Is Propionibacterium Acnes Associated With Hair Casts And Alopecia?

The document from 2012 examined four patients with diffuse non-scarring alopecia, hyperseborrhea, and keratinaceous hair casts, where Propionibacterium acnes was found in the scalp of two patients and observed in the hair follicles of another. Standard treatments for seborrheic dermatitis were ineffective, but systemic antibiotics targeting P. acnes improved symptoms, suggesting a potential role for P. acnes in the development of hair casts and possibly alopecia. The study proposes that P. acnes may be directly involved in this condition, which appears to be distinct from seborrheic dermatitis, and recommends considering oral doxycycline or erythromycin for similar cases, with a call for further research to explore this potential link.