Sudden Whitening of the Hair in an 82-Year-Old Woman: The 'Overnight Greying' Phenomenon

An 82-year-old woman experienced a sudden and dramatic whitening of her hair over several days, a phenomenon often referred to as 'overnight greying.' She had not used any hair-coloring products, nor had she experienced any significant stress or illness that could explain the change. Physical examination revealed diffuse alopecia, with a notable loss of pigmented hair, while white hairs remained. Histological examination did not provide a definitive diagnosis, but the clinical findings suggested a diffuse form of alopecia areata (AA), which can selectively target pigmented hair. Laboratory tests showed no abnormalities. The patient was treated with topical betamethasone valerate for 6 weeks, but there was no improvement at the 10-week follow-up. She was then discharged with a prescription for wigs. The case was unusual due to the rapid onset and dramatic change, with the absence of typical diagnostic features of AA, suggesting a possible late 'burned-out' stage of the disease. The patient accepted her condition, and a conservative approach to management was deemed most appropriate.