Day: January 1, 2023

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Pull Test and Telogen Effluvium

Why is a pull test positive in cases of telogen effluvium but not in mpb. If a pull test was positive is this a definate indication of telogen effluvium

The pull test can reflect many conditions, including a variety of autoimmune alopecias, telogen effluvium, possibly even androgenetic alopecia when it is very active. The test constitutes grasping about 60 hairs between two fingers near the scalp, then pulling gently (but firmly) on the hair. A positive test will yield 6 or more hairs and it is often done on 4 different parts of the scalp.

Do not wash your hair for 2 days prior to doing the test. If you decide to do the test on yourself, do not keep repeating it as you can pull out more hair than you really want.

This would not be a reliable test for male pattern balding diagnosis, because the hair loss from this condition varies. I suspect that when the process is not active (like when a patient is using finasteride / Propecia), the hair loss has stabilized so that the pull test would or should be negative. There are much better ways to make the diagnosis of MPB than by using the pull test.

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Pull on the Hair and Rub Garlic On It for Regrowth?

I read about this hair regrowth technique on the internet about massaging the scalp, and pulling on the hair and at night rubbing garlic into the hair and sleeping with it (it suggested other things like nail scratching and brush scratching the scalp, ect. I tried it for about two weeks (the first week putting olive oil on every night before bed).

Now my hair, which was a bit receded on the sides has significantly receded on the sides and into the top. In only two weeks (and it was pretty stable before). I am wondering if any of these techniques (like the scalp massages, or pulling, or even the garlic) could have caused the losses.

I just feel so lost and a bit depressed as to why it changed so drastically and what to do about it, if I can just even get it back to the way it was two weeks ago.

Thanks so much for your help.

Rubbing on the hair and scalp can force out weak hairs, and that is why we suggest no rough scalp massage. Pulling on your hair absolutely will not help either. I have heard of such remedies over the years. Some of them are pretty funny, like keeping various animal droppings on your head while you sleep, pouring animal urine on the scalp, standing on your head for hours (just being upside down is thought to bring more blood supply to the head), and on and on.

What is wrong with going to a doctor who knows things that you do not, can diagnose what you can not, and can treat you with appropriate effective treatment modalities? The real cost to you is the time delays you are putting into getting to the root of the problem. To answer your question though, garlic won’t regrow your hair… but added to butter, it makes for a tasty sauce on bread.

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Published studies on Topical finasteride and systemic Dutasteride

https://pubmed.ncbi.nlm.nih.gov/10495374/

https://pubmed.ncbi.nlm.nih.gov/26636418/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969473/

All three of these research papers discuss the impact on scalp and systemic DHT. Dutasteride reported a low incidence of sexual side effects 1.7% but although this number is thought to be low, if you subtract the placebo group from the sexual side effects group on finasteride it comes out about 2%.


2020-08-02 15:42:19Published studies on Topical finasteride and systemic Dutasteride

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Publication on forum site stating Merck lied about sexual side effects from finasteride?

https://www.hairlosslearningcenter.org/topic/merck-makers-of-propecia-caught-lying-for-second-time/3390

This is all speculation at this time; however, it is appearing in many forums as fact. We must wait for the court to go through its process before judging Merck here.


2019-09-18 10:52:54Publication on forum site stating Merck lied about sexual side effects from finasteride?

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Pubic hair for donor and recipient sites

In one of your posts on the blog you said you’ve done pubic hair to scalp transplants in a patient(s) before. This certainly isn’t to undermine any work done but wouldn’t a person have a bizarre appearance with pubes growing out of their head? And how well do they survive on the scalp since they are hairs with apocrine glands?
It works provided that it is not put up front and it was mixed with donor hair from the scalp. It has considerable blunk and can be hidden in the top or crown when placed appropriately. More times, however, the hair would be transplanted to the pubic area in many women who didn’t have hair there. I find it interesting that if they have hair, they shave it off, but it they don’t have public hair, they may want a transplant to have it.
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Psychology Study Says Porn Causes Performance Anxiety

Hi dr. You often mention sexual side effects when discussing propecia but here is a recent psychology study that shows that there are often more reasons for performance anxiety

Link: Internet pornography destroying men’s ability to perform with real women, finds study

The report can be found at Psychology Today, and essentially blames online porn for libido problems in young men. I don’t know if there’s anything to this, but it certainly is interesting. The report suggests that in 6-12 weeks, the problem could be resolved by staying away from the porn and perhaps leaving your penis alone.

There was a large survey of Italian men published earlier this year that concludes internet porn causes “sexual anorexia” (see here).

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Psychological Effects of a Wig Wearer?

I have been reading your blog for quite some time and i see you repeatedly emphasis not to hold your breath on the baldness cure. I totally agree with you, my dad went to Europe in the 70s to talk with doctors and find a cure for his baldness the doctors then told him there may be a cure in 2 or 3 years! It has been 40years since then and i must admit he still has hopes that those 2 or 3 years is not far away!! Me on the other hand have no hope of seeing anything new at least till 2020 considering if the trials succeed by 2013 go for FDA approval.

So i have considered going for a wig or a hair piece, i just wanted to know what is the psychological effects that you noticed with an average person(non-celebrity) who uses a wig? Do they get addicted to it and would they be able to live without it after awards if they choose to lose it? Also how much emotional scare does it do if it comes of in a public place like a swimming pool?

What is your advice on the best hair piece available, which would look real and shows the scalp and not something that looks like a thick road kill.

Thanks.

HairpieceWhile I do hope we see a cure for hair loss at some point, we’ve all been hearing the same story for decades. Who knows — 30 years from now, people might be having a conversation about how foolish we were in 2010 for hoping the cure was right around the corner.

As for the wigs / hairpieces… well, people all respond differently. There’s possibly the initial wave of confidence, but with that comes new problems you have to deal with.

The attachments used are critical, because you do not want to make the hair loss worse from traction alopecia caused by pulling of the hair under the hair system. Most people will shave the head under the hair system to minimize the impact of traction. There are clearly limitations with a hairpiece (like swimming).

Interaction with women is a problem if the lady wants to run her fingers through your hair… and gets the hair system instead. Most men who wear these pieces realize that there is a “no-touch zone” around their head and watch people carefully when they approach (especially women or relatives).

I really don’t have advice on where to buy them or what to buy, but judging by the amount of spam I get from wig vendors that read this site, I’m sure plenty of them will offer their 2 cents.

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Psoriasis Treatments to Keep It Under Control?

Dear Dr Rassman,

Firstly i would just like to thank you for providing such a constructive and educational forum for unbiased, informative hair loss advice. I work in a hair transplant clinic and never hesitate to refer patients to this site for additional information.

My question however is regarding a friend of mine who suffers from psoriasis, her scalp being the worst affected area. I felt compelled to seek your advice after seeing her in tears yesterday, fed up with the constant irritation and discomfort. She is nearly always scratching her scalp and is now experiencing noticeable thinning and loss in some areas.

Can you recommend any particular treatments to control the condition or at least alleviate the itching? She has seen numerous doctors and dermatologists but is yet to find anything that works.

Any advice would be greatly appreciated.

This is a standard dermatologic condition which any good dermatologist should be able to address. The best person to treat your friend’s psoriasis is her dermatologist, but as she’s having difficulty finding a treatment that works, I found a good list you can both review at the National Psoriasis Foundation site.


2008-10-21 15:27:34Psoriasis Treatments to Keep It Under Control?

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Psoriasis and Hair Loss

Hi,

I have male pattern baldness. it started at age 18 from my temples and has been receding terribly over the years, and more esp over the last 5 years. I am now 43. I used to have severe psoraisis on the face and scalp and was told the hair loss was because of that. Now the psoraisis has gone down considerably, alomost completely but the receding continues. i also have thick scabs on my scalp on and off that do not look like psoraisis scabs, i think it could be symptomatic of systemic yeast/eczema?

I used to have a very thick full head of hair, more than the average person so the hair loss over the years was more apparent to me than to others. Now, it is apparent to everyone. i just have a strand or two to cover my unnaturally high forehead, the hair on top is very thin, weak and sparse, there is more at the back but that too has recently thinned a lot.

In the last 3-4 months, my hair has been falling out in clumps, and is extremely coarse, dry and brittle. Please dont tell me it is age because this has been happening throughtout my adult life , but has has gotten much worse recently and esp since my first ever perm a year ago. But the frontal hair has been receding steadily since age 18. It has been very distressing and depressing for me, and nowadays, i dont even like to look in the mirror and see my unkempt hair. No matter what i do – hair oils, etc, it is as dry n weak as ever and receding all the time. help would be very welcome and appreciated.

This is an area where I have first hand knowledge, with the worst form of scalp psoriasis one can have. Mine, like yours, burned out in the scalp and I have almost none of if at this time. But I never lost hair because I was careful about not pulling off the plaques which would have almost certainly produced traction alopecia. Psoriasis does not cause hair loss unless the plaques are pulled off and the hair comes out with the plaques regularly.

With regard to hair transplants, I am frequently asked by people with psoriasis, if the psoriasis can be moved from one part of the scalp to another. In my experience, psoriasis can not be transplanted from the affected area to an unaffeced area, but any surgery done on active psoriasis, can make it worse, unless it is treated topically prior to the surgery.

You may have a skin condition and this must be defined by a good dermatologist. The rest of your needs are easily dealt with through traditional hair transplantation, which is extensively discussed in my book, The Patient’s Guide to Hair Restoration.


2005-11-10 13:35:41Psoriasis and Hair Loss