Alopecia Following Deoxycholic Acid Treatment for Submental Adiposity

A retrospective review of 66 male patients who received deoxycholic acid treatment for submental adiposity showed a 15% incidence of alopecia, with hair loss first noticed approximately four weeks after injection. Of the eight patients who developed alopecia, five reported improvement or complete resolution. A case report included a biopsy from a patient with alopecia after treatment, revealing a nonscarring alopecia with 75% of hair follicles in the telogen-catagen phase, which is significantly higher than the normal count of ≤10%. The histological findings suggested that the alopecia could be a form of localized telogen effluvium, possibly due to an inflammatory response disrupting the hair cycle. However, the presence of pigment hair casts and persistent alopecia in some cases could not be fully explained. The study also noted thrombi at the dermal-subcutaneous junction, which might indicate pressure-induced alopecia. This is the first report of histological findings in alopecia following deoxycholic acid injection, highlighting the need to inform patients about this potential adverse effect, despite the majority of affected patients still being willing to continue treatment.