Two case studies of persistent white hair regrowth after alopecia areata turning pigmented following treatment.

BACKGROUND: There is a strong correlation between alopecia areata (AA) and the development of white hair. The AA presents itself in many clinical manifestations of depigmented hair as the condition advances. It is uncommon for unpigmented hair to extensively regrow for more than one hair growth cycle in AA and successful conversion to pigmented hair after treatment has not yet been reported.

AIM: We report two case studies involving the persistent regrowth of white hair after AA that became pigmented through treatment.

PATIENTS: In the first case study, a 47-year-old woman with AA exhibited a fully regrown head of hair, which remained unpigmented. However, after 2 years of treatment with oral methylprednisolone and compound glycopyrrolate, her hair eventually regained its normal pigmentation. In the second case study, a 7-year-old boy with diffuse AA received compound glycyrrhizin (50 mg once daily) and methylprednisolone (4 mg orally once daily) for 3 years.

RESULTS: The both patients experienced regrowth of black hair on his entire head, with occasional white hairs. It is hypothesized that the aforementioned medications may regulate immunity by influencing melanocytes or melanin-associated antigens; however, the precise mechanism must be validated through additional histopathological and molecular analysis.

CONCLUSION: A larger patient group, possibly in randomized controlled trials, is needed to determine how the indicated treatment affects hair repigmentation after AA. Therefore, more patients must be included for more substantial outcomes from this study.