Author: Dr. William Rassman

Im a 21 year old male and recently had a serious car accident managing to get a double fracture of the pelvis amongst other less serious injuries.

Initially doctors thought I had neck injuries so i had a neck brace fitted and was on me for only three days. Apparently i was vigorously thrashing about in the bed between the times i was sedated and a 6 inch across patch of my hair fell out.

It has been 4 weeks now since the hair fell out, no other hair loss has occured i am just worried as to whether the hair will grow back, bits of stubble have appeared round the edges of the gap but not much at all in the middle. I am grateful for any response.

This condition is called pressure alopecia. Pressure alopecia is typically seen after a long period of immobilization that patient’s head stays in a fix position. It is more common in Intensive Care Units patients after long periods of sedation and after surgical procedures that require a patient’s head to lay in a certain position for a long time. This patchy baldness is usually transient and hair should grow back in a few months (3-6 months). Many Intensive Care Units use various mechanical systems (special rotating air mattresses) to keep pressure off of various parts of the body that had, in past years, produced ulcers and skin problems. Pressure baldness is no different and it could be prevented by a periodical change of the position of the patient’s head during surgery or when sedated. The key is not to allow long term pressure to any part of the body for extended periods of time.

I am writting to you so that maybe you can answer some questions for me. I am a US Marine currently deployed in Iraq and about a month ago I got a bite or something on the back of my head. It swole up really big and when squeezed alot of puss and blood would come out of it. I was given atibiotics like cephalexsin and steriods such as zithromax, which worked temporarily, but the infection would come back after about a week. I now have a bald spot the size of a dime-nickel which continues to get bigger. Will the hair grow back? ANd if not, could any surgery or procedure be done to fix the bald spot? Thank you so much for your time, and I eagerly await your response. Thank you again

It sounds like you had a local infection that has now cleared. Unfortunately, it seems you are left with a bald spot that is most likely the result of ‘reactive’ hair loss, something that we often see in such situations. The localized hair loss is likely temporary and it may return in 3-8 months.

If it does not return by the 8-12 month time frame, it is probably permanent. You can have a hair transplantation to cover the area. In fact, it is a relative common procedure to cover the scarred/bald areas on the scalp. Hopefully though, you will not need a hair transplant and it will regrow on its own.

I am a former Army Vietnam surgeon and I personally understand what war is from a first hand experience and how painful war is for everyone involved. Have a safe return home. Hoorah!

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I’ve been experiencing excessive shedding off and on for the past 1-2 years. When the hair falls out is almost always has a large ball of white/yellowish skin on the end. Sometimes there will be 2 hairs attached to one ball. What could this be? I’ve been to dermatologists and they seem clueless to what it is. I’ve had the standard blood work done and it all seems normal.

The yellow/white “balls” at the end of your fallen hair are just sebum, wax, and dead skin. It is normal to lose around 100 hairs a day (as there are other new hair growing constantly). That being said, if you are concerned about losing hair in specific pattern and notice excessive loss or thinning, you may want to see a hair restoration doctor who can map your scalp for more signs of miniaturization and/or pattern of hair loss. There are many competent doctors out there who can help you. Don’t get discouraged. Take command!

hi dr. my dad is in his early 50s and has a full head of hair, but his father had a noticable receding hairline at sides of the crown(not completely bald). do i have to be concerned with my grandfathers receding hairline….or just my fathers?

You need to find out if your balding pattern (if you have one) parallels your grandfather’s pattern at the age his started. That may point to your answer. Hair loss can skip generations, and the gene can be carried from either the maternal or paternal side.