarding the use of these shampoos, including the recommendation to wash your hair with a regular shampoo first before applying the medicated one.

As for the possibility of regrowth without medication, it can be challenging to predict. Some individuals may experience natural regrowth over time, especially if the underlying causes of hair loss are resolved. However, if the hair follicles have been significantly damaged or if there is scarring (as seen in conditions like scarring alopecia), regrowth may be limited.
In terms of lifestyle factors, managing stress is crucial. Chronic stress can exacerbate hair loss, so incorporating stress-reducing activities such as exercise, meditation, or hobbies can be beneficial. Additionally, maintaining a balanced diet rich in vitamins and minerals that support hair health (like biotin, zinc, and vitamins A and D) can also contribute positively.

In conclusion, while there is potential for hair regrowth in areas with fine hair, it is essential to address any underlying hormonal or scalp issues. Regular follow-ups with your dermatologist and possibly an endocrinologist will provide a clearer picture of your situation. In the meantime, continue using your medicated shampoo as directed, manage your stress levels, and maintain a healthy lifestyle to support your hair health. If you notice any changes or worsening of your symptoms, don't hesitate to reach out to your healthcare providers for further evaluation and guidance.

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