April 2008 – Page 11 – Balding Blog

April 8, 2008

Should I Take Propecia at 16 Years Old? – Hair Loss Information by Dr. William Rassman

Hi doctor, I have a question. I am sixteen years old and I feel my hair is falling because I have like a balding twirl in the vertex. It seems like if the hair in my vertex is starting to fall. Also, the hair on the top of my head is thinning. I don’t have a receding hairline, but I am scared to loose all my hair before I am twenty. I don’t know if this could be the cause of genetic hairloss (my dad is bald, but he is 52) or if it is another thing. Also, my pubic hair seems less dense. Do you recommend any drug like finasteride or propecia????

Any good doctor can do this and it is critical (particularly at 16 years old) that you get excellent metrics from a miniaturization study to determine what is happening to your hair before starting on a life long course of Propecia (finasteride 1mg).

You need a Master Plan for your overall management of your hair loss and you should have your scalp hair mapped out for miniaturization prior to starting any treatment. There is no reason not to take it if you are really balding, but you may not be balding, so find out first! That being said, safety of finasteride was studied at age 18 and above. Your prescribing doctor will have to be the one to make the call on whether the benefits outweigh the risks. Get a good doctor to help you with this.

April 8, 2008

Girls In Haiti Orphanage Are Losing Hair – Hair Loss Information by Dr. William Rassman

There is a wonderful ministry called “Love a Child” which has an orphange in the country of Haiti. The owner/manager of the orphanage is struggling to help several of her African American orphan girls who are suddenly suffering from hair loss. She has pictures of the girls on her site at loveachild.com

From reading various information on your website and others it seems the only options are:
1. Stop tight hair braids (but it’s too late now)
2. Costly hair implants

Any suggestions or advice you might have to help these precious children would be greatly appreciated.

From the photos in the link you provided, it seems the girls on the site have traction alopecia from wearing tight hair braids for long periods of time. Unfortunately, traction alopecia is permanent and there are no good treatment options. Hair transplantation surgery may help, but it cannot replace all the hair that was lost as even with a hair transplant, the supply of hair may exceed the demand for hair in the balding area.

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April 8, 2008

Acid Reflux Medication and Hair Loss – Hair Loss Information by Dr. William Rassman

I’m a 23 year old male with something like a Norwood II or III hairline. My family history is likely to blame, but I’ve also been on various medications for acid reflux, including omeperazole, protonix, nexium and prevacid for some time. My family Dr. noted that some of these drugs could cause hair loss before prescribing propecia. Do you think this is true, and is any one best?

Practically every day over the years, I’ve received questions asking whether a specific drug or drugs cause hair loss. Again and again, I must remind everyone that there are many drugs that MAY cause hair loss as one of MANY potential side effects. Protonix (pantoprazole), Prilosec (omeprazole) and Nexium (esomeprazole) have very rare instances of hair loss reported, but the most important thing to remember is that male pattern baldness (MPB) is the number one cause of hair loss in men. Drugs are the very very last on the list of cause for hair loss in men.

If you believe you are balding or losing hair you should have your doctor evaluate your hair (with a miniaturization study if possible) to see if you indeed have genetic male pattern baldness. Starting on Propecia (finasteride 1mg) just because you believe you are losing hair without a clear diagnosis is not a smart thing to do either — this is why Propecia is a prescription medication. If I may bastardize an old metaphor — when you are being charged by a herd of dancing elephants, don’t look at the ants that may get trampled.

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April 8, 2008

Accutane Now Lists Hair Loss As a Side Effect? – Hair Loss Information by Dr. William Rassman

My 17 year old brother has had rapid hair loss for over a year now. Mainly on the top of his head & now the hairline is receding as well. There is no male pattern baldness on either sides of the family. We have taken him to several specialist & have had all possible bloodwork & even a scalp biopsy done. He has finally been diagnosed w/ Chronic Telogen Effluvium. He has C3 & Igg deposits in his follicular bulbs. There are an increased number of catagen & telogen follicles accompanied by shriveled, wrinkled, glassy membranes & fibrous tracts. The lower follicular epithelium is visibly in necrosis in some slide levels. There are few inflammatory cells. It is believed that the cause of the TE is medicine induced from Accutane. He has been off the medicine for one year & has continued to have hair loss & no re-growth. Accutane is now listing hair loss that may be permanent as one of it’s side effects due to the overwhelming amount of cases of this. Some people have had regrowth well others have not. Since it has been over a year & based on the diagnosis, is regrowth still possible? Will he go completely bald? Would he still be a candidate for a hair transplant down the road? What are the possible treatments for him? He has already tried Rogaine, Tagament, & the laser comb. He is devastated & is becoming more & more depressed. Any advice would be greatly appreciated. Thank you.

I can not fully answer this question, but I’ll do my best. For people with chronic telogen effluvium (TE), long term use of minoxidil may help. The good news is the chronic TE implies that the hair is still there, unlike in the case of genetic hair loss. As I am not a dermatologist and have limited understanding of chronic TE, your brother will be best served by someone with expertise in this field and a track record for it. Good luck to your brother and thanks for sharing this with us.

April 7, 2008

Hair Loss InformationUsing Saw Palmetto to Treat Hair Loss – Hair Loss Information – Balding Blog

I need to know once and for all. Does saw palmetto work for pattern hair loss?

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Saw palmetto plant Most of the excitement for using saw palmetto as a treatment for androgenic hair loss is based on its mechanism of action and the evidence that it works for prostate problems like benign prostatic hypertrophy (BPH). Besides anecdotal reports, there is actually little evidence that it also works for hair loss.

There has been only one study thus far published in the medical literature examining saw palmetto to treat pattern baldness. In this small study, 6 out of then 10 subjects with androgenic alopecia who received saw palmetto were reported to benefit from the treatment. This is far too small a study to draw any conclusions on its efficacy for pattern hair loss.

April 7, 2008

Wrinkled Brow Measurements for Mature Hairline – Hair Loss Information – Balding Blog

Hi Doc, please can you clarify the measurements from the brow wrinkle for a mature hairline. When you say “just over an inch at the temples”, how much more? 1/8, 1/4? My hairline is about an inch and 1/8th from my top brow wrinkle and hasn’t receeded at all in the middle? Should I be worried? I am 34. Thanks

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You are right on for the mature hairline. My rules aren’t always strict when it comes to the maturing hairline, but I draw conclusions based upon my observations. The 1/2 inch – 2/3rd inch up from the highest crease in the midline and 1 inch – 1 1/2 inches from the sides is a generally good rule to use as a measurement.

Please see Maturation of a Hairline — Moving From Juvenile to Mature for more.

April 7, 2008

Hair Loss InformationLong Black Hairs Growing on My Shoulders and Back – Hair Loss Information – Balding Blog

Well, let me try to explain my situation: I am a 30yo male with hairy legs and dark eye brow hair and I’ve been told I have a very hairy public area (I am Italian and Spanish). The thing is, the hair on top of my head is very thick. But My chest has a little bit of hair and occasionally I find single LONG black strands of hair on odd parts of my shoulders and back. So I am wondering, being that I just turned 30yo, is it possible that those lonely ONE-hair strands will be joined by a whole team of others? In other words, should I be expecting to be a hairy man when I get much older? Do people still grow body hair after 30yo? Is there any way one can speed up or “help” the growing process to get a healthy full hairy chest? I’d rather be either very hairy or smooth, not in between. I’ve also noticed that older men with thick eyebrows usually are hairy allover. And I am the only sibling out of 5 boys that has thick eyebrows. (I am not sure about their pubic areas as that would be embarrassing to ask, hehe). Thanks!

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I really can not predict what will happen to you. Generally, as you get older, more body hair appears in most people, but “most people” are not you. I couldn’t say for sure whether these few stray hairs are going to result in a wild forest of hair as you age. Some people have reported that they lost body hair as they aged. Each person is different.

April 7, 2008

Stopping Minoxidil Shrinks Capillaries? – Hair Loss Information by Dr. William Rassman

Dear Dr.

I have been taking Minoxidil 4% plus progesterone for 16 years and stopped 3 months ago because I was worried about the possible long term effects and I wanted to look at a more natural approach. Since then the shedding had increased dramatically (over 150 hairs during shampooing), my scalp can now be seen through my hair for the first time ever and the hairs that are falling out are thinner and in some cases shorter than before I stopped.

It was suggested by a trichologist that I am seeing that when you stop using Minoxidil the capillaries shrink to smaller than their original size, reducing the blood flow to the hair and causing them to fall out. He also suggested that they dont return to their normal size for up to 9 months and in some cases never as the damage is permanent.

However another trichologist told me that the hair loss could not be so sudden and it would take 6-12 months before I would notice any hair loss and even then it would only be the hair that was “saved” by the Minoxidil in the first place that would fall out. Can you tell me:

Do you know of any research to support either of these claims?

Is there anything I can do to stem the shedding if the cause is the fact I have stopped using Minoxidil?

Could blocked follicles (as the first trichologist suggests) also be a contributing factor?

Thank you for your time.

You are asking me to comment on what your trichologist told you and I don’t know what to say about blood vessels, shrinking capillaries, etc. What I do know is that for 16 years you used minoxidil and that you most likely have minoxidil-dependent hair that will not grow back unless you go back on the minoxidil and are not too late in doing so. So to answer your questions:

I’m not aware of any research, but I can’t say that it doesn’t exist.
Stopping minoxidil will result in losing benefits of the minoxidil — which would be any hair retained or regrown by the medication. You’ve been on the medication for 16 years, so you’ll have a difficult time guessing which hairs were saved by the minoxidil (meaning, the hairs that will be lost).
Isn’t this the same as question 1? I don’t have an answer for you, unfortunately.

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April 7, 2008

Female Hair Loss from Lexapro or Anesthesia? – Hair Loss Information by Dr. William Rassman

Hi,

I had two surgeries, one in October 2007 and the other 4 weeks later in November 2007, to remove ovaries and surgical adhesions from a hysterectomy performed in September 2007. I started experiencing numbness and tingling on my upper/lower extremities in February 2008. My physician ordered Lexapro to reduce associated diabetic neurological symptoms. I’ve been on this medication now for 6 weeks and have started losing my hair and now have bald spots. Coincidently, I had hair loss after having undergone anesthesia 2 years ago as well. Is this hair loss due to the anesthesia or Lexapro? I am taking 10mg Lexapro. If this is causing the problem, can you recommend any natural supplements that can help with this issue?

Anesthesia and/or Lexapro (Escitalopram Oxalate) can cause hair loss. If you are having bald spots, sometime surgery and stress can even induce alopecia areata. You need to see a good dermatologist to look at this and determine the cause of your problem. This is not something I can determine via the Internet.

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April 7, 2008

Does FUE Produce Higher Hair Counts? – Hair Loss Information by Dr. William Rassman

Getting confused here.

I read that the average hair per FU for strip is 2.0. On the other hand I read that average hair per graft for FUE is 2.3 or higher. Is it correct that FUE produces higher hair counts, and if so how come ?

With follicular unit extraction (FUE) you can select how many hairs per graft you want, while with strip harvesting what you get is the average density in the strip. That means that if you want a higher hair count per graft, in theory FUE will give it to you if they are present in the donor area in adequate quantities.

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