Current State of the Crown: Foundations of the Battleground

So I decided to make a blog series about my experience with Alopecia Areata, starting with out with my hair's current state and some progress pictures.

I will also be sharing with you my trichoscopy photos and how my medication is affecting me. I'm hoping to make this a daily post, but will most likely be an every other day thing. I still want to post about different things and I have a couple of posts that I am pretty excited to post about.

So, let's get started.


As mentioned in my previous post, I was diagnosed with Alopecia Areata on the 9th of January, 2017 by my father's cousin, Dr. Felix Paolo Lizarondo. If you need a friendly, understanding and knowledgeable dermatologist based here in the Philippines, I highly recommend him!



Just a heads up, some people may be a bit grossed out by the next pictures, which are my trichoscopy photos.

Trichoscopy is a hair and scalp evaluation technique which helps in distinguishing conditions like Alopecia Areata and and Telogen Effluvium in my case. These are usually 10-fold or 70-fold magnifications but I think mine is just 10-fold.

The red flags of alopecia areata are visibly noticeable on my scalp, such as the exclamation mark hairs, coudability hairs and broken ends or what I used to call regrowth. I included a photo from the internet for comparison.








I also have the yellow dots and black dots, indicative of hyperkeratotic plugs and destroyed hair follicles.



Hyperkeratotic plugs are an indication of a presence of an abnormal quantity of keratin resulting in rough, cone-shaped, elevated papules. The openings are often closed with a white plug of encrusted sebum.



As for the scaling and irritated parts of my scalp, those are mostly after effects of me not washing my hair everyday -- resulting in itchy scalp, dandruff and icky stuff.

Now that we have that laid out, let me show you how my hair currently looks now, fresh out of the shower.

01/10/18

I have Diffuse Alopecia Areata, so rather than having patches of bald spots, I have very noticeable thinning all over.

Here are photos taken in a similar fashion so you can see the progression easily.
       






I have a very active case of DAA , which is why Dr. Lizarondo decided to act fast and prompt my system to hit the brakes. I was prescribed corticosteroids to be taken daily for 2 weeks. I started taking them on the 10th of January 2017 and holy fuck I wish I was warned about the taste. And the after taste. and the after after taste. Heck, even my burps taste like it !! The only thing that was able to "extinguish" the taste was a cup of milk.

I was told to monitor myself for anything out of the ordinary, and girl, I took that to heart. I am now monitoring my weight, mood, temperature and blood pressure.

    01/10/18
    Weight: 53kg
    Mood: Irritable
    Temperature:
    Blood Pressure:120/90

I think I'll monitor my water intake and food intake as well. Just for shits and giggles. I mean, I used to, and I don't know why I stopped. Life, I guess.

I was also prescribed a topical scalp ointment, calcium and Vitamin D supplements and a medicated shampoo. Let me just quote my journal entry for my first impressions regarding these products.

    ...the shampoo, well, it's medicated. What can I do. The smell is not too bad and it doesn't really linger. No irritation so far, except for a teeny sore bump I had on my nape after shower. It's gone now though. The shampoo felt a little weird when I washed it off though, as if my scalp absorbed the bubbles and it's just some viscous liquid that I applied. The cream is.. satisfactory, for the price. Come on. It cost nearly 3k for that tiny bottle! Of course I expected at the very least a cooling sensation, or a nice scent, or something. But no. It was just a semi clear gel that smelled literally invisible and felt like nothing when I applied it. Just a bit greasier.

To end this, I'm just a bit disheartened to know that it's not recommended to use a hair concealer or spray to hide the obvious balding spots yet, as it may interfere and contaminate my scalp and treatment. I mean, it's for vanity purposes, yes, and I know why it's not recommended, but your girl needs a little boost you know? I can't live in hoodies and not going out forever. Which means 2-3 months, since that's how long it takes for hair to actually and noticeably grow back.

Do I have anything else to say?

Hmm. Nope. Don't think so. I guess I can always add it in if needed.

That ends the first Current State of the Crown, meeting adjourned.

Information provided by my doctor, American Academy of Dermatology, Philippine Society of Cutaneous Medicine and National Alopecia Areata Foundation.

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