Induced alopecia areata in Parry-Romberg syndrome (PRS) cases


Author: M C0STlN - FUE Europe, Director

PRS is a slow and progressive degeneration of half their face leading to frontal asymmetric atrophy in tandem with facial osseous decalcification, often manifesting secondary symptoms like alopecia areata, catalogued as idiopathic progressive hair loss.

What is the PRS mechanism
In healthy people, the tissue and muscles is nourished by a continuous flow of blood. The flow of blood and the intricate biological processes are controlled by the nerve terminations on the tissue.
In PRS patients these local nerve terminations are impaired and can not regulate the correct blood supply. As such the tissue is not provided with enough nutrients to sustain the biological processes.
The tissue starts to atrophy, the bone decalcifies, the skin becomes thinner, resembling a balloon stretched over, hair follicles suffer from chronic hypoxia and begin shedding all hair strands.
Another side effect of PRS is the apparition of alopecia areata-like symptoms.
Because hair follicles are extremely dependent of proper nourishment and oxygenation, most of the time these alopecia areata-like symptoms appear first, before more serious manifestations start to evolve.
Alopecia areata is a clinical condition where hair simply stops growing on specific patched on the scalp skin, leading to round, hairless areas on the head. In PRS patients, these symptoms are incorrectly diagnosed as having other causes, such as stress or even as plain acute alopecia areata.
 In fact, it's a case of misdiagnose in which a pediatrician may label the case as idiopathic hair loss, idiopathic  trichologic disorder or as alopecia areata, all of the above being incorrect (pseudo-alopecia areata).
The real cause of this type of hair loss in PRS cases is actually the capillary hypoxia-induced asphyxiation and its underlying condition, the Parry-Romberg syndrome.
In mild cases of PRS, it takes between 2 to 3 years between the onset and full manifestation of PRS.
If patchy hair loss symptoms appear in young patients, this should automatically raise red flags due to the fact that the onset of alopecia areata is usually happening after the age of 20.

How to treat PRS
At present there is no known effective cure for PRS. It is also not known how far is goes, for how long it will last, or even if it the disease spreads to other locations or not. The condition seems to burn-out or even stop when the patients are in their early twenties. Reconstructive facial and hair transplant surgery are the only effective options.

PRS versus alopecia areata
Vascular hypoxia (capillary hypoxia-induced asphyxiation) is the main cause of alopecia areata-like symptoms in PRS patients, whereas the real cases of alopecia areata are cause by the defective immunomodulating processes in specific areas of the scalp skin.
In alopecia areata as well as alopecia universalis and alopecia totalis, the hair follicles are incorrectly identified as foreign bodies and attached by the immune system. The result is the complete eradication of the hair roots with its inevitable consequence: total hairless areas.


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