Hi Jenny,

The mom and I realize that she is undergoing the telogen effluvium
that normally occurs postpartum but we are worried because
she had a colocalization of alopecia and vitiligo after her last  
pregnancy...

She lost nearly all of her hair not only in a diffuse pattern
typical of postpartum alopecia but to the degree of bad case of  
female pattern
baldness and with alterations of her hairline consistent with androgenic
alopecia...

She is afraid it is going to happen again because it is happening
even earlier this time...

She saw six different doctors none of whom offered her anything but  
the advice to wean.
(They saw her balding but they didn't see her white regrowth)

She certainly wants to see a doctor again and an internist is a good  
suggestion
but this time she would like to go with a list in hand of treatments
compatible with breastfeeding...

With input from the Lactnettes she is planning to ask for tests
for thyroid function, hormones, CBC with dif, and vitamin and mineral
deficiencies...

Now we are at the point where we need advice about treatments
compatible with breastfeeding...

Cortisone injections worked for her when she had quarter sized patches
when she was young, but she was told she couldn't take them while  
nursing...

I saw in the Lactnet archives that injections were compatible with  
nursing
but I was wondering if that would still be true for larger areas?

For the androgenic alopecia perhaps progesterone
would help block androgens from the receptors and she is
passed the 6 week mark postpartum...estrogen is probably
preferred by docs but she wants to keep her milk...

She has accepted that nothing can be done about the telogen effluvium
she would just like not to have large patches and altered hair line...

Any more input would be great!

Jen O'Quinn IBCLC



On Aug 19, 2006, at 3:50 PM, Jenny Thomas, MD, IBCLC wrote:

> I second the suggestion for a good internist to see her.
>
> The process of hair loss after delivery is called tellogen  
> effluvium and =
> is
> not related to the autoimmune disorder that is alopecia.  Telogen  
> effluvi=
> um
> is not thought to be an autoimmune disorder.
>
> She may just have alopecia but it can go along with other autoimmune
> processes.  She needs to have someone take in the whole picture.
>
> Jenny Thomas
> www.drjen4kids.com
>
>
>

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