Month: January 2023

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My Dermatologist Said He Can’t Tell If I Have MPB (with Photos)

Doc

I’m 19 year old and I’m afraid I’m losing hair, even though my father has a head full of hair, because of the irregularity of my hairline and recession at the temple.

I’ve consulted a dermatologist that said I have seborrhoeic dermatitis and that he can’t tell whether I’ve male pattern baldness, thinning or receding hairline before my dermatitis is cured but even using the foam, nizoral and pills he prescribed I still have dermatitis and I’m afraid I’m wasting time when I could be curing my hairloss.

I really want to know what do you think? Do I have a receding hairline and hairloss?

I took these pictures this morning, feel free to publish them. Thanks

Click the photos to enlarge:

 

I will post your photos for the readers that may like to comment, but if a doctor examined you in person and couldn’t diagnose genetic male pattern baldness, I don’t know how we could be expected to provide a diagnosis just based on photos. It does appear that you may have some hairline recession, but you’d need your hair bulk analyzed and scalp mapped for miniaturization in order for me to be able to know if you’re thinning in various areas of the scalp. The photos don’t show me that.

I am not sure why you would not want to follow the recommendation from your doctor, who gave you a treatment plan. Did you use the medications he recommended for the length of time he prescribed? If you feel your doctor is wrong with the diagnosis, then you should seek another doctor for a second opinion. Treating seborrhoeic dermatitis wouldn’t be a waste of time, though.

And just to be clear, there isn’t a cure for hair loss.

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My Dermatologist Just Told Me to Use Minoxidil and Didn’t Run Any Tests for My Female Hair Loss

Hello – I hope I’m not being redundant with this question but I didn’t see a similar question on your site or on the many others I’ve searched (have also read lots of books). I’m 54, female and am not yet in menopause. About 4 years ago, I noticed that a relatively thick layer of my bangs would no longer grow past my eyebrows. In general, this layer of shorter hair extends to both temples and stops at the front of the ears (although it is obviously most noticeable right in front and makes styling a hassle). I have become much more careful with heat styling and have been taking supplements (Black Currant Oil, Bio Available Silica , EFA’s, Multi-Vitamins, Special Hair Formula Vitamins, Calcium, and have recently adjusted my diet to include salmon, nuts, good fats, etc — and I’ve seen some overall thickening and lengthening.

I recently went to a local dermatologist who is a specialist in hair and he diagnosed me with androgenic alopecia and prescribed rogaine for the small area at the hairline. If I recall correctly, he said I had a brief anagen phase. I show no signs of shedding or thinning and I have a very thick head of fine hairs (I know I’d be an excellent candidate for transplants should I need them!). I asked him about whether I could take birth control pills (low androgen ones) or spirodactone instead of or in addition to the Rogaine (which seems like a mess and hassle — for the rest of my life). He said no no no and wouldn’t run any tests for ferritin, hormonal issues, etc. I would think that the fact that I’m 54 and still menstruating (and have a very large uterine fibroid that’s still being fed by estrogen; I’m being watched by my ob/gyn) would suggest some hormonal atypicality for my age, but what do I know?. Although he was very nice and kind, I’m not 100% confident in his diagnosis because the hair has improved significantly since this problem began. Is it possible that I have a different problem? Could I first try to treat this issue with anti-androgen medications before I sign on for life with Rogaine?

Thank you for time and best wishes.

Your dermatologist is probably correct with his assessment. Many people will have a shorter anagen phase as they age. This means that as hair grows at about 1/2 inch per month, if your anagen phase is shorter (let’s say to the tip of your nose in the front), then you can calculate backwards the length of the anagen cycle by dividing that distance by 1/2 inch.

You should have the battery of tests run, which will rule out other causes of changes in the anagen cycle other than genetic causes. These blood tests include:

  • Sex Hormone tests
  • SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
  • Estradiol is a sex hormone
  • FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
  • LH (Luteinizing Hormone) is a sex hormone
  • Free Testosterone
  • Total Testosterone
  • ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
  • TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
  • Test Iron status
  • TIBC (Total Iron Binding Capacity)
  • Ferritin
  • Iron

As you are using a variety of other substances, I can not tell you what has worked, but clearly it sounds like something is working to increase that cycle time. Go back to your dermatologist and be more forceful with getting him/her involved in the diagnosis. For more information, please see Female Genetic Hair Loss Is Different From Male Genetic Hair Loss.


2008-07-24 16:23:16My Dermatologist Just Told Me to Use Minoxidil and Didn’t Run Any Tests for My Female Hair Loss

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My Dermatologist Doesn’t Believe That Mites Can Cause Hair Loss

Dr. Rassman,
I know you have written about demodex mites on this site in the past. A quick search of the blog revealed two times you discussed it with readers and the possibility that it could lead to hair loss when mites multiplied in great numbers. I for one agree with you… my derm not so much. She like many doctors in the field, believes that it s just a myth and that they do not lead to hair loss, rosacea and acne (in some cases of course, not all).

I have strange hair loss and papules that have appeared in my brows for over 12 years now and steroid creams have only exacerbated the condition. I believe I might have a mite infestation (as I have researched the topic extensively through various medical journals) and although my symptoms are rare, there have been documented cases much like mine. My problem is my derm doesn’t believe it’s even a factor. She says even if we do a skin scrape test to look for mites (by my insistence of course) and she finds them in increase numbers it doesn’t mean anything and furthermore that there is no known drugs to treat it. What are your thoughts? I wanted to know if you could recommend any derms that might be open to recognizing/treating demodex? I reside in the near the LA area.I mean after all is demodicidosis just a made up condition? Doesn’t add up!

It seems you are insistent on proving your dermatologist wrong. Maybe you are right. I haven’t personally treated any one with demodex mites. I did write in past that it may cause localized hair loss if there’s an abundance of mites around the follicle, but that is more of my educated guess. In general, demodex mites are considered benign and it do not cause hair loss.

If you really believe you have the mites on your eyebrow and you are not satisfied with your doctor, find a doctor who will listen. If you really want to know, find someone who can diagnose your condition with skin scrapes, etc (as you state). At least you will know. I don’t know if there is a definitive treatment, but I am sure you are savvy enough to search out on the Internet for resources.

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My Daughter’s Hair is Processed and There Are Bald Spots

13 year old african american daughter having continuous hair loss for several years. Hair is processed and has several bald spots especially in back. Suffers from excema if that helps. Please HELP! Beautician just sews false hair in her head but has yet to get it to grow. Can you please tell us where to start.

It sounds like your daughter is having chemical problems with the things that the stylist is using. Hair loss is common when chemicals are applied to relax the hair. I am wondering what you mean that the beautician is sewing false hair into her head, though.

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My Daughter’s Hair Hasn’t Been Chemically Processed for Years and Now It’s Breaking

My daughter is 15, she has not had a perm in 3 years or more. Just recently her hair began breaking off on the ends and around the edges of her scalp. She uses biosilk shampoo and conditioner and she does flat iron and blow dry her hair at least 3 or four times weekly. What can we do to stop the breakage and promote the growth of her hair? We are african american.

The use of the flat iron could still contribute to damage, but this is best managed by a good hair stylist with lots of experience with African hair types.

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My Daughter Has Been Losing Hair Since She Was an Infant

My daughter started losing hair across the back of her head as an infant (like many do, from turning their head in their crib). It was breaking as much as it was falling out. It continued to break and be brittle. I was told by her pediatricians that she would grow out of it, and that nothing could be done. 4 years ago a dermatologist could not diagnose her either. She is 13 years old now and her hair has never been 100% haelthy, although she has had times when it was better than others. A week and a half ago she tried using Head and Shoulders shampoo, thinking it might help. As of last night, on the top and across the back of her head there is nearly no hair. She is not “bald” back there per se, but the hair there is less that 1/8 of an inch long. Another trip to a different dermatologist this morning revealed nothing. He had no idea, other than that it was “extreme, and apparently rare” and he did not know what the cause was. He suggested a peanut oil treatment and biotin. I’m considering asking her pediatrician to run some blood tests, but am not sure what to request. Hormones, vitamin deficiency, thyroid? Any insight you can give me would be much appreciated. Obviously at the age of 13 this is devastating for her. Thank you.

I can appreciate that it is very devastating to your child. Unfortunately, I really have no input here aside from the fact that you seem to be taking the right steps and seeing specialists. You may benefit from still another opinion with another dermatologist or a hair transplant doctor who might give you a different perspective after an examination. I would like to help, but I am not her doctor and the blog is not an appropriate medium for such.

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My Daughter Had a Bad Chemical Burn on Her Scalp When She Was Hours Old

I have a 11 year old daughter who has a bald spot in her head. She received this chemical burn when she was about a few hours old when she stopped breathing and they had to put an IV in her head. She has really dealt with this situation for the past few years but now she complains because she can only wear her hair one way. I have taken her to a dermatologist and they said that her follicules were dead and that she would have to have a hair transplant. I have been researching about microscopic follicular hair transplants and I think I want to have it done for her this summer. I really want to know if you think she is to young for this surgery.

Depending upon the size of the area, the treatment should be customized for that size and location. Some children develop very large areas of balding from such events and these may require more than a hair transplant. I would have to see photos of her to tell you what could be done (you can send them here and please reference this post in your email). Photos will remain confidential unless permission is granted to use them.


2008-05-19 08:39:56My Daughter Had a Bad Chemical Burn on Her Scalp When She Was Hours Old

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My Daughter and I Diet Together and Lose Hair Together!

January 2008 my daughter and I went on a diet. By June 2008, I lost 40 lbs and she lost 30 Lbs. We went off our diets for the summer. Enjoyed the sun and baseball games, but both got minor sun burns on our heads. By July we noticed too much hair coming out in our brushes. Our heads are itchy and dry and it is now October and our hair continues to come out too fast. In the shower and on our combs and brushes we get balls of hair. We had blood work done, we are fine. We are going to see a dermatologist but they are booked up untill the spring. By that time, we could be bald. We were using pantene shampoe, and recently we are trying Infusium shampoe. I am 42 and she is 15. My husband and 12 year old son are fine. They also aren’t itchy and dry. We tried extra virgin olive oil more in our diet. We are taking salmon oil pills. We rubbed aloe vera on our heads and wash our hair every two days. I dont know what else to do. What could this be and what can we do, why are our heads dry and itchy and what can we use. We dont have dandruff or any other problems. Anything you can tell me would be really appreciated. Thank You.

Diet can cause hair loss and if you lost too much weight too fast, then that could be a problem. Caloric restriction in conjunction with a balanced diet is the way to losing weight and not losing your hair (assuming that you have this connection). Without examining you in detail, I can not offer you other advice here.


2008-11-03 09:21:01My Daughter and I Diet Together and Lose Hair Together!

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My Dad Was Completely Bald at 35 Years Old, and I’m 39 Now…

Hi Dr Rassmann,
currently i am a norwood 2 to 3, i am 39 years of age started to notice hairloss around 21 years of age, same as my father.i have been on proscar for 9 years all good with a touch more hairloss in crown area, recently changed to avodart. seems to be going ok. i have also recieved 2300 FUT in the last 10 years or so, with good results.My concern is this,my late father was close to a norwood 7,at 72 years of age, also had senile alopecia (thinning sides and back) mothers side no balding, well norwood 2 maybe her father couple of uncles, same as dads side.As i mentioned before me and dad started balding at same age 21, though dad was completely bald at 35.Dad had thick hair i have very fine hair.Have i made a mistake having hair surgery?

Although you gave me a great deal of information, I can not judge you enough without seeing you to tell you what I think. Generally, at 35 years old, some miniaturization will show up in the future balding area by now. Most Norwood Class 7 patients have their hair loss pattern complete by the age of 35, so I would expect that with regard to your fear of a future Class 7 pattern, it may not occur. With regard to your hair transplants, this should have been covered by you and your doctor when you built your Master Plan for hair loss. I would revisit it again and update it based upon where you are now and the degree of miniaturization found on your scalp. Senile alopecia may be genetic, so that is a real concern, but not for the short term (next 20 years of so). If you are happy with your transplants, then I doubt that you made a mistake (assuming that it corrected what you wanted to correct) and now can enjoy the value of the transplanted hair for the future.

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My dad has a Class 7 pattern so I guess that will be me too

my dad went completely bald, so i know my future. im curious as to whats the highest (average donor) capacity of grafts someone could extract, and how much grafts are needed to make the head appear full. I know that Caucasian people roughly have 100.000 hairs, i cant understand how some fue results with around 10.000 grafts show great results whereas others with 10.000 grafts look like shit basically. is it even worth it to go for a transplant if i know im going to be completely bald? cause then i end up with some hair on my top, cant wear the sides shorts cause of scars?

You need to find a doctor who can follow you and develop a Master Plan with you for your future hair loss, assuming that you will have it. You may not follow your father’s hair loss pattern but the earlier your find out, the better. Our blog site is loaded with information to answer your questions: Two recommended posts are here: 1- https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ 2- https://newhair.com/resources/#tab-id-4

I would be happy to work with you, especially if you can get to Southern California.