Supravenous Repigmentation of Hair Shafts in a Patient with Regrowing Alopecia Totalis: A Case Report and Hypothesis

This case report describes an adult female with alopecia totalis (AT) who experienced unique hair regrowth patterns after treatment with augmented betamethasone dipropionate 0.05% ointment. Despite initial depigmented hair regrowth, she developed linear bands of darkly pigmented hair overlying superficial scalp veins. This phenomenon suggests that local temperature and corticosteroid-induced changes, such as reduced inflammatory cytokines and increased endothelin release, may influence melanogenesis and hair repigmentation. This finding has not been previously reported and provides new insights into the mechanisms of hair regrowth in AT.