Hair Loss from SSRIs – Hair Loss Information – Balding Blog

Hi, I would like to request clarification on something. I saw a post where you mentioned Sertraline causes hair loss as well as Zoloft. I also saw on some posts where SSRI’s are said to cause hair loss. The questions is how common is this? I have seen different sources use different percentages to represent how rare or often this can occur. I ask this because online it appears as a significant amount of people have voiced their concerns about Sertraline or Zoloft possibly contributing to their hair loss. However, there have to be many people who simply will never come to these forums because they are not affected. Also, how long does the hair loss take? Some posts mentioned period from 2-8 days, while some people blame the meds after they have used them for 4-6 years.

I have been told by several physicians that hair loss with SSRI’s is simply an alergic reaction which is rare. Do you agree with that? Thank you for your help.

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PillsHair loss from SSRI (selective serotonin reuptake inhibitor) drugs are relatively uncommon, but they can occur. First and foremost you need to find out if there is a pattern to your hair loss. Is the hair loss everywhere or just confined to the front/top (in a pattern)? If the hair loss is happening in a pattern like those shown here, then it is most likely not from the drug. Hair loss from drugs will often impact the donor area, which is what we generally refer to as “permanent” hair not susceptible to genetic factors.

Most doctors (and even the doctors that treat hair loss, such as myself) do not know the exact mechanism of why some people lose hair from certain medications. We must believe the patient when they say that they are noticing some correlation with the timing of starting these medications and the hair thinning, but these things are often very difficult to narrow down. It is just not that simple, as the patient may also have underlying genetic hair loss as well. Remember that more than 50% of the population have some form of genetic balding which has nothing to do with SSRIs or other medications! I do not think hair loss from SSRIs (or other medication in general) is an allergic reaction, but more of a rare side effect. If hair loss is caused by a medication, I do not think it would happen in the time frame of a few days, but more likely several weeks to months.

Finally keep in mind of the big picture, rather than focusing only on hair. You are taking a certain medication for a reason, such as the SSRI to treat depression. What you are experiencing with respect to hair loss may or may not be related, but the reason of WHY you are taking the SSRI or other medication is real and the pros and cons (risks/benefits) need to be discussed with your physician before taking any action.

Hair Loss InformationNew Hair Loss Gene Finding, APCDD1 – Hair Loss Information – Balding Blog

I’ve received quite a few emails in the past day or so about the news of a hair loss gene finding that was announced. Thanks to all the readers that sent in links.

Here’s a snippet from one of the articles:

Researchers have found a gene mutation which leads to thinning hair and which can even start taking effect in childhood. The gene, APCDD1, causes hair follicles to shrink, leading to thinner hair. Now the team at Columbia university hope the findings could help discover new ways to treat the condition.

The condition leading to thinning hair is known as hereditary hypotrichosis simplex and the researchers believe they have pinpointed the gene behind it. However the scientists the cause of the more common male pattern baldness, which affects most men at some point in their lives, remains elusive.

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DNARead the rest of this article at Telegraph UK. And here’s a couple other news links about this — CNN and WebMD.

I wasn’t involved in the research so there’s not much I can add beyond what these articles have already mentioned. It is an interesting finding and I am pleased that there is ongoing scientific research into the cause and the genes for hair loss. Unfortunately, as Dr Angela Christiano (lead author of the research) notes, “The gene we discovered for hereditary hypotrichosis does not explain the complex process of male pattern baldness.

One thing I am particularly happy to read about is that they discuss the miniaturization of the hair follicle, which is a process that needs to be quantified as a miniaturization study when diagnosing balding patterns (as we have stressed here on this site for many years).

Using Toppik to Cover a Transplant Scar? – Hair Loss Information – Balding Blog

Hey dr. How are you on this fine day ?

i was just wondering on your opinion on using toppik to camouflage a transplant scar so buzzing hair down to a number 1 would be an option with the addition of the use of a trichophytic closure. would this be a viable route for someone who appreciates short hair?

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ToppikI am fine. Thank you for asking.

Some people use Toppik, DermMatch, black marker, or even permanent tattooing with reasonable results. I am not sure if you already have a linear scar or are thinking of having a hair transplant and worried about a scar, but really, successfully camouflaging a scar on the scalp all depends on the scar itself. If the scar is wide (despite a trichophytic closure) a number 1 clipper haircut may still show it somewhat.

Dry Scalp Contributing to Hair Loss? – Hair Loss Information – Balding Blog

I notice my hair has been thinning quite quickly the past few months and my scalp has been awfully dry which I’m sure is a contributing factor. When my hair falls out I can usually see the “roots or follicles” at the end. I have taken notice of your responses regarding alcohol and hair loss. While I usually over indulge on the weekends, I wouldn’t call myself an alcoholic.

My main question is, I am taking Milk Thistle supplements to try and maintain healthy liver function, but if I were to start taking Zinc and Gingko Biloba supplements, do you have any knowledge of these helping? Thank you much!

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If you have a zinc deficiency then taking zinc supplements might be helpful. Otherwise, zinc and ginkgo biloba are used in some hair products to promote healthier hair, but they won’t stop genetic hair loss if that is what you are experiencing. Also, a dry scalp will not likely accelerate your hair loss.

Eye Irritation from Rogaine for Women – Balding Blog

(female)
I tried using Rogaine a couple of years ago but stopped after 3 months because my eyes became very red and sore. I am considering starting to use the foam for men, 5%. Is there a known problem with the female version causing sore eyes?

Is it possiblle the foam will not have this effect – if it were indeed side effect of the Rogaine?

Rogaine FoamThat could be an allergy to an added ingredient in the minoxidil liquid or it could even be the minoxidil itself. The liquid is known to cause eye irritation in the 5% solution. The female version that you used is likely the 2% formula… so if you had the problem with your eyes with 2%, I’d expect you would see it from the 5%.

That being said, it might be worth giving the Rogaine Foam a try since it is a different way to apply the medication.




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Richest Man in the World Has a Bad Hair Transplant? – Hair Loss Information – Balding Blog

Hey doctors! Love the site. Have you seen this article about how the richest man in the world Carlos Slim has a weird hair transplant? Thought you might enjoy it.

Bad hair transplants, number 3: Carlos Slim, richest man in the world

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For those that haven’t heard of Carlos Slim, he is the world’s richest man and owns many telecommunications companies throughout Mexico. You can learn all about him here. As for the article about his hair, well, we have all seen bad hair transplants… but this doesn’t appear to be one. Why? Well, because I don’t believe it is a hair transplant at all. Take a look at the hairline close-up:

Carlos Slim hairline

Although the author of the article quoted an unnamed “expert” trichologist to give some added weight to his story, I think he’s wrong. What Carlos Slim is showing here looks like a natural pattern of hair loss, though if there was a transplant I certainly haven’t seen enough to make that claim.

Hair Loss After Radiation Treatment – Hair Loss Information – Balding Blog

I lost a lot of hair due to radiation treatment last June. I had a benign tumor removed and my doctors wanted to be sure they effectively treated me after surgery. They pretty much covered the top of my head with the treatments. It all fell out but only some of it grew back. And it’s obvious. I had a full, thick head of hair before this and now it looks like I have male-pattern baldness (and a large scar on top of my head from the surgery is visible). Would finasteride be at all helpful in this case? I can’t seem to find any information that speaks to this particular problem.

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Finasteride will not reverse hair loss caused by radiation, as it only works for men with genetic hair loss. The good news is that hair loss from radiation may grow back, though it can take up to one year.

Will Beard Hair Grow Back After Pulling It Out? – Hair Loss Information by Dr. William Rassman

If you pulled out beard hair some times it will grow back? When you say doctor you have to pull too long, that hair generally not to grow back, this means years or just a few times. Thanks in advance

Plucked out beard hair will grow back. I have plucked a few of my beard hairs (the stray ones I don’t like) many times in the past for many years… and at least in my case, they still grow back! I suppose if you keep pulling the same ones they may eventually not come back. There’s no exact amount of pulls before it becomes permanent, though.

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I’ve Got More Questions Since My Consult at NHI! – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I wanted to ask you a question about hairlines but first, I wanted to personally thank the staff at NHI, Dr. Pak and you for the wonderful visit I had at NHI this past Friday. This is a bit long winded but please bear with me.

I am a 25 year old caucasian male with light brown hair and am in good health. I started noticing a little thinning at my temples over the last year. To be honest, I was very nervous. I then went from nervous to hysterical. I could not stop thinking about it. Nothing can be more vicious than your own imagination and mine was painting all kinds of horrible scenarios.

In lieu of this, I made several appointments to see various hair transplant doctors here in Southern California. Of course, I never ACTUALLY meet with a doctor. Instead, I ended up talking to a consultant. To be perfectly honest, I did not gain a great deal of insight from these visits. I wanted something empirical to measure my hair loss, a metric I could use to stay informed and make an intelligent decision about my hair loss. None of these visit’s gave me that information.

The balding blog has been a part of my daily routine for a little while now and I decided to do what you suggest in so many of your posts and get my hair mapped for miniaturization and start my master plan. I was looking forward to my visit but also fearing it a little as well. So many things over the last few months have convinced me that I was going to bald to a Norwood class 4, 5 or 6. Pictures I had taken in the last few months, the look of my hair when it is wet or under bright lights. Except for my temples, I looked normal but I felt awful.

Then I came to NHI this Friday and that all changed in about 5 minutes.

I can’t tell you how much better I feel after visiting your office. I made an appointment to see Dr. Pak and he was very informative and understanding. He magnified my donor area for me to show me what non-miniaturized hairs look like. He then moved the scope to various parts of my head. This is the part where I held my breath. However, when he zoomed in on my crown, he saw no miniaturization. The same was true for my vertex and other parts of my head. In fact, the only area that showed any miniaturization was my temples, something my paranoid imagination would not let me believe.

Words can not describe how relieved I was. Dr. Pak was very helpful and he answered all of my questions. However, on my drive home I though of one more question I wished I had asked him and it is this: If none of my hairs, other than my temples, displayed miniaturization then where does my fight against balding go from here?

In your Hair Loss for Dummies Book (page 12) you say the following; “If you’ve inherited this pattern (Class 7), it is usually evident by the time you are 30“. In my examination, Dr. Pak said that my fears about progression to a class 7, 6 or 5 were unwarranted. In fact, he didn’t assign a class at all. He said my hair was healthy all over and my density (2.0) was normal (only miniaturization at the temples).

Am I simply developing a mature hairline? In this post from your blog you say that the mature hairline develops from ages 17-29. I guess what I am trying to understand is the correlation between someone’s age and their degree of miniaturization. At 25, is it too early or difficult to diagnose what class I may (if ever) progress to? Could a Norwood 7 be a lot easier to spot at my age that say, a norwood 3 or 4? I only ask because if I don’t progress any further in the next 5 to 10 years, would some moderate temple restoration be out of line with FUE?

I am 25, but I am not so naive as to think that the battle is over. I do not intend to let anyone else touch my hair except NHI now that I have visited your office. Dr. Pak put me on finasteride and I fully intend to visit your office on an annual basis to check on my hair. Like you say, tenacity and diligence.

Sorry again for the long winded question and many, many thanks to Dr. Pak and you for keeping me informed about my hair loss and educating me before I gave into my fears and did something drastic and foolish.

Sincerely and respectfully

If at any point in the future you want to address only the front corner areas, you can always do so with a small hair transplant procedure using FUE.

You may have a maturing hairline… perhaps in combination with slight recession in the corners. It remains to be seen as you age, but take comfort that Dr. Pak did not see miniaturization beyond the front corners. Stick with the medication and we’ll see you again for your follow-up appointment.

Finally, thank you for the kind email and allowing us to publish it.

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I’ve Been Losing My Hair Since 14 Years Old! – Balding Blog

Dear Dr.Rassman,
I am so scared about my hairloss because it is so severe. I started to have a receding hairline around 14 in which I had a NW3 hairline. Now at 17 (almost 18) it’s safe to say may hairline is fortunately still an NW3 however i am starting to lose a little bit of hair in the front of my head and at the crown. I cannot stop thinking about it and I don’t want to be bald by the time I’m 20. Am I too young for a hair transplant? If so am I old enough to use propecia? If not is there anything I can do to stop or at least slow down my hair loss? Please help me out!

First and foremost, do not let fear interfere with your choices. Empower yourself with education to learn about hair loss. Unfortunately, 50% of men will have some type of hair loss in their lifetime. When it is genetic it usually starts above the age of 18, though there are cases that I’ve seen start around the same age you saw your loss start. I can empathize that you are frightened and afraid of going bald, but if that is in your genes, it is something you are going to have to accept. Fortunately, taking Propecia may solve the problem if you have the correct diagnosis. Get a doctor to map out your scalp for miniaturization and with that metric in hand, if you have miniaturization present, then the drug Propecia is the right way to go. Propecia was studied in men as young as 18, and as you’re nearing that age you should be fine.

Just know that you have choices and there are treatment options and plans, but you need to first start by seeing a physician that will address your concerns and come up with a life-long Master Plan. Propecia can certainly help if you have male pattern baldness, but you need a diagnosis first. Something else to note — Propecia has limitations and it will not completely stop or reverse hair loss. Hair transplantation may also be an option later on, but it is very important that your physician address that master plan to determine a worst case scenario of how bald you may be not just one year from now, but 30 years from now. Right now, you are too young for surgery.




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