One Doctor Said I Had MPB, Another One Said I Have Alopecia Areata

Dr. Rassman

I am a 22 year old male with no family history of MPB. About 2 months ago I saw a dermatologist that diagnosed me with MPB and wrote be a script for Propecia. His exam wasn’t as thorough as I would have liked (No Pull test or tests for minimization). So I decided to seek a second opinion from another dermatologist in town. She preformed a multitude of tests and determined that under my circumstances I most likely had Alopecia Areata, and then proceeded to give me a cortisone injection. Now I understand that Alopecia is an autoimmune disorder but my question to you is:

1) Can a blood test be used to accurately determine whether I have Alopecia?
2) Would the cortisone injection have a negative effect on my hair loss if I do in fact have MPB?
3) Can I still take propecia, while receiving the cortisone treatment?
4) If I was misdiagnosed, what would be the appropriate measures to take to find out the real cause of my hair loss?

Thanks

Aside from a good history and physical exam, one way to diagnose alopecia areata is a biopsy of the scalp. More importantly, I would need to know more of how you present and what your hair loss looks like.

1. Blood tests cannot diagnose alopecia areata (AA) or androgenic alopecia (also known as male pattern baldness/MPB). Note the word “alopecia” is just a scientific term for hair loss and is not a diagnosis.
2. Cortisone injections do not work for treating MPB or AA in all cases. I realize some doctors use cortisone injections for AA, but it is not a cure and doesn’t work to treat everyone with this condition.
3. Propecia is for treating MPB and you should not be taking it if you don’t have MPB.
4. You need to seek out a doctor who can explain these things to you in person, and give you a diagnosis and a treatment plan with your options laid out.

Taking Propecia (finasteride) without a confirmed diagnosis is not a good approach to your problem. I have written many times about having a microscopic exam of the hairs in different areas of the scalp (miniaturization study) and having your hair bulk analyzed. This system can determine if your hair on one part of your scalp has less fullness than another part of the scalp. In young men, this is the best way to make the diagnosis of male pattern baldness.