Q: I have got patches of hair loss in my beard for one and a half years. I consulted a skin specialist and took treatment for about 10 months from him. He gave one steroid tablet with some anti-allergic medicines. After couple of months there was growth of hair and he discontinued the steroid tablets but after some months the problem recurred. The cause of the alopecia he said was tension. I went to another doctor who said that it was due to a fungal infection. I had fungal infection prior to this problem which was not treated properly. This doctor kept me on anti-fungal medicines and also, I believe, on steroid tablets. The problem was cured completely in about 7 months. Its been 5 months since the medicines have been discontinued. Now, the problem has recurred. What is the cause of the disease? How is it treated and for how long? I have been losing hair on my head also. Is it because of this problem?

A:Alopecia means a patch of skin devoid of hair. This can occur in a number of conditions. Alopecia areata is an example. Fungal infection leading to alopecia is very rare on adult scalp, but is seen in children. Fungal aetiology can be confirmed by microscopic examination of the broken hair. The natural course of alopecia, and the kind of response one should expect from treatment will depend upon the correct diagnosis of the disease. For example, alopecia areata which can affect any hairy part of the body, is characterised by exacerbations and remissions. It may run for a few years. The choice of treatment in this condition will depend upon the extent of disease, site of involvement and the cosmetic disability experienced by the patient.