June 2007 – Page 10 – Balding Blog

June 8, 2007

Hair Loss from Motorcycle Helmet? – Hair Loss Information by Dr. William Rassman

Dear Doc,
Can pulling on and pulling off a motorcycle helmet every other day cause hairloss or weaken hair at the root so it falls out? I try to be as careful as possible but rubbing my hair on the sides is unavoidable! Thank you.

Usually hair loss from motorcycle helmets if fitted properly should not occur. However, I recently saw a patient who wore a very tight (not properly fitted helmet) for a few months and he had hair loss on certain areas where the helmet was rubbing on his scalp/face. This type of hair loss is caused by traction and is known as traction alopecia, commonly seen in women who braid their hair too tightly. This type of hair loss may be permanent, depending on how long the insult has been occurring.

June 8, 2007

Hair Loss from Hair Twirling? – Hair Loss Information by Dr. William Rassman

Does twirling the hair at the front of the head cause extra hairloss? I am 37 and have had male pattern baldness.

Only if you pull on it while you are twirling it. If you have not seen hair loss in the area you are ‘working’ I would not worry much about it.

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June 8, 2007

I’m a Female with Thinning Hair – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,

I am a 27 year old female. Just under 2 years ago I began to notice my hair was quickly becoming thinner and thinner and stacks of it fall out each day. I have not counted exactly how much hair falls out, I just measure more by the thickness and amount left on my head and also the density on my scalp. I am about 1/4 Lebanese on my dads side but his sister has lots of hair and she’s 60. The men in my family still have full heads of thick hair, and most of my female relatives do too, although my mum and grandmother have had hair thinning, but after menopause, some stress and in my grandmother’s case, after prednisone.

My hair is sort of wavy/messy curly and I used to have very thick hair up until the last few years. I have many health concerns at the moment, but I’m pretty sure I have been tested for things like thyroid function, lupus and hormone levels. I have been on and off medicines such as the pill, some antidepressants, epilum and zyprexa, but even after being off all medications for a couple of months, my hair continues to fall out. I do not brush it very much, but I am not concerned that the loss from brushing is a build up over days, I also do not blow dry, straighten and colour my hair more than a few times a year. I even tried laureth sulfate free shampoos which seemed to possibly slow down the loss for a couple of weeks, before it resumed again, but its hard to tell. Do you know of anywhere in Sydney or Canberra Australia that does this miniaturization testing you speak about?

Are there any other causes you know of, or things I can do to help this problem? I am pretty young to be on Rogain or permanent medicine.

Any advice or insight would be appreciated, as I am frustrated and concerned by the hair loss and the lack of answers.
Thanks.

You clearly need a good doctor to take charge of your complex situation. See ISHRS.org for a doctor in your area. There are a number of good doctors in Sydney and throughout Australia.

June 8, 2007

Hair transplant scars – Hair Loss Information by Dr. William Rassman

What does a normal scar look like?

The first photo is a patient from our office who had one procedure totaling 3000 grafts. The scar measures about 2-3 mm wide and with his hair combed down, unless he shaved his head or cut it very, very close, it would not show. The second photo is my scar. I believe these to be scars that represent what’s “normal” and I am showing them to educate those people who are overly concerned about scars and want to know as much as they can.

Click the photos to enlarge.

The scar of a patient who had 3000 grafts in one surgery:

My scar:

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June 8, 2007

Increased Hair Loss from Finasteride – Hair Loss Information by Dr. William Rassman

Hello Dr.Rassman,

I am a 28 year old person who is balding and reads your blog with great interest. I’m not very bald though as yet and I have been taking finasteride for 4 months now. I am going to again ask you a question which has been previously answered by you.

Do you think finasteride causes increase in shedding in the frontal and the temporal region?

I am experiencing very heavy shedding since last one month. I believe I have become more bald in last one to one and half months than I would have become in 2 years had I not gone on this medication. I am more bald and more sad. I know you have previously stated that in your experience finasteride should not cause increased shedding, but after extensive search on the internet I have come to a conclusion that once your are on this drug, increased shedding in the front and side is a fact experienced by numerous people who emphasize earnestly that its just not their regular shedding which is coincident with the start of medication. I am not sure if you can understand them. I can because I am going through it.

There is guy who claims to be a physician and is planning to sue the company as this shedding is not mentioned as a side effect in the official drug literature. I hope this gives you an idea of the gravity of the situation. As for my case, please tell me what do you think. Should I continue the medication? I am in catch 22. As an aside, to the people who are experiencing sexual side effects I would like to recommend taking some time out and working out. I perform better sexually during the period I workout.

I have answered your question in the past and this answer was based upon the large number of people who have been prescribed Propecia by me. I do not remember anyone who has had your complaint, but an internet group of doctors collectively have reported some cases of shedding of hair on the drug. Frankly, it makes no sense to me in that 5 alpha reductase blockade should not impact shedding. There are two comments worth making:

2. Hair loss is a progressive process that comes on in spurts, of periods of accelerated loss and periods of less loss or stability. What you are going through may be one of your normal cycles, coincident with your taking Propecia. Everything you are observing may not be Cause / Effect.

Frankly, I am only a clinician with a great deal of experience with this drug prescribing it to many young and older men. I am only reporting what I know, but I will pass this question to Merck and see what they say about it.

I will publish their answer when I get it from them.

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June 8, 2007

13 Year Old Panics About Hair Loss! – Hair Loss Information by Dr. William Rassman

I am a 13 year old girl and have a perm from curly to straight and it would be very nice of you if you would pleeeease help me. I went on a winter vacation with my family for 3 days and the second day I went to the pool with out a cap. After a while I went up to my hotel room by myself and blow dried my hair. After the vacation was over I went home to wash the chlorine out of my hair with V05 conditioner and shampoo. After I washed it, I blow dried my hair some more.

Now, every time I comb my hair a whole chunk of hair comes out of the back of my head. This has been happening every single day for 3 weeks. I only noticed when my hair dresser told me it looked like a short boys hair cut. I started to cry for weeks. I did not want to go out in public, especially to school where my friends had better looking hair than I did. I felt jealous and lonely because a few of them had longer hair than me and it was straight without a perm. I don’t really want to show my natural hair because it’s crazy looking so if you would pleeeeease help to grow it back faster i’ll feel much better again and take better care of it. Thank you so much.

I know it feels horrible when you think your hair is a mess, but the only thing you should do at this point is wait it out and keep from perming your hair until it all grows back. Hair grows at 1/2 inch per month so it will grow back in time.

June 7, 2007

Lisinopril, Sular, and Hair Loss in Your Mid-50s – Hair Loss Information by Dr. William Rassman

Hello

I am a 55 yr old male, and have had gradual hair loss since in college. I have used minoxidil since the early 80’s, and have had hair loss under control pretty well, although it got worse in my mid 40’s.

I begin taking Lisinopril/HCTZ 20-12.5 and Sular ER 30 mg for my creeping high blood pressure about 9 months ago, and my hair on top is looking very thin, and my hairliine is also thinning more than before. Do you think this could be attributed to the meds? If so, do you have any suggestions?

Thanks

Your hair loss may be attributable to the medication. However, medication is usually the LAST in the list of causes for hair loss. You may have a genetic component to hair loss or you may have other medical causes. You need to see a doctor and have your scalp hair mapped for miniaturization before you can hypothesize about your problem.

June 7, 2007

I Have an Uneven Hairline, Inherited from My Mother’s Side of the Family – Hair Loss Information by Dr. William Rassman

I was hoping for some advise on a matter that has been bothering me for the past few years. My hairline started to “recede” at 21, and stopped at 24. According to my dermatologist there is no further recession or miniaturization and seeing that the only bald person in my family is my paternal great grandfather, and his hair loss was at the crown only – I’m pretty hopeful that the gene won’t affect me. The problem is, that I seem to have inherited the uneven hairline from my mother’s side. Every male in her family has one side slightly higher than the other. My mirror twin in fact also has the same problem, but on the opposite side. The question is, whether it would be worthwhile transplanting hair into the right hand side of my hairline to even it out, considering I am only 26.

Thanks in advance: Guy who is tired of hiding behind a fringe.

This is a classic cosmetic surgery challenge. Yes, you can fix it and if you never bald, you will be finished with it after a hair transplant.

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June 7, 2007

Head Fungus from Diet Pills? – Hair Loss Information by Dr. William Rassman

could my prescribed diet pills be the cause of my head fungus and breakouts on my face? the prescription’s name is phentermine. i took the pills for 1 yr and a year later my head fungus developed. could another possibility for my head fungus be my nerves and stress? should i get therapy?

Just so I’m clear, here’s the summary of what you’ve told me is going on…

Perhaps you are on the right track of considering therapy.

Phentermine is a potentially dangerous diet medication and you should be under close medical supervision. I do not believe phentermine would potentiate head fungus. It may be multifactorial — including your stress level causing a depression in your natural body’s defense system.

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June 7, 2007

Hair Transplant Done By the Doctor or the Technicians? – Balding Blog

Hi Dr. Rassman, I had hair transplant procedures last week. My doctor who puncture holes first and then more than six different workers to place grafts for me. I wonder who control the hair direction. The doctor or workers ????

Ballet The direction is controlled by the person who puts in the ‘holes’. The grafts, once placed in the recipient site, will follow the direction of the hole. It seems simple enough, but the recipient sites must be placed at a horizon angle that is correct and in a direction pointing forward between the ‘parts’. See Transplanting Hair in the Correct Direction for more.

The modern hair transplant is a very labor intensive process and a team must do the work in order to get it done in a reasonable timeframe. The technicians/nurses who place the grafts must have years of experience. If the grafts are not handled gently, if they are left open to air for more than a few seconds, they may die… so transplanting the grafts may not produce growth if the grafts dried out before they were put into the recipient sites. There are many subtle nuances in the technical side of this process and when there are all done with precision, it is like a ‘ballet’ beautiful to watch.

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