Author: Dr. William Rassman

I recently went to the trichological clinic in Costa Mesa, CA and had microscopic hair analysis. After examining my hair bulbs and shafts, the trichology specialist, said that I have hyperhidrosis and excessive lactic acid cause the hair to fall out. I have noticed my hair loss since the beginning of this year and lost agressively for last three months. I have receding hairline but I don’t have much thinning on crown or vertex though I can see my scalp due to excessive hair loss. The specialist showed me the hair affected by DHT to compare with my hair affected by lactic acid. The hairs affected by DHT are encapsulated by DHT and my hairs don’t look like them. She said my hair bulbs are healthy but the acid is eating away the hair. I have never heard of this condition and before I start any kind of treatment I like to have second opinion from you.

Hyperhidrosis implies increased sweating and the suggestion that the sweat contains lactic acid which damages the hair makes no sense whatsoever. DHT encapsulating the hair is beyond the science I know, but the storyline might be believable with a good salesman or saleswoman presenting it. Why look to other causes of hair loss if you have genetic hair loss? Not only have you not heard of it, but neither have I… though the Internet does contain references to the concept, so I guess some people are believers. I don’t know that I would trust anyone with that type of sales pitch.

I recently fostered a dog from our local animal shelter. The dog had hair loss on its front shoulder, elbow, and belly. I was told that the dog was loosing hair due to stress. After 7 days of being at my home with me and my cat- both of us began itching. The cat was having the same symptoms as the dog- lots of chewing, liking and biting.

My head is itching like crazy – I have tried lice shampoos and scalpacin and a scabbies cream Permethrin from head to toe. After a month and a half my hair has started falling out in large amounts. My cat was taken to a specialist in pet dermatology – she does not have ringworm, scabies, or fleas. she has gone on a special medication – which has lessened her symptoms but not gotten rid of them-and they had no definitive answers. Maybe we are passing something back and forth? But I cant imagine what this could be?

You need to take both of your animals to a vet and yourself to a doctor. Why would you try lice shampoos or scabies medicine without knowing you have lice or scabies? Those shampoos can do more damage than good if you don’t have lice or scabies. You need a good diagnosis before trying something blindly.

Hi Doctor,

I’ve read that the hairs on the sides and back are resistant to DHT and that is why they stay on while top and front hairs go. Is there a drug company that is looking into turning those top follicles to behave like the back and side follicles? Also is there an aromatase cream or something where you can locally inhibit DHT?

Thanks.

MPB is not something that you will cause hair loss on the sides and back of your head. For reasons not fully understood the hair around the head is not susceptible to hair loss. I don’t know what various companies are working on at any given time, but I’ll be sure to report on any hair medications as they’re announced.

In my quick research, I found oral aromatase inhibitors like Cytadren, but nothing topical. I do not prescribe aromatase inhibitors, but be careful if you start experimenting, as higher doses of aromatase inhibitors caused hair loss in around 10% of those women studied (se Aromatase Inhibitors for Breast Cancer in Postmenopausal Women). The study was on women because aromatase inhibitors are anti-estrogen medications, and used to treat breast cancer (although commonly abused by bodybuilders).

Note: The following post is courtesy of Dr. Russell Knudsen from Sydney, Australia. It was sent to doctors in an email group I belong to, and reposted here with his permission.

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Biotin deficiency (Vit H) was noted to be associated with alopecia in Eskimos who fed entirely on seal livers that were Biotin deficient.

If any of your patients are –

1. Native Eskimos who live in remote arctic communities
2. Dieting mostly or entirely on seal livers
3. Suffering diffuse hair loss associated with both of the above

Then by all means recommend its use (together with silica, Zinc etc). If, however, your patients suffer androgenetic alopecia, and you recommend or supply this, you will have inadvertently become a trichologist…