January 2006 – Page 10

January 16, 2006

Hair Loss from Procerin – Hair Loss Information by Dr. William Rassman

I noticed hair loss in my hair line back in august and about 2 months ago started taking an herbal supplement called Procerin. Since then instead of just losing it in the hair line the whole top of my head is falling out. I read something about a shedding phase that sometimes occurs when products of this nature are taken. Can you shed some light on this for me please? Thank you VERY much for you time!!

Unfortunately, since Procerin is not regulated by the FDA (as most supplements are not) there is little to no information in the medical literature regarding side effects and very few (if any) scientific studies. To complicate matters, humans will go through a shedding phase naturally and it is nearly impossible to tell if your hair loss is normal or due to some substance (like a supplement) you have added to your diet. You could do a hair count (count all the hairs you shed daily for a week – average should be no more than 100), or you could also just wait and see if the accelerated loss subsides on its own. If it continues, however, I would suggest seeing your doctor (or a dermatologist or a hair loss specialist) to get evaluated for other medical conditions which could be causing hair loss. Get your scalp hair mapped out for miniaturization. Just do not assume that the one thing you may have identified is the only cause of your hair loss; you have too much at risk.

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January 16, 2006

Hair Loss After Adult Chicken Pox – Hair Loss Information by Dr. William Rassman

When i was i think 19 i had chicken pox. i had a fever for about two weeks. after i recovered, one day when i woke up i saw my pillow had many hairs on it and when i combed my hair, many hairs fell out. before i had chicken pox my hair was very thick and long, but now is not so much bald but the thickness is gone. my hair in front of my head is in the shape of an M. and my hair in the top is not very thick now. im 22 now.

What you describe is very common. Significant illness or stress to your body can precipitate a “telogen effluvium”, also known as a “shedding phase” which is transient – it grows back. Now, several years later, the “M” shaped hairline you describe is consistent with male pattern balding – another common condition. These two conditions are likely unrelated. Hope that helps!

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January 13, 2006

At What Age Does Hair Stop Growing Naturally? – Hair Loss Information – Balding Blog

Hello
I am 23 years of age and I am losing hair (mainly because of dandruff). I would like to know until what age does hair regrow naturally.

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We generally say that the hair wreath around the sides and top of the head, a 2 1/2 inch high area that runs from ear to ear, is permanent. We see this in the men who are very bald; they really never become fully bald as this wreath of ‘donor’ hair stays for life. The rest of the hair on the head of a very bald man may or may not last the lifetime of the man, depending upon their genetics. In women with no genetic hair loss, the same applies and the hair loss remains for the life of the patient. The small wreath of hair that we say is permanent in men, may not be permanent in women. Therein lies one of the differences in women’s genetic hair loss as compared to men’s genetic hair loss. On many women and men, the overall population of the hair may be decreased with age (unfortunate medical term is senile alopecia), but that rarely impacts more than 30% of the hair in impacted areas. So, worse case, an answer to your question is that fully 70% of hair on the head will last a lifetime, if genetic factors do not force it into an early death.

My grandmother lived to 114 years of age, and her hair was long (2-3 feet) and still growing when she died. She had a full head of hair. My grandfather died at 102 years of age with a full “Ronald Reagan” type head of hair with a hair line like he had when he was 10. He had a hair cut about every 3 weeks, and died at work behind his desk, a few days after his last hair cut (something he enjoyed doing very much because he got out and about). It’s all in the genetics of what our parents and grand parents gave to us (life span for ourselves and for our hair).

January 13, 2006

Bald Spot in Back of Head – Hair Loss Information – Balding Blog

I have lost a circular patch about an inch and a half of hair in the back lower center of my head just above the neck line. The rest of my hair is naturally very thick and healthy. Any prognosis? I am 27 years old male. Thank you.

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This is the ideal case for Propecia — crown balding in a young man. A good number (more than 50%) of men your age (in my experience) will regrow hair on this drug and many of them will reverse the visual impact of the loss. Get yourself checked out for miniaturization to see where else on the scalp that you may be losing hair and get it quantified and then remeasured after 8 months on the drug. In young men, many of the early signs and measurements of balding will disappear if the miniaturization is subclinical.

January 13, 2006

Diffuse Thinning in Female – Hair Loss Information – Balding Blog

Dr. Rassman – I am a 41 yr. old female and have been experiencing diffuse thinning. I noticed this happening about 5 months ago and have been on an endless quest ever since and no one can seem to offer help. I have been told to try everything from hair transplants to ScalpMed, (which I saw your response to), Rogain and then not to use any of those treatments. I have seen 3 dermatologists, 1 holistic doctor, 2 GP’s, and an endocrinologist. I have had every blood test as described and nothing has been found. My 2 uncles on my mothers side are bald although my parents, sister and brother do no have thinning. I have scalp psoriasis mainly on the crown and sides of my head. I recently had a scalp biopsy and interestingly enough the pathology report stated that, “on the basis of this punch boipsy, the favored finding is psoriasis/sebopsoriasis, findings of alopecia are not present in this biopsy, and negative for scarring alopecia, lupus or any known inflammatory dermatosis (other than the psoriasis). I am currently using Clobex shampoo and lotion, not at the same time, and I know that I can only be on these for short periods of time due to the side effects, and that they can cause hair loss. I have sent photos to Dr. Bauman in Florida and he suggested the hair transplant. If someone would have told me 6 months ago that I needed a hair transplant, I never would have believed them. My problem is my hair is still thinning, and before I lose it all I would like to stop it. I am losing about 150 hairs a day and I have heard anything over 50 is extreme. I have done extensive research and still I have no answers. I understand that when the plaques get bad enough it can cause hair loss and that I need to get the psoriasis under control, however I have received so much contradictory information, I don’t know who or what to believe anymore. Is there someone that you can recommend here locally that may help? This entire situation is taking a toll on my health and marriage. Thank you.

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First, I would like to acknowledge that you have a problem significant enough to affect your mental health. I have dealth with many patients in your circumstance. In your case, Psoriasis does not cause hair loss unless you pull on the scales, thereby producing traction alopecia. What you have done (including the biopsy) seems reasonable. If you have diffuse hair loss impacting even the sides and back of your head, and continue to shed hair, I do not recommend hair transplantation, for you will be transplanting some of the impacted hairs, not just the recipient area. Doing a hair transplant for a patient who is currently experiencing active Telogen Effluvium is bound to fail. Through the internet, it is impossible to treat you without examining you. If you live in California, consider visiting one of my offices (in Los Angeles or San Jose). If not, send me photographs to the email address on the Contact page and I will see if I can help you any further. Please avoid hair transplants until there is a clear plan in front of you.

January 13, 2006

Tachycardia from Minoxidil? – Hair Loss Information by Dr. William Rassman

What is the likelihood minoxidil caused an episode of tachychardia where patient is a healthy 48 year old female with no cardiac history or risk factors who used it on her scalp for a week prior and whose symptoms did not recur upon cessation of use?

There may be a direct association between tachycardia (fast heart rate) and minoxidil (which is a hypotensive agent that drops blood pressure). Many people complain of dizziness with this drug and what they are probably experiencing is a small drop in their blood pressure. When blood pressure drops, the first thing the body does to compensate for it is to increase the heart rate, so your symptoms fit nicely into the physiology of the cardiovascular system.

January 13, 2006

Remember to Vote for Balding Blog – Hair Loss Information by Dr. William Rassman

I need your help!

This is the last reminder to please vote for Balding Blog in the annual Medical Weblog Awards! When you click the link below, find the little circle to the left of “Balding Blog” (4th in the list), then click the Vote button. It just takes a few seconds of your time and is very appreciated.

Thanks again for your support!

UPDATE: Voting is now over. I’ll make a new post about it when I know the results.

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January 13, 2006

Psoriasis and Rogaine – Hair Loss Information by Dr. William Rassman

I have scalp psoriasis and consequent thinning patches. Would using Rogaine aggravate the psoriasis?

Rogaine (minoxidil) can cause skin irritation and may aggravate your psoriasis. You might try it and see. The worst case is that you make the psoriasis worse for a few days. Many people with psoriasis have to experiment on how to manage the disease. It behaves differently in different people.

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January 13, 2006

Miniaturization? – Hair Loss Information by Dr. William Rassman

I have gone to a number of doctors and asked, as you have advised, to map my scalp for Miniaturization. They do not know what I am talking about? What should I do? Are you the only one who does this? How important is it?

There are a series of hair metrics (measurements) that any good doctor must do for a proper analysis of your scalp. First, if the doctor waves his/her hand over your head and says that you have a fine hair density, run for the hills. Good metrics require scientific measurement and the science of densitometry as I have defined it in scientific publications (such as this article from 1993 which discusses densitometry) .

If you step back for a moment, you will see that if you do not know just how much hair you have and the value of each hair, then you do not know much about the way your hair (or lack thereof) will meet your needs as you replace it. Metaphorically, think about a house, where half of the house has been eaten by termites and you need to replace the wood that is not any good. Then you want to add a room on at the same time. It would be crazy to try to do this job without assessing just how much wood is rotten (miniaturized hairs), how much wood is available from the lumber yard (assuming that you have a limited amount of wood/hair from the donor area), and how much area you intend to build up from scratch (the balding area which needs to be restored). If you can not measure any of these factors, you can not determine your needs, which must be matched against supply. It is not very complicated when you know what you are doing.

It would be absurd for a doctor to tell you that measurements are not important in determining early balding (miniaturization). It would be as if he/she is saying that the pending termite damage is irrelevant, and to just wait until the house caves in. Crazy? If you do not know if your wood supply is in 2×2’s, or 4×4’s then you do not really know the value of the essential replacement resources you have. If you have miniaturized hairs in the donor area, then you might have a disease which will contradict a hair transplant, but without measurements you can not say. If the termites have invaded the wood supply (miniaturized hairs in the donor area which is a disease in men and a common finding in women with genetic hair loss), then you can not build a house (trusses and all) with 2×2 studs alone (damaged or otherwise inadequate in quantity), you need wood beams and 18 on center 4×4 studs to support a wall properly. Likewise, you can not put in single hairs or damaged hairs into the transplant to do what god’s follicular units are doing for you now like when you were young.

So, to conclude, a doctor adds very little value to your Master Plan to help you determine what you must do over time, when the doctor does not use measurements to determine:

what the status of your scalp is at the time he starts Propecia with regard to miniaturization and in predicting your final hair loss pattern
what you are losing
what you have for supply to replace what you are losing or lost

This is not about the doctor making money doing hair transplants to all balding men, but rather using a full arsenal of treatments available to you, determining the value of those treatments over time and using his/her skills to your overall benefit. You have must a real clinical scientist / caring physician on your team who puts your benefit and goals above all else.

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January 13, 2006

Best Hair Thickening Agent? – Hair Loss Information by Dr. William Rassman

I am a 42 year old male with thinning hair both at the front & crown area of my head. Without entertaining hair transplants, what do you recommend to improve the appearance of my hair? What is the best Thickening agent/shampoo out there? Are there any products that actually work in your opinion? I used minoxidol years ago but gave it up quickly.

Thanks

There are many thickening agents/shampoos on the market and people respond differently to each depending upon texture, shaft thickness, the wave in the hair, and other factors. I generally tell people to buy a series of such products and then test what works best, or ask a hair stylist who works with such products daily and get a recommendation from them. Minoxidil does not impact the texture or shaft thickness from above the skin as thickening agents/shampoo will.

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