“Why Did I Suddenly Develop a Patch of Hair Loss on My Scalp?”
Hair loss that appears suddenly can be alarming, especially when it occurs in distinct patches. At Reena Jogi, MD Dermatology in Katy, Texas and Houston, Texas, we frequently evaluate patients who notice unexpected hair loss that may be related to autoimmune conditions affecting the hair follicles.
A recent patient asked during her visit:
“Why did I suddenly develop a patch of hair loss on my scalp?”
This case highlights a common condition known as alopecia areata, an autoimmune form of hair loss that can appear suddenly even in patients with no prior scalp symptoms.
Case Report: 61-Year-Old Female with Sudden Patchy Hair Loss
A 61-year-old female presented as a new patient with concerns about sudden hair loss that had developed over the past six months.
Patient History
The patient reported:
Sudden onset hair loss
Moderate severity
Patchy hair loss affecting the scalp and frontal hairline
No current treatment for the condition
The hair loss was noted in multiple areas including:
Right central frontal scalp
Right lateral forehead
Right inferior frontal scalp
Right inferior lateral forehead
Because sudden hair loss can have several causes, a careful dermatologic evaluation was performed.
Dermatologic Examination
A complete examination of the scalp, face, eyelids, lips, and neck was performed.
Clinical Findings
The exam showed patchy areas of hair loss, raising strong suspicion for alopecia areata.
Although the clinical appearance was suggestive, a punch biopsy was discussed as an option if further diagnostic confirmation becomes necessary.
Diagnosis: Alopecia Areata
Alopecia areata is an autoimmune condition in which the immune system mistakenly targets hair follicles, leading to sudden hair loss.
Key characteristics include:
Sudden onset of patchy hair loss
Smooth areas of scalp without scarring
Possible recurrence over time
Hair follicles remain alive, allowing potential regrowth
Although the pattern in this case was slightly atypical, the presentation strongly suggested alopecia areata.
Treatment Options for Alopecia Areata
During the visit, several treatment options were discussed with the patient.
Common treatments include:
Intralesional corticosteroid injections (ILK)
Topical corticosteroids
Topical minoxidil
Anthralin therapy
Other advanced treatments depending on disease severity
For localized alopecia areata, intralesional steroid injections are often considered the most effective initial treatment.
Treatment Performed: Intralesional Kenalog Injection
The patient elected to proceed with intralesional corticosteroid therapy.
Treatment Details
Medication: Kenalog (triamcinolone acetonide)
Concentration: 2.5 mg/cc
Number of lesions treated: 7
Total injected volume: 1 cc
These injections help reduce inflammation around hair follicles, allowing hair growth to resume.
The patient was counseled about potential risks including localized skin thinning (atrophy).
Additional Treatment Plan
In addition to steroid injections, the patient was instructed to begin:
Topical Therapy
Apply once daily to the affected areas of the scalp
Minoxidil helps stimulate hair follicles and can support regrowth when used alongside other therapies.
Comfort During the Procedure
To help ensure patient comfort during the procedure, Pro-Nox analgesia was used.
This system delivers a mixture of nitrous oxide and oxygen, which can help reduce:
Anxiety
Procedure-related discomfort
Lightheadedness during injections
Patients are monitored closely throughout the treatment.
What to Expect with Alopecia Areata Treatment
Hair regrowth typically occurs gradually after treatment.
Typical timelines include:
4–8 weeks: early regrowth may begin
2–3 months: more noticeable hair regrowth
Multiple treatments may be required for optimal results
Because alopecia areata is an autoimmune condition, recurrence can occur, and ongoing monitoring is important.
Follow-Up Plan
The patient will return to the clinic in:
6 weeks
At that visit, we will:
Evaluate hair regrowth
Repeat intralesional injections if necessary
Adjust treatment based on response
Alopecia Areata Treatment in Katy, Texas & Houston, Texas
At Reena Jogi, MD Dermatology, we diagnose and treat many types of hair loss, including:
Alopecia areata
Female pattern hair loss
Male pattern hair loss
Telogen effluvium
Scarring alopecias
Our clinic offers advanced hair loss treatments including:
Intralesional corticosteroid therapy
Topical and oral medications
PRP hair restoration
AlmaTED hair treatments
Personalized hair restoration plans
If you are experiencing sudden hair loss or patchy hair thinning, early diagnosis and treatment can help improve outcomes.
Schedule a consultation with Reena Jogi, MD in Katy or Houston, Texas to learn more about your hair restoration options.
