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will a biopsy always DX Alopecia Areata?

Discussion in 'Women's Alopecia Areata' started by amye, Nov 18, 2006.

  1. amye

    amye Guest

    Hi there ladies-

    I wanted to ask if a biopsy will always DX Alopecia Areata?

    I swear I am leaning toward this because of my hair loss. Started SUDDENLY about nine months ago and is very diffuse, also loosing hair in lots of other places!!

    I have already had one biopsy will no conclusion. It came back fine.

    I go back to the derm in DEC and she is going to do another biopsy, so I want to be armed withas much info as possible. She is so intent on saying Androgenetic Alopecia...though I now know she says that to everyone.

    If I have Androgenetic Alopecia, then fine, I will deal with it, but I want to rule out everything else first!!
  2. babanoushi

    babanoushi Guest

    Hi Amye,
    I am like you, wondering exactly what kind of alopecia I really have, but from reading the notes from others I have learned more than I have from the derm I visited. I could write a LONG story about that experience! I had blood work to rule out thyroid issues...no biopsy. But it seems that even a biopsy is not conclusive. So here we are. I'm going to my 'real' dermatologist in December, a woman, with long grey hair, who will at least be supportive, I hope. To me, that is more important at this time than the diagnosis. Does that make sense?

    My hair loss isn't diffuse, it's just one growing shiney bald spot, the size of a large avocado... :(

    This forum has helped me deal with the loss more than anything..you will 'hear' me repeating this over and over, like an Alopecia Areata (alcoholics anonymous) thing..."keep coming back".
  3. Artista

    Artista Guest

    They way I understand it, Alopecia Areata is patchy areas of hair loss. No diffuse thinning. I didn't even bother with biopsy. It's not covered by insurance, and I too am finding I learn more from this board and what may help, and know more as a result than from any derm I've seen.

    I saw my pcp and she knew more about it than the derms! It's such an area that's not quite fully understood, and treatments are hit and miss and who knows, that I find I'm being my own "doctor" of this thing. I told my pcp to write me an rx for Spironolactone, so I now have that going along with Yasmine and Rogaine. That's all I'm trying. Propecia and the like it too expensive for a big maybe.
  4. amye

    amye Guest

    Well, there is a such thing has diffuse alopecia areata. I've had heard that it is rare, but still it exists. It presents with no patchy areas of loss, but all over diffuse thinning....which is me. My loss is evenly distributed all over my head.

    After about nine months of this crap I have a hard time thinking it's TE

    Anyway, I know Petunia got this DX and am wondering if anyone else has and if it was via biopsy.

    I just want to have all the info I can get so she (the derm) doesn't blow me off with a possible worng DX, you know?
  5. Sammy

    Sammy Guest

    Hi Amye - I have the same loss as you and had a biopsy taken in July, which proved inconclusive. Results indicated only that it was diffuse loss. I was told CTE but at the time I was not losing any other body hair. When I went back to this particular derm in October, I told him about my additional peripheral hair loss and he said other body hair loss was indicative of Alopecia Areata, which means that in my case it would be diffuse Alopecia Areata. However, he stressed he has never seen anyone with diffuse Alopecia Areata and since the biopsy didn't detect it, he doesn't think I have it. Regardless, he still prescribed topical corticosteriod lotion telling me that since we're "reaching" it wouldn't hurt to try it. I found the lotion accelerated my loss so I don't use it. We will be doing another biopsy in the new year to see if there has been any change.

    What I do know from my own research is that hormone imbalance could also cause body hair loss.

    Good luck,
  6. Petunia

    Petunia Guest


    I've been trying to find others who have had a biopsy to see what they're results where and what they were told. I don't know if this is o.k to ask but would you mind telling me what they were? Or PM them if that's o.k?
    I just wonder....how similar or different they can be and how doctors are interperting them...When I compare my results with what I find online sometimes I think I have TE really but the doctor said he was pretty sure it was diffuse alopecia...sigh..anyway.

  7. AmandaC

    AmandaC Guest

    We no longer have the ability to pm. :(

    So, I will just tell you about my biopsy. It was taken just off center and to the left in the crown area. I was having itchy/burning sensations, so I figured something was going on under the surface (the outside appeareance of my scalp was jsut fine). And the dermo decided I had Androgenetic Alopecia before she even took my bloodwork. Well, the biopsy came back with slight inflammation of unknown origins, and no mention of miniaturization going on. So she changed her tune and ran the bloodwork and discoved the anemia/very low ferritin /hypothyroidism. So I have been treated both conditions ever since and waiting impatiently for my hair to regrow. :roll:
  8. amye

    amye Guest

    My biopsy was also taken on the crown..right dead center. My scalp was obviously very red and infalmmed and the doctor tired to biopsy where it was the reddest.

    It came back perfectly normal . Normal number of telogen hairs, anagen hairs..no vellus hairs...and oddly enough no inflammation. It did say there was slight minituization on one follicle, but the derm said that you can find that on anyyone's head who is nearing thirty.

    So here I am losing 200 hairs a day with a perfectly beautiful biopsy..WTF!!

    I go Monday back to derm #2 and she is going to do a biopsy fromt the back of my head (yippee) and compare it with the first one to see if there are any changes. I'll let you know how it goes!
  9. AmandaC

    AmandaC Guest

    Isn't it great when the testing brings about more questions than answers? Ugh. It's like you can't trust anything to help you. :x
  10. Sammy

    Sammy Guest

    Hi - My biopsy was taken just below the crown off-centre towards the right side. I wasn't given a copy of the results but I was told that everything was normal. No inflammation and no signs of minituraization, just less hair. The biopsy was taken at the height of my hair loss and I've been regrowing and losing ever since. The 2% minoxidil has helped stabilize the loss to some degree, meaning I'm not losing 200+ a day but I still think I'm losing too much relative to what's on my head.

    What I have noticed in the past few months is body hair loss - at first I thought it was only eyebrows and other "specific" areas but it really is all over, including legs. This to me screams hormonal imbalance even though all my hormone tests came back "within normal range" (except for testosterone, which was lower than normal). I also have three endometrial polyps, which I am having removed this week. Frankly, I can't help but feel the two are related somehow because they started around the same time, although every single doctor (and let me tell you there were plenty of drs!) I questionned has stressed there is no link. At the end of the day, I know intuitively there is some connection and that 'normal' isn't the same for everyone. I have started taking Maca herb, which is supposed to encourage the body to balance its own hormone levels naturally - I've been on this for one month and the one effect I have noticed to date is increased energy (I began suffering from extreme fatigue around the time all of this started). I may be off the mark with my own self diagnosis (lord knows I've already diagnosed myself with everything under the sun) but I always come back to hormones because of everything going on in my body at the same time.

  11. amye

    amye Guest

    sammy- how bad was your shed form the minoxidil? I am going to start after the holidays...and I am scared too death.

    I am also hopeful it well do something about this horrible shed !
  12. Sammy

    Sammy Guest

    Hi Amye,
    I won't lie, my shed was pretty bad, mostly due to the 5% I believe (I was on 2% in the morn and 5% in the eve) - what a wasted shed since I couldn't continue using 5%! The 2% is much more tolerable for me - I use twice a day but I usually use 1.5ml each dose because my loss is diffuse and there's a lot to cover. The total shed lasted for almost 2.5 months. Before minoxidil I had been losing up to 200 + a day. Now it varies. I've stopped counting but I would say for the most part it's anywhere from 30-100, with a few spikes thrown in for good measure. However, I have much less hair on my head so even losing 100, which is typically 'normal', I feel is too much for me now.

    Whether my shedding would have decreased naturally, I'll never know. What I do know is whenever I skip a dose, which I do intentionally every few days, I seem to lose more hair - not a ton more but enough to notice. I do believe the minoxidil has helped to some degree but it hasn't worked any wonders, however, it could take up to 1 year to realize its full potential. I've just passed the 5 month mark.

    Are you planning on starting with the 2% or 5%?

  13. amye

    amye Guest

    thanks for the info sammy-

    my derm recommends starting with the lowest dose of 2%. she says that way, if I disn't very effective for me, I have room to go up. Regardless, I am just as scared of the 2% as i am of the 5%. I have lost so much that a dread shed will wipe me out I am afraid. :(

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