Managing Sudden-Onset Hair Loss and Rash in a Teen: Alopecia Areata and Atopic Dermatitis Treatment in Houston & Katy, TX

Provider: Reena Jogi MD – Hair Loss & Skin Specialist in Katy and Houston, Texas

At our dermatology clinic in Katy and Houston, Texas, we recently evaluated a 17-year-old female who presented with two primary concerns: sudden-onset hair loss and a persistent, itchy rash. Both issues developed within the last month and were significantly impacting her daily comfort and confidence.

1. Hair Loss Evaluation: Alopecia Areata

The patient reported a sparse patch of hair loss at the back of her scalp that had developed rapidly over the past month. Clinical examination and dermatoscopy revealed discrete, non-scarring patches of hair loss on the mid- and right occipital scalp, findings consistent with alopecia areata—an autoimmune condition where the immune system attacks the hair follicles.

🔍 Diagnosis: Alopecia Areata

We provided detailed education to the patient and her mother about this condition, emphasizing that while alopecia areata often responds well to treatment, it can be unpredictable and recurrent.

💉 Treatment Initiated:

• Intralesional Kenalog (ILK) Injections

  • 10 lesions treated using 2 cc of diluted Kenalog (2.5 mg/cc)

  • Risks such as skin atrophy were reviewed prior to treatment

The patient tolerated the injections well and was scheduled for a follow-up in 4–6 weeks to monitor for regrowth.

2. Rash on Arms and Neck: Atopic Dermatitis

In addition to hair loss, the patient also presented with a moderate, itchy rash affecting her arms and neck. She had been using fluticasone and Eucrisa with minimal relief.

🔍 Diagnosis: Atopic Dermatitis (Eczema)

The rash was determined to be likely caused by allergic contact dermatitis, possibly triggered by fragrances, preservatives, or long-term use of certain skincare products.

We discussed the chronic and often frustrating nature of eczema, especially in sensitive areas like the neck and upper arms. Patch testing was suggested as a potential next step if symptoms persisted.

💊 Updated Treatment Plan:

• Vtama 1% Cream
  A newer non-steroidal topical treatment for eczema; sample provided for trial use.

• Skin Care Counseling:

  • Use fragrance-free cleansers and detergents

  • Moisturize at least 2–3 times per day

  • Avoid scratching and hot water

The patient was advised to follow up in 6 weeks and contact the office sooner if symptoms worsened.

Patient Outlook

This 17-year-old is now on a dual treatment plan for her autoimmune hair loss and eczema-related rash, combining clinical precision with gentle, individualized care. Early treatment of alopecia areata in teens can significantly improve outcomes, while proactive eczema management helps reduce flares and skin damage.

At Reena Jogi MD, we specialize in treating complex skin and hair conditions in teens and young adults, offering comprehensive care in Houston and Katy, TX.