Letter in Reply: Alopecia Areata After SARS-CoV-2 Vaccination

    May 2022 in “ JAAD case reports ”
    Angela Lo, Adnan Mir, Naveed Sami
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    TLDR A woman developed alopecia after her second Pfizer vaccine but regrew her hair with treatment and had no issues after a booster shot.
    The letter discusses a case of a 61-year-old woman who developed alopecia areata (AA) after receiving the second dose of the Pfizer SARS-CoV-2 vaccine. The diagnosis was confirmed through biopsies showing follicular miniaturization and a lymphocytic inflammatory infiltrate. The patient was treated with topical fluocinonide, minoxidil, tacrolimus, and intralesional triamcinolone acetonide, resulting in full hair growth within four months and no relapse after receiving a Pfizer booster vaccine. This case supports the possibility that mRNA SARS-CoV-2 vaccines may trigger a T cell-mediated immune response leading to AA, even in older individuals without a history of autoimmune diseases. The successful treatment with topical tacrolimus and minoxidil suggests that SARS-CoV-2–induced AA can have limited disease progression and may be effectively managed without systemic drugs.
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