July 2006 – Page 10 – Balding Blog

July 13, 2006

I Think I Have a Diffuse Alopecia – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I’m a 20 yr old white male and I’ve seen my beautiful dense hair reduce it’s volume to about 40% over a 7 months period. It all started about a month after I relocated to another city. 2 months ago I went to a dermatologist. She gave me this treatment: Hairgrow 2% Minoxidil, Ducray Sabal shampoo and some vitamins. I don’t think it’s working because I’ve analyzed my scalp and I have less hair than 2 months ago. The thing is, I don’t have MPB but rather a diffuse alopecia. I honestly have no idea what the cause is because I have a healthy life style with balanced meals and workout. My father has MPB so in the worse case I should have developed MPB as well.
I would be forever grateful if you could shed some light on my problem. Thanks in advance.

Block Quote

When you describe a diffuse alopecia, I really do not know what you are seeing. When I describe a diffuse alopecia, I expect to see miniaturization of hair throughout the scalp, including the rim of hair around the sides and back (we call this the permanent hair zone). When miniaturization occurs in the permanent zone in a man, this is a very bad omen for long term deteriorating hair loss, something that is not easily managed with drugs and certainly not transplants. Rather than go into the complex area of the real diffuse alopecias, their diagnosis and management, I would suggest that you get your scalp mapped for miniaturization to find out what is really going on. Is this real? Is this a disease that you are manifesting?

July 13, 2006

Hair Loss InformationVirtual Reality Hair System – Hair Loss Information – Balding Blog

You seem like a wonderful person to spend so much time answering people’s questions and helping us. My question is about “Virtual Reality Hair”. This seems to be a hair system that claims to be undetectable to the sight as well as feel. The base is suppose to be like a contact lens…very very thin. The maintenance is very high and it is expensive. Can you let me know if it is unhealthy for the skin? I am only 23 with a receding hairline or a maturing hairline and this would save my social life if it works. Thank you for your time.

Block Quote

I cannot comment specifically on the Virtual Reality Hair system, as I have not seen it and have no experience with it. Generally though, these hair systems should not be “unhealthy” for the skin. However, sometimes these systems may cause local irritation or even contact dermatitis in rare cases. The way such systems fit to your hair and scalp can cause traction alopecia from the rubbing of the hair system and the pulling upon your hair. You should also be aware that as you wear them for periods of time, you will sweat and need to clean and maintain them from developing that worn-in odor (as with your favorite hat). As you stated, the maintenance cost is very high and expensive.

July 13, 2006

Why Am I Losing Hair At Only 17? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I am a 17-year-old male that is experiencing moderate hairloss. I’ve had this problem since I was a pre-teen have gone throughout highschool with this embarrassing feature, as it has increasingly gotten more and more noticeable. The problem is I don’t know why or how this happen as the hair loss take on no typical male pattern hair loss pattern and is thin throughout my entire scalp. I’ve been to a doctor and a dermatologist and all they did was prescribe rogaine and propecia. I’ve tried rogaine for a series of months with no results and propecia’s outside of my budget. Can you please give any clue as to why this is happening to me at such a young age and how i can treat it. I have no medical conditions.

thankyou for your time.

There are many causes of thinning. These can include changes in your hair character itself, something that happens as a person matures. I have seen young men with a coarse hair character change to a finer hair. If this is your situation, then this is the new you. Of course, the first thing you must do is get a diagnosis. Genetic balding, the most common cause of hair loss in men, can easily be diagnosed with a process I call mapping our your hair for miniaturization (which most regular readers know that I mention quite a bit). Even without patterns of hair loss, miniaturization does occur in a variety of medical conditions. I never tell people to go at this blindly. Get your diagnosis first, then go from there figuring out how you might deal with the problem, that is, if there is really a problem there.

Paid advertisements (not an endorsement):

July 13, 2006

Rapid Weight Loss and Gain Caused Female Hair Loss? – Hair Loss Information by Dr. William Rassman

(female) I have been on Topamax 200mg twice a day for over a year now, I have also been taking Ritalin 20mg twice a day for the same lenght of time, and taking Xanax 2mg three times a day and Baclofen 20mg three times a day for about six months. I have also had a problem with anorexia and Bulimia for quite a number of years now and been up and down on my weight from about 72 pounds to around 145 to being stable at around 90 pounds for quite awhile now. I am a strick vegetarian and am now taking 65mg of iron twice a day and drinking a protien drink every morning. But for about the last four months my hair has been falling out all over the place, it falls out when I shower,in my sleep, when I run my fingers through it, blow dry it, brush it, on my clothes, ect..I am taking all the vitimans I can think to take but it just keeps falling out…and I had stopped taking my medications to see if that was the problem but it hasn’t helped. Could you please advise any helpful information on what I can do to stop the hair loss and get it to regrow, your help would be greatly appreciated.

You have “been there and done that” with things that are known to cause hair loss, including the medications, severe changes in diet with weight loss, and dietary problems that could lead to a variety of vitamin deficiencies (too many to list here). These stem from your weight problems. Looking over your list, I would not know where to start. I think that you should find a good doctor that you trust and can form a bond with, and then tackle your hair loss problem as a matter of focused attention. This is not something for internet medicine. I wish I could offer more, but I’m limited to what I can do through text on a screen.

July 13, 2006

Rapid Growth in Frontal Area, Slow Growth in Crown After Transplant – Hair Loss Information by Dr. William Rassman

I had a 1565 follicular unit transplant 3.5 months ago and I seem to be experiancing a more rapid pace of growth on my frontal hairline compared to that of the growth on my crown. I am curious to know weather of not this is common and if the number of hairs within each follicular unit impacts the rate of growth? The doctor who operated on me put 3 and 4 hair follicular units on the crown and 1 and 2 hair units in the frontal region.

Almost every patient will experience varied rates of growth by where in the scalp you are looking. I have seen the crown exceed the frontal growth rates and visa versa. You must have patience. Generally you can expect newly transplanted hair to grow within 8 months. You seem to have a relatively early growth and I suspect the transplanted crown area to catchup.

July 13, 2006

Propecia and Androgenicity – Hair Loss Information by Dr. William Rassman

I have been on propecia for the last three month. I am bout to end month three and have noticed that my temple hairs have become noticably thinner than before I started propecia. I have increased sex drive and more morning erections. For a while I was having some scalp irritation which has gone away. Is it possible I am being affected by androgenecity? Prior to taking propecia I had my total test. checked and it was at about 250. I am 24 years old. I am hoping that my temple hairs have been pushed into telogen and this is why I have thinned in these areas. I have a good amount of hair on my head and want to maintain it. What do you think? Also, many of my hairs that have been falling out look to have a white type of pulp on the end near root.

Your report of an increased sex drive is a well known side effect of Propecia (most people seem more concerned and worried about the decreased sex drive which occurs in 1/100 to 1/200 patients). Men generally get an increased testosterone level of about 18% on Propecia in the initial month or so. This often returns to normal after 1-3 months. Testosterone is a far more potent that DHT as a male hormone for sex drive.

Your hair loss may just be a normal progression of your male pattern hair loss and Propecia may actually be slowing its progression (even if it seems you are losing hair). If you are concerned about hair loss, you may consider visiting a hair specialist who is able to quantitatively record the miniaturization of your scalp hair and perhaps even determine the degree of future hair loss.

Paid advertisements (not an endorsement):

July 13, 2006

Patient Letter to Dr Rassman – Hair Loss Information by Dr. William Rassman

Every now and then I’ll receive an email from a patient years after seeing them and it brightens my day. I thought I’d share this one I just received…

Dear Dr. Rassman,
I am [name removed for privacy] and I had a procedure for almost 2 years now (2280 grafts).

WELL!!! By looking at every single FOLLICULAR UNIT you had transplant onto the front of my head, I couldn’t tell that I had a hair transplant. Man, that is how good you are. I am so glad I got you as a Doctor. It changed my life forever because I feel more comfident about myself now and a lot more of the man I know I am because of you, Dr Rassman.

You know what my dream is Dr. Rassman? My dream is to have another TRANSPLANT from you but my girl friend doesn’t let me because she witnessed what I been through and she was so scared. To me I feel great and I would do it over and over again. I guess she just cares for me too much and I thank you GOD for that. Who ever reads this, please bear with me. It sound like I am a super pussy. Maybe, I will do it again without letting her know. If you do my surgery, that would give me more motivation to convince my girl friend to let me have another procedure.

Thank you for all the staff. You are part of my life.

What a nice letter. I can not tell if you are worried about pain from the surgery or from your girlfriend who may not be backing you for a second surgery. If you are worried about any pain, since your last surgery, we have made substantial changes in the anesthesia protocol we use with the use of a medication called Versed. This medication is a type of narcotic which does make the local anesthesia far less painful if you had trouble with it before. We have also added a stronger narcotic for the first night when the muscle spasm hits so that the first night is more tolerable for those who experienced pain. With these changes, you should think twice about any pain fears that I think you are expressing here. With regard to your girl friend, well most men either have wives, girlfriends or significant others and these folks do get involved in decisions we make like undergoing still one more transplant.

For the blog readership: this patient has agreed to let me post his photographs and he will be coming to see me shortly so that we can not only discuss the email posted here, but also take recent post-surgery photographs so that we can all know just what he is sooooo excited about.

Paid advertisements (not an endorsement):

July 13, 2006

Anabolic Steroids, Propecia, and Rogaine – Hair Loss Information by Dr. William Rassman

I was wondering Dr if you take steroids at a young age (19) (I know certain steroids are more harmful to your hair than others), and you do start to loose your hair but after 4 years you still have very thick hair but you do have mild hair loss and you still have enough thick hair to cover up bald spots, what does that mean? Are you predisposed to loosing all your hair or the hair you lost while on steroids is that it, has the hair loss stopped? Mind you, I have been on propecia for close to 2 years but I did stop for close to 6 months and none of my hair in the back fell out but my frontal line receded a bit.

Also, can rogaine cause hairloss? Because I was using rogaine and I did get some growth but I also felt I had some hair loss so I went off of it (I was on for about 6 months) then I have started to lose more hair. I am on propecia, so what is going on? PLEASE HELP ME.

Steroids, especially anabolic steroids (the kind bodybuilders use), may cause hair loss. Unfortunately for reasons not clearly understood, once you start losing hair it seems to continue as if a “switch” has been turned on.

Finally, the hair loss you are noticing may just be your natural course of hair loss indendent of Rogaine or Propecia. Propecia and Rogaine may have slowed down your hair loss to a certain degree, but we will never know the degree of how much of gain or loss you had because you did not continue the drugs for an extended period of time. My opinion is that you may want to continue the Propecia and/or see a hair specialist who may better assess the degree of your hair loss and its balding pattern, hopefully by mapping our your hair for miniaturization to obtain measurements on what is happening to your hair.

Paid advertisements (not an endorsement):

July 12, 2006

Using Straight Razor to Shave Head Stimulates Growth? – Hair Loss Information by Dr. William Rassman

My hair has been thinning since I was about 18. But it seems to have accelerated in the last year or so since i grew my hair long. (I am now 23) I decided to shave my head, and boy did that reaffirm my receding hairline. When it grew back it looked a little bit odd to me. My left side had no border; it has basically a 2 1/2 by 2 1/2 inch patch of thin hairs (with more density towards the top) with hugh gaps between them from my “peak” in front to the side areas. On my right side it is thinning but there is a border and it is a lot thicker and less receding. There is a major difference. How many years could have stress and growing it long accelereated my hair loss, if what I described is normal. Secondly, I used a straight razor to shave my head thinking that would stimulate hair growth, eventhough i was told about it scarring and or killing the follicles.

I do not believe using a straight razor will stimulate hair growth. If that is true, I would be in the hair shaving business!

You make an interesting observation of being able to see the pattern of hair loss with the short shaved head. What you are seeing is the miniaturized hair, which has less bulk than normal hair. This is fairly difficult to see in patients with average men’s hair lengths. That is why I often write about mapping your scalp for miniaturization with the densitometer that we routinely use at New Hair Institute. Alternatively, if you can not find a doctor able or willing to map your head for miniaturization, you can get a very short hair cut and see with the eye where the miniaturization is.

July 12, 2006

Saw Palmetto for Women? – Hair Loss Information by Dr. William Rassman

What course of action do you recommend for women with thinning hair? I have low thyroid and take medication for this condition (.75 mg levoxyl)

Should women take Saw Palmetto, or any other product that reduces production of DHT? I am nearing menopause and my estrogen levels are reading very low: >.32. Would HRT help?

Does a completely bald father and mother with thinning hair compound a child proclivity toward hair loss in middle age in women?

My hair loss started 10 years ago mainly in the forhead area and temples. It has now progressed into a triangular pattern stretching toward the back of the head. Luckily I had a thick head of hair to begin with or I’d be wearing a wig by now.

Any advice would be greatly appreciated.

You should discuss these issues with your regular doctor — especially with respect to HRT. HRT may help with your low estrogen levels and overall well being. However, there are breast and cervical cancer issues that your doctor needs to discuss with you before starting HRT.

Saw Palmetto has been implicated with DHT reduction (correlations not based upon good clinical science) however if your hair loss is not DHT related it would not work. Women rarely have such a connection. You should be evaluated by a good specialist who can correctly diagnose the cause of your hair loss. Please note that just because there is a diagnosis, it does not mean there may be a solution, as is the case in many women with genetic hair loss.