People ask, how I treat a bald patch. It really depends on what they're referring to. In my mind, this brings up two points, one being, a bald patch, meaning a bald spot on the top of the head, or two, being an actual small area of baldness that occurs almost over night. That's referred to as alopecia areata. That's an autoimmune condition, where the hair just disappears in either a small or a larger, round, patchy zone, for reasons that we don't really understand.
Both of these treatments can be different. For the bald spot on the crown, we actually treat that best with hair transplant surgery. It can be done in conjunction with medicine and laser therapy, but the permanent solution is going to be the transplant.
If we are looking at alopecia areata, we can treat that in a different way. Often, this hair will come back on its own, but we can stimulate the growth and have it occur more rapidly by doing things with topical medications such as the minoxidil.
We can actually use a steroid preparation, or we can inject intralesional steroids right into the area. Generally, we do that around the periphery and a little bit in the center. We can see that these hairs will start to come back.
We often combine that with laser therapy. If the area does not grow back over a year or two, that alopecia areata, we would call burnt out. If it's burnt out, then, we can transplant into that zone.
There's no guarantee that the hairs we transplant into that zone will continue to grow. Most of the time, if it's been burnt out, we can transplant into that area, and hair will continue to grow.