April 2008 – Page 10 – Balding Blog

April 10, 2008

Diagnosing MPB By Feeling Hair Shaft Thickness? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman (or other contributing doctors),
I was wondering if for genetic hair loss (male pattern baldness), you can actually diagnosis yourself by feeling the thickness of the hair shafts on your scalp? So, if hairs that fall out daily look much thinner than your typical terminal hair, and the hair on your scalp also feels thinner, can you be confident of a diagnosis for genetic hairloss, or is a miniaturization test necessary? Thanks alot.

Feeling the thickness of the hair shaft is an art that I’ve learned over time. I can estimate the thickness of a hair shaft when it is rolled between my fingers. I have checked myself with a micrometer to measure my accuracy, and I can tell the difference between fine, medium, and coarse hair. I believe that the miniaturized hairs, when compared to the hair from the back of one’s head, can be felt to have less bulk. That being said, the ‘feel’ will not be as accurate as studying it under video magnification (miniaturization mapping of the scalp), which I promote often on this blog. If you wish, you can buy a micrometer at a hobby shop or over the internet for about $25 and make your own measurements of single hair shafts, but to have real value these shafts must be measured amongst many others.

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April 10, 2008

Body Hair Loss from Stress After Pregnancy Years Earlier? – Hair Loss Information by Dr. William Rassman

Hello Doctors…
My sister has been losing her hair for 2 years now, she is 22…it all started after she had her first baby…shes been stressed out since then…around 300 hairs fall out a day maybe more…she recently went to a dermatologist and they checked her iron, zinc, and thyroid…they said everything looked good…she is losing body hair or should i say pubic hair and she mentioned something about her eyelashes as well…she gets these red spots on her scalp sometimes…the dermatologist said that her losing her hair is due to the new born she had 2 years ago…is that possible?…i told her to get a second opinion, i mean they should take samples of her scalp or something right?…or could it just be the stress?…i never heard stress making you loss body hair and stuff but i dont know…she decided to get ScalpMed, but i have a feeling it’s not going to work because its not just the scalp that losing hair it’s also everywhere else…what do you think about all this? Thank you for your time.

It is virtually impossible for me to diagnose her over the internet. I think that if she is not satisfied with the one opinion, get another one. Her hair is too important to let this go and what you are describing does sound serious for her hair and psychological state of mind.

April 9, 2008

Hair Loss InformationUsing Lasers to Remove Hair Transplants from 14 Years Ago – Hair Loss Information – Balding Blog

Hello,

I am 33 years old and had a transplant surgery done in 1994. My hairline had receded slightly and I thought I was going bald, so made a rash decision and had the procedure done. Since that time I have lost very little hair and currently have a full head of hair.

I have never been happy with the results, as it looks unnatural and obviously not my own hairline. Now, at 33, I would like to have it fixed. I have been in contact with a local doctor who operates a medical spa and he has recommended laser hair removal. He said it should take about 4-6 months to complete.

I have 3 questions: First, is laser hair removal effective for removing transplants. Second, is scaring likely. Third, if successful at killing the hair, will laser hair removal address the issue of the bumps I feel at the base of the transplants? And if not, what are options for smoothing out these bumps?

Thanks.

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Cases like yours are unfortunate, but it is an important reminder that hair transplants are permanent. As such, you need to make sure you are getting the treatment done by a physician and a medical group that you trust and that you have checked out for competence in this area. Do not search for the best deals, but rather do the research and make an informed decision. Most importantly see prior patients up close (not just photos) to gauge your realistic expectations.

Laser removal does work on transplanted hair, but you would need many treatments and there may be some discoloration of the skin. More importantly your “bumps” will still remain. In the end you may be left with no hair, but with bumps that are discolored. If this is still something you are interested in, you need to ask the doctor if he/she has had experience with cases like yours and if so, ask to see former patients and results.

You may also consider a consultation with a hair transplant doctor to see if there are repair surgeries possible to soften your unnatural hairline. As an example, you can see some before/after photos of repair work at NHI. Also, there’s a story I posted a while ago from a man that wanted to “undo” his hair transplant, complete with photos — Horror Story with a… Happy Ending?. What is important in that “Horror Story” is that the patient was happy with the results of his laser treatments, although I would imagine that many of the viewers here may not find it acceptable. Compare where he ended up with where he began, as everything is relative.

April 9, 2008

Traction Alopecia or Trichotillomania? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I have been rubbing my scalp and playing with my hair at the roots since I was about 12. I’m noticing that my hair seems to be thinning now. I’m 30, female and have beautiful hair, but I’m concerned that my OCD behavior towards my scalp and hair roots is causing this hair loss. My hairdressers insist I don’t have thinning, but I can clearly see that I do when I look at old pictures.

In addition, my aunt on my mother’s side has experienced major hair-thinning. She now wears a “fall.” I think you should also know that a couple of years ago I noticed my hair to be thinning, so I abstained from “playing” with my hair. I saw regrowth (or, at least I perceived it) soon after. I realize I should never have restarted the behavior, but I guess I’m an anxious person…

My questions:

What is my chronic scalp-rubbing considered? Is it Trichotillomania or traction alopecia?
And, if I stop this behavior (which I’ve done as of yesterday), am I likely to experience regrowth like in the past?

Thanks!

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Trichotillomania is a psychological disorder that makes oneself pull on the hair, causing traction alopecia. It seems you have this type of behavior. This problem is very difficult to control on your own. You may benefit from seeing a doctor or joining a support group.

If you have seen return of the hair from stopping your rubbing/pulling, then maybe it is not too late for some of your hair in the impacted area. Best try to stop… and stay stopped.

April 9, 2008

How Long Do I Need to Wait After Surgery to Repair Strip Scar with FUE? – Hair Loss Information – Balding Blog

Dr. Rassman

Congratulations once again on a great blog that is truly informative and of great help to the hairloss community. My question revolves around FUE into scar.

On past blogs I know you mentioned that you like to wait at least 5-6 months to do a scar repair… but if I understood your reply correctly I think you were referring to a tryclosure revision.

I recently got a HT (2400 grafts) and part of my scar got a bit infected. One side came out perfect with no problems and the other one not so much. Luckly the infection wasn’t necrosis or anything too serious but I have experience shockloss around it and was wondering how long do you recommend before I or anybody can do a small FUE session into the scar. I seriously refuse to go the strip route ever again even for a repair. BTW, I’m only about a 1.5 months out of the surgery (which was closed using tryclosure technique) and this was my 2nd HT. I know it’s too early to panic on the healing of the scar but wanted to know a timeframe as to when is the earliest I can act to correct this if need be.

Thanks to you and your staff once again for taking he time to answer our questions.

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It takes about 6 months for any scar to heal relatively fully, thus I recommend waiting out that 6 month time frame.

April 9, 2008

Nitric Oxide and Minoxidil Are Both Vasodilators – Hair Loss Information by Dr. William Rassman

If Nitric Oxide the supplement is a vasodilator, and so is Minoxidil, does that mean that taking the NO supplement would have the same effects? You answered a question and said NO would not haev any effect on hair loss. How is this contradiction explained?

If there is a vasodilator effect of nitric oxide, it has nothing to do with the impact on the hair growth cycle that I know of. Minoxidil works such that it probably impacts the growth cycle of the hair follicle, prolonging the anagen phase. Nitric oxide has not been studied for hair loss and we do not know what it does to the hair cycle.

April 9, 2008

Biotinidase Deficiency from Accutane Causing Hair Loss? – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,

firstly I would like to thank you for your website, I’ve been a keen reader for many months. Well about me, i’m 23 years old and ever since I stopped a nine month course of Accutane at the age of 19 I suddenly began to lose my hair rapidly in a diffuse pattern on the whole scalp area. This is very depressing as I used to have long thick hair. My hairline is relatively intact but I would say i’ve lost 60% volume at least, so you can see my scalp through it. There is some balding on my mothers side but they didn’t start balding till age 40+ and not in a agressive diffuse pattern like me. I strongly believe this is from the Accutane, maybe it has accelerated my mapped out MPB that I would get later in life. But also I’ve heard of people suffering Biotinidase Deficiency after a strong course of Accutane that can last for years and cause severe hair loss. Do you think biotin or any other vitamins could benefit post accutane treatment? I’ve been on 1mg propecia for 1 year with no regrowth or noticable benefits and Rogaine also with very slight regrowth, so these seem to not be helping my hair loss at my tender”ish” age.

Also i’ve was diagnosed with arthritis a few months ago and i’m on 4x 500mg paracetamol/30mg codeine tablets a day to help with the pain, but i’ve read that paracetamol reduces the effectiveness of rogaine do you know anything about this?

thanks for your time.

Marc P DiFazio, MD authored a good source for botinidase deficiency information, available at eMedicine.

I don’t know enough about the connections other than what I have learned via the web (researched briefly after your question was received). I am sure that you know the information on Accutane (isotretinoin) and hair loss seems to be a real problem for many people, but the solution to this problem is not evident. I did write to an email group of experts on the subject and there was no real insight into the connections you are looking at. I do not know if there is reaction between minoxidil and paracetamol, so I’d discuss this further with your prescribing physician.

April 8, 2008

White Bulb vs Darker Bulb on Fallen Hair – Hair Loss Information by Dr. William Rassman

Hey Doc,

What exactly are those white ‘bulb’ sort of things that are at the tip of hairs that fall out? Most of my hair that fall out have that white bulb sort of thing. What are those?

Also, somewhere I read by a noted hair doctor that a white bulb means that the hair fell out in it’s growing phase, whereas a darker bulb meant that the hair was already grown or such. Is that true?

The white bulbs are likely sebum, a remnant of your oil gland that happened to come out with your hair. The darker bulb just came out without the sebum.

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April 8, 2008

Took Finasteride for Years And It Didn’t Stop My Hair Loss – Hair Loss Information by Dr. William Rassman

I took finasteride 1mg for two years, and it did not stop my hair loss. Five weeks ago, I switched to dutasteride .5mg, and I am still seeing the same level of hair loss. What are some of the possible factors resulting in my continued hair loss? Might it have something to do with the DHT still residing in my scalp?

Also, how much of a decrease in DHT is generally required in the blood and/or scalp in order to stop hair loss?

Male, Age 31

Thank you

Neither dutasteride or finasteride are guaranteed to stop the hair loss. There is a race between your genetics and your attempt to stop the loss and from what you are saying, your genes are winning. If you were to become a Norwood Class 5 balding pattern by the time you are 23 years old, for example, I would doubt that finasteride or dutasteride will stop the progression completely, but it may slow down the process a bit. Do you get what I am saying?

There is no magic DHT level that you must hit as your genes do not seem to care (metaphorically speaking). You are under the illusion that DHT can be controlled, but the issue is with your genes, not DHT levels. Certainly what you are reporting appears that way.

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April 8, 2008

Teenager’s Eyebrow Never Grew Back After Shaving It 3 Years Ago – Hair Loss Information by Dr. William Rassman

(male) I shaved a good bit of my eyebrow when I was twelve – I’m, fifteen now. In short, they never quite grew back right. Will rogaine work? If not, what can I do?

I don’t think that giving a 15 year old advice on medication should come from me. Assuming that you were of legal age to make such decisions on your own, minoxidil might grow back eyebrows… and then again it may not. See a doctor and have your problem managed. You should also get a parent/guardian involved in your situation.

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