Month: May 2008

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Hair Loss InformationLorazepam and Hair Loss – Hair Loss Information – Balding Blog

Howdy Dr. R!

As a faithful reader of your excellent blog, I wanted to pass along some (hopefully) useful information to your readers. I have been taking Propecia for 6 months now and have been VERY pleased with the results. It has strengthened and increased the hairs on my crown and even some in the front hairline! About a month ago I noticed that my hair was becoming thinner, and I was seeing more hair come out in the shower, and seeing more scalp than normal. After looking into what might be causing this change, I realized that I had been taking Lorazepam on an almost nightly basis during this period. After realizing this, I stopped taking Lorazepam completely and saw an almost immediate return to healthier, thicker hair. I understand that many factors vary from one individual to the next, but I think people should be aware of the negative effects that I experienced with Lorazepam.

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Thanks for your comments. Perhaps other people will have had similar results to report. Lorazepam (also known as Ativan) does list hair loss as a possible side effect. I’m not suggesting that readers discontinue any medication without consulting their prescribing doctor first.

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Hair Loss InformationAll of My Body and Scalp Hair Just Stopped Growing! – Hair Loss Information – Balding Blog

Five days ago the hair on my legs, underarms, etc. just stopped growing. I am 45 yrs. of age. No other symptoms except that for the past two years I have had very irregular periods approximately every two weeks. It has been 4 weeks since the last one this time and still no period. I have been to my gyno a year ago and everything seemed ok. I am scared that I will now loose the hair on my head but so far so good even though it is not growing any longer.

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I am not your doctor and I can not offer an opinion based upon what you gave me above. However, at 45 years old with a change in your menstrual cycle, the first thing I would think about is menopause, so your gynecologist may be the first place to look for answers.

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Hair Loss InformationAlopecia Contentionalis – Hair Loss Information – Balding Blog

Dear Dr. Rassman

What do you think of the new (hypothetical) concept about hair loss called “Alopecia contentionalis”, i.e. high scalp tension causing less blood circulation?

Wouldn’t the risk of getting this condition increase by the number of FUT’s (strip extraction)?

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If you are suggesting that a tight scalp that undergoes strip excision will get tighter, I believe you are correct. I do not believe, however, that a tight scalp causes hair loss.

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Assisted Reproductive Technologies (ART) and Female Hair Loss – Hair Loss Information by Dr. William Rassman

I am a 37 year old breastfeeding mom. My hair started thinning in my early thirties a little, but not noticeably. I had to have two rounds of in-vitro fertilization to have my baby (17 mos old now). After the first round of IVF (not pregnant) my hair started really falling out, thinning all over but more at the crown and top. My doc said he didn’t think there was a connection. The second IVF was successful and my hair got thicker throughout my pregnancy until my baby was three months old. Predictably, my hair started falling out again, but just to the thickness it was before. However, after my baby turned one, I started losing more hair and now my scalp is visible in the crown/back . I’ve been to an endocrinologist (i have atypical PCOS symptoms. he recommended propecia when i am finished procreating) and a dermatologist who specializes in hair loss. The derm said she would put me on Rogaine and Yaz birth control pills once I stop breastfeeding. I do not want to wean my baby for this. However, I am panicking a little because my hairloss is so rapid! I am otherwise healthy, and am normal weight, no thyroid issues. My questions: is there any research into ART and hair loss; and is there anything I can do to treat my hair loss while I am breastfeeding? Thank you so much for your time.

Generally, when you breastfeed, you do not want to take any medication because it will enter your baby through the breast milk. I rarely deal with women who have polycystic ovary syndrome (PCOS) or endocrine issues that could relate to hair loss. Propecia (finasteride) may help, but absolutely not when you are ever going to have a child. You need to discuss the risks with your doctor. While I’m not sure of any research relating hair loss and in-vitro fertilization, I am aware that fertility drugs like Clomid (clomiphene) can cause hair loss in rare cases (see RxList.com).

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Hair Loss InformationIf I Start and Stop Propecia, Will My Hair Be Worse Than Before? – Hair Loss Information – Balding Blog

I am 28 years old and have noticed that my hairline has changed over the last year (at the temples). This has caused a great deal of alarm that I might go bald. I went to Dr. Bernstein for a free evaluation & he said that he saw some minaturization in the front but as to future predictions, it’s hard to say as i’m adopted.

I have wrestled with whether or not I should take propecia as I don’t like medications/side effects. It is possible that my hairline might “mature” & then stop… but i don’t want to wait until it’s too late.

IF i start propecia & then decide to stop – will my hair be worse than if I had never started in the first place? If in-fact fate/genetics have it that I am not meant to go bald – will taking propecia interfer with the “nature of things?” and leave me dependent upon a medication whereas I wouldn’t have needed it before?

Thank you.

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Think of a timeline that you are progressing on (your timeline), then look a couple years down that line — assuming you took Propecia (finasteride 1mg) for the first year and then stopped it, you will be in exactly in the same place as if you never took it. I always tell patients that when you stop taking Propecia, you undergo what appears to be rapid hair loss, but it is just ‘catch-up’ hair loss to bring you back to the degree of hair loss you would’ve had anyway. Propecia will not reverse the mature hairline back to your juvenile hairline.

My process for following patients is simple: the full value of Propecia takes a full year or so. We use general rules about balding and although most men slow down their balding process in their 30s (28 is almost 30), some don’t follow the doctor’s rules. Hair loss is a progressive process in most men, but fortunately it slows down to a “crawl” by the time most men reach their 40s. You should be followed by a good doctor with yearly miniaturization studies and Dr. Bernstein in NY is a good doctor to do this for you. At the least, it will give you a good metric as to how you are doing. Good photography will also help define what is happening to you. You need to have a good dialog with a doctor who can work you through the process.

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Hair Loss InformationTransplanting Men In Their Early 20s – Hair Loss Information – Balding Blog

Dr. Rassman,
I am about to turn 23 and recently (though I believe it started a year or two ago) I have noticed more and more that my hairline is thinning and receding. The recession isn’t in the dramatic “m” pattern, more of a general recession all the way across, though when pulled back can definitely see the edges going back further (the furthest on the left, the hairline all the way across has become a bit uneven and can see lone hairs as well as other thinned hairs).

My main question is what your feeling on a hairline transplant would be for someone my age. I think I would be more than happy with a transplanted area about a half inch wide or so across the forehead(i’m not sure how many graphs this would approximate to…essentially lowering my hairline a half inch or so). The rest of my head, both behind the hairline and on the crown seem to all be fine. I know I saw a video on newhair.com which showed the results of someone 24 who had a transplant which prompted me to inquire for myself.

I greatly appreciate your time and information

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I have transplanted hair in men of your age. There is no 100% applicable age rule, but there are some requirements that must be met, including:

  • Maturity
  • Realistic expectation
  • Being on Propecia
  • Enough balding to make a difference
  • Enough donor hair to do the short term and long term job
  • A pattern of hair loss that I can anticipate

It would be best to come to an open house event where you can meet with myself or Dr Pak, meet directly with a dozen patients who had the surgery, and view an ongoing surgery that day. There is no better way to do your research in my opinion.

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Hair Loss InformationHigh Altitude and Hair Loss? – Hair Loss Information – Balding Blog

Hi,

I have been using rogaine for many years. I have never been close to bald, but I started using rogaine as soon as I noticed small amount of hair loss. However, I am now shedding hair fast. In fact, at the current rate I will be bald within a couple of months. Is this normal? I am thinking that I have developed a tolerance to rogaine, maybe?

I moved from sea level to high altitude to live about one year ago. The excessive hair loss started about a month after moving to high altitude. Could living in high altitude (5000 feet) cause the hair loss? When I moved here my hair was very thick but one year later I am close to being bald.

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PlaneI highly doubt high altitude has to do with your hair loss. Otherwise, being a pilot may be a risk for balding. I’ve read nothing about this phenomena (you’re the first person to ask this question) and I’ve yet to experience this in my one-on-one with patients over the years.

The most common cause of hair loss in men is genetic male pattern baldness. It is in your genes and it can happen relatively quickly. While it may be possible that you may have built some tolerance to Rogaine (minoxidil), the hair loss should not be as drastic as you describe it, especially if you are still using the medication.

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Hair Loss InformationAntihistamine and Hair Loss – Hair Loss Information – Balding Blog

Im a 30 yr old male who just recently discovered a small round bald patch on my beard about 3-4 months ago.

I am an asthmatic and suffer from Seasonal Rhinitis (Hayfever). for the allergies, i take various antihistamines daily, namely Loratadine (Claratin) or Pseudoephedrine based ones…

My hayfever has been pretty bad over the last few months and i am taking a pill at least once a day round about the time this patch formed…

What started out as a little round patch grew over the last few months into a golf ball sized patch with no hair at all and im starting to notice very small dots forming on other parts of my beard as well as a small one on the front of my hairline.. Im really starting to get worried. I went to see a dermatologist who gave me topical steroid cream and minoxidil 5% as well as a zinc and vitamin C supplment which ive been using religiously over the last 3 weeks, but it has not slowed down the growth of the alopecia.

Last night i read on the leaflet for the antihistamines i take (Loratadine) that some of the adverse reactions to it is Alopecia. Ive also read on tihs site that a few people complained about the same thing, losing hair because of Claratin. I have not found much conclusive evidence online which link antihistamines with alopecia, but as of yesterday ive stopped taking the antihistamines and continuing treating the patch with the oiintments etc.

Is there any proof that there is indeed a link between antihistamines and alopecia..?

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There is no proof there is a link between antihistamines and alopecia. Many drugs can cause hair loss as a rare side effect, but by far, the most common cause of hair loss in men is genetic balding. What you’ve described is patchy hair loss (even around your beard). This may be alopecia areata, but I would follow up with your dermatologist for a diagnosis. I did write about Claritin and pseudoephedrines before here.

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Hair Loss InformationI’ve Shaved My Head for 10 Years, I Think I’m Norwood Class 7 – Should I Bother Taking Avodart? – Hair Loss Information – Balding Blog

Dr. Rassman,

I am considering asking my doctor to prescribe avodart, I began balding around 19-20 years old. I shaved my head for past 10 years and now would like to explore my options. I am most likely Type VII but can see many blond immature hairs so makes me believe follicles aren’t dead. Do you think its even worth trying? And if so, what do you recommend? I am 31 if that makes any difference.

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Norwood 7Let your hair grow out for about 2 weeks and then get an examination. You should get your hair mapped out for miniaturization to see where your balding pattern is now, since you don’t seem sure of your pattern and I’d guess that you haven’t had a doctor actually look at your scalp in quite a long time. Avodart (dutasteride) is yet to be FDA approved to treat hair loss, so if you have a doctor that is willing to prescribe it to you, it could be worth trying — but I couldn’t say without seeing you.

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Hair Loss InformationUsing the Restroom During the Hair Transplant Procedure – Hair Loss Information – Balding Blog

Hi Dr Rassman,

I am a male and recently discovered i have interstitial cystitis. Am using minoxidil but cannot take finasteride anymore. So my questions is the following: During a HT session and when one is awake is it possible to do the procedure on someone who would have to use the restroom or are there ways to work around it?

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Our patients have a private restroom available to them right outside the operating room next to where the transplant is done. Getting up during the surgery to use the facilities (as long as you let us know and don’t just jump up from the chair) is not a problem.