Hair is Smelly Even After Washing – Hair Loss Information by Dr. William Rassman

i have a niece that has a very strong odor coming from her hair. she washes very well yet the smell does not cease. do you have any ideas of what could be going on? thanks!

There are many things that can cause bad smells from the body or hair, and they include:

  1. Washing incorrectly. I had a patient who came here with his family with the same complaint. He smelled badly to me in the office, like someone who did not wash his body or his hair, yet the family told me that they knew for a fact that he washed his hair twice a day when he showered. When questioning him about what he was doing in the shower, he told me that he stood under the shower and let the water flow on him, his hair and his body. I then questioned him on how he uses soap and shampoo. He told me that he never used them and on further questioning the family, I found out that he had a learning disability. I suggested that his father should go into the shower with him and make sure he washed, or if necessary teach him how to wash correctly. It turned out that I hit the bullseye. His odor went away and neither he, his hair, or his clothes smelled anymore.
  2. Infection. There are infections that can cause odors and these include fungal and bacterial problems on the skin. Treatments for bacterial problems are different than those for fungal problems. A good examination by a completent doctor would help review her entire body and determine where the actual odor is coming from. Appropriate cultures of the skin/scalp/gland area, etc. may point to the problem.
  3. Disease. There is a disease called Hidradenitis Suppurativa (other related names and diseases include: acne inversa, acne triad, acne tetrad, hidradenitis axillaris, apocrinitis, intertriginous acne, pyoderma fistulans sinifica, Verneuil’s disease, Verneuil disease, dissecting cellulitis of scalp and neck, acne conglobata, follicular occlusion triad, follicular occlusion tetrad, pilonidal sinus, acneiform disorder, apocrine occlusion). As noted from these names, the scalp may be impacted. This condition or a variant of it may be present in 1-4% of the young adult population to some degree (see this article on eMedicine.com).

Hair Wax Plugging Follicles? – Hair Loss Information by Dr. William Rassman

Thank you for creating this blog, it has been very helpful!

Recently a friend told me that using hair wax causes hair loss because it plugs the hair follicles. He said to go to a hairdresser and get a stripping shampoo, I guess to get rid of any wax that may be plugging follicles. My question is, do you know anything about using hair wax and it causing hair loss?

Thank you!

I am not clear what your question is. If you are asking about the wax that is made from the hair follicle (sebum) which is made in every person with hair, then this does not cause hair loss for if it did, the homeless people we see on the streets (who never washed their hair and probably have considerable wax buildup) would be bald and the compulsively clean person that washes their hair many times a day would be the hairy population. Sometimes I wonder if there are less bald homeless people out there then well washed coiffured people who hold real jobs. At the least, the homeless people I see in Santa Monica (sleeping on the beach) may have less stress than those people with big house payments (with heavy debt) and we know that stress does cause hair loss (not wax or dirt).

If you mean hot wax, as used in hair removal, I would not recommend any stripping shampoo or wax that strips hair. Any reasonable chemical assault that goes after hair or wax should cause hair loss, eventually permanent.

If you are referring to the wax in grooming/styling products, then I do not believe that these will cause you any problem.

Interesting Letter From Patient – Balding Blog

So, Dr. Rassman, it’s the day after my surgery and I don’t think I’ll be able to sleep for a few days. No, it’s not because of any pain or discomfort; rather, what you and your team did today will forever change my life.

As you know, my journey began in late 1993 in Beverly Hills. One scalp reduction and two 100-graft sessions later, even I could tell my ‘Master Plan’ at the time was bunk, BS, a no-go situation. And I’m no doctor, mind you.

Because I was still losing hair and now my large grafts began to show, I entered the world of hair systems ala Hair Club for Men two years later in the fall of 1995. The cover charge for entry into Sy Sperling’s party was a steep $2625.00, however, and that took me by surprise. Funny thing is, I now look back at those photos from that period of my life, and the hair looks shiny and oh-so-fake. Kind of like a horse’s tail. Maybe it was? No, that’s too harsh. I’m sure it was farmed from ladies in the far east, stripped of its cuticle and dyed to my hair color. It just had this otherworldly sheen to it and in no way did it appear real. Man, I wonder how many people knew?

Flash forward to the year 2000. I joined the Directors Guild of America (DGA) that year, was making union wages as an Assistant Director, and then stepped up a notch to a Richard Farrell hair system. Farrell reminds me a lot of you. He blows the lid off the hair replacement industry, and has a completely transparent salon. His systems are indeed the best, but no matter how much they appear to be growing out of your scalp, they are not. Further, they never will. My first two systems in August 2000 were just over $3000.00, reasonable for the quality I was getting. Since the lace bases were very sheer, they eventually ran their course and were replaced. In 2005 I did just that, except the cost of two systems at that time was $5000.00 (inflation of course). So, that’s $8000.00, excluding the monthly servicing, coloring, hair additions and haircuts I received. When you include those items, I spent $16,2000 from August 2000 through January 2006. OUCH!

Of course, the sad truth is I work in the film industry on set as an Assistant Director. I had the good fortune of working with Scorsese, Coen Brothers, Clint Eastwood, and directors of that caliber who attract similarly-accomplished crew members. I was unfortunately busted wearing a hair system by the hairstylist of a prominent Hollywood actor by none other than George Clooney’s personal hair stylist, a guy named Waldo Sancez. He is a cool cat, and he personally didn’t make fun of me or even let one that he knew (a class guy). He simply relayed to me that the entire hair and make-up trailer was abuzz because they were convinced I wore a hairpiece. When I was in the dressing from, he looked at my hairline the entire time, and never asked me if it was true. Conclusion: They all knew. OUCH!

Don’t get me wrong, if I were an accountant, mortgage broker, etc, I could have gotten away with a system of Farrell’s quality. It’s a completely different story, though, when you are standing eye-to-eye with an Oscar-winning hair and make-up artist giving warnings to the actors sitting in the chair getting ready for set.

After Waldo’s revelation, I was never the same AD. My self-confidence deflated like the proverbial balloon. I wore a ballcap every single day on set since 2000. All the while paying thousands of dollars to upkeep the systems that were supposed to allow me to NOT wear a ballcap. Irony anyone?

Flash forward to today, Feb 23, 2006. NHI is the real deal! You are every bit as caring and accomplished as any doctor I’ve met. I’d even hire you as my primary care physician if you moonlighted on the side. Bottom line: Your patients come first; your company’s earnings are secondary to the end result (and safety!) of those who enter 9911 Pico Blvd. looking for help.

I CAN NEVER THANK YOU FULLY for what you did for me-hell, and my career, for that matter-today. I am in the queue for a HUGE movie later this fall, and I know my confidence will be at an all time high. You can’t put a price tag on that. It’s about value, and what you’ve done for me far exceeds the “price” of what I paid NHI yesterday.

This fall, I can’t wait to knock on the trailer door, look the hair department head in the eye and proclaim, “Camera will be ready in 10 minutes. What’s your best guess on having actor _______ ready?”

I edited this letter before publishing it here, because it contained things that should not be the focus of such a letter (even for humor). I always believe that if you have nothing good to say about someone/something, best not say it. This man was a delight to work with and we bonded in a very special way (I always seem to develop a special bond in this strange world of the hair transplant repair process). Many repair patients have a unique type of pain that they live with, a type of pain that fortunately does not happen much with the modern techniques used today. The bonding requires building trust where none existed because of the history of the bad experience, well defined by this patient. I was humbled by reading his letter as I am every day working in this field.

William Rassman, M.D.




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Balding Forum - Hair Loss Discussion

Switching from Rogaine Back to Propecia – Hair Loss Information by Dr. William Rassman

Dear Dr,
Thank you for a most informative web site. I wanted to ask a question on how to progressively reduce reliance on Rogaine, which as you have noted gradually looses its effectiveness.

I am 40 and had mild thinning over the crown and frontal areas..just becoming noticeable. I used Propecia for an initial 3 mths period only in 2004 then stopped, then continued on with Rogaine (5%) for the past 14 months with good response. It now seems to be slowly loosing effectiveness with hair shedding.

Is there an option to restart taking the Propecia on a daily basis and then slowly reduce the application of Rogaine? Or after close to 1.5 yrs do you feel the hair would have become conditioned to it? I would welcome your advice as I would like to ’switch over’ to Propecia and one day cease the Rogaine if this is an option.

Thank you for your advice.

Sounds like you have lost the benefits of Propecia. Go back on it. As you are already on Rogaine, stay on it, at least until the process has stabilized. Then work with a good doctor to put together a good Master Plan for you.

Balding Forum - Hair Loss Discussion

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Full Activity After Hair Transplant – Hair Loss Information – Balding Blog

How soon after hair transplant can I lift heavy weights and also go surfing? Are there any vitamins for the hair, so that the transplanted hair grows healthy and strong?

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If you have a traditional strip harvesting technique for hair transplants, I would suggest that you wait until the stitches or staples are out (14 days or so) before going to soak your hair for long periods of time with activies like surfing. Heavy weight lifting also is included with some restriction for a month or so (to be safe, you should wait around 4-6 weeks before doing any heavy lifting where you have to strain your neck muscle). Running, biking, and such can be started within 5 days after a strip harvesting hair transplant.

If you have an FUE (Follicular Unit Extraction) harvesting technique, you can resume full activity including scuba, surfing, or weight lifting within a week of the surgery. You can go surfing a few weeks after surgery, including light weight lifting.

All healthy people will grow the hair after a hair transplant. You can not stop it from growing; well, almost true, except for those people who do not exercise good judgments.

Transplanting Females with Diabetes, High Blood Pressure, and Glaucoma – Hair Loss Information – Balding Blog

Hello I have several more question I need answers for before I consider a transplant procedure. Can you preform this procedure if you have diabetes or high blood pressure and glaucoma and if not do you have another kind of treatment for a candidate like me. Is there a medication in a different form? I am female.

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I am assuming that the hair transplant is appropriate and you are concerned about the existence of the medical problems. These problems are not contraindications for hair transplants which are performed under local anesthesia. I have my diabetic patients continue to eat and take the same medications that they would normally take. I would expect that the blood pressure is under good medical treatment and that the glaucoma is also well controlled. In people like you, any problems have not been different than in people without diabetes or high blood pressure.

My Hair Is Turning Wavy – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

This is not a hair loss question! I am a 40 year old bi-racial (white + Korean or AmerAsian) female. I am also adopted and do not have biological-medical history. In the past year, my very straight hair has turned quite wavy. It is still thick and healthy, but changing! I have always had straight hair. I have not reached menopause yet, so I don’t know if this change can be attributed to hormones? I haven’t changed my diet, nor am I taking any medications (other than multi-vitamins). I cannot seem to find any substantial information concerning the potential “cause” of this change. Do you know why my hair is changing? Is this common to aging? I would appreciate any insight you can generously offer. Thank you!

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Hair changes its character and thickness with age. Usually, it gets finer and will become wavy if it was straight when it was thicker.

Lost All Hair from Back and Sides in the Past Month – Hair Loss Information – Balding Blog

Doctor,

Within the last 25 days I’ve lost all of my hair from mid back and sides and seem as though it is moving toward the top. I am a black woman 46 years old, I’m taking several medication along with vitamins. Such as Zocar, Zeta, Enulose and Flax Oil, One A Day women vitamin and Calcium. I’m under stress with adult sons and job and I’m planning our wedding with my fiance which that is a happy ordeal in my life. I am very stress now that my hair is coming out in comb full three times a day if I comb. One day I decided not to comb and waited to the next day, only to have two hand full of hair. I recently had blood work with my primary Doctor, who said my blood work was good and recommended me to see a Dermatologist. Which I did make an appoitment. My diet is not the worse, very little fruit but lots of vegetables,fish and chicken or turkey. Little fried food. Beverages is water or juices. Please give me your opinion, I know you cannot give me a diagnoisis. Maybe a suggestion.

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Are you losing hair in the frontal and top area too? It is best to wait and see a dermatologist first so that he can map your hair loss pattern out and possibly biopsy your scalp for any inflammatory processes, if indicated. Genetic female hair loss can be made worse by stress and mediations like Zocar, which can cause hair loss as well. This is a multifactorial problem in you and a good dermatologist should be able to help you discern the contributing factors.

Top of My Scalp Is Sore – Hair Loss Information – Balding Blog

I am 34 year old African American female. The top of my scalp is sore, thinning and I can not get rid of the dandruff. Is this part of Alopecia? Also, Why do I have soreness at the the top of my scalp and I believe thinning? What can I do for the soreness and thinning? I relax my hair approx every 4 Months. Please help. Thanks.

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Chemicals that relax your hair for a long period of time, may cause skin irritation and/or hair loss. Drandruff treatment are found in every pharmacy and you need to experiment with each until you find one that works well for you.

2 Years After Transplant, 50% of My Transplanted Hair Has Fallen Out – Hair Loss Information – Balding Blog

Dr. Rassmann,

I apologize for the lengthy message, but I’m very concerned about my current situation and really need 3rd party insight.

The Situation:

Approximately 24 months ago, I had a transplantation procedure by a well known and highly respected expert in this field. Procedure deilvered over 3,300 FU’s to frontal 3rd in one session. The results at 12 months were incredible, as my hairline and overall density were more than I had hoped for. At about 18 months, I started noticing steady hair shedding, lasting for months. During this time, and up until today, I noticed structural changes to the transplanted hair (very thin in dia., squiggly, etc). Bottom line, at a little over 24 months I now have less than 50% of the density I had at 1 year with no improvement or regrowth. My diet is immaculate, very healthy, workout, take finasteride, minoxodil, etc. etc. In phone conversations with the doctor, he believes it’s Telogen Afluvium. However, this was not sudden loss all over my scalp that has been followed by growth. We’re talking about a steady loss of the transplanted hair, with nothing re growing, and the hair that’s remaining looking very ill.

Questions:

1. Are you aware of any similar cases like this?
2. If so, any insights on what causes it what to do to stop/generate re-growth?
3. Is it possible to consider this failed FU’s even though they looked great at 12 months?

Thank you for your time and insight.

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Loss of ‘permanent’ hair from a previous hair transplant is very, very unusual. I would expect that the answer to your problem lies in your donor area now. If you lost 50% of the hair transplants, then you should have lost 50% of the hair population in the donor area. I have seen men develop Diffuse Unpatterned Alopecia after a hair transplant, though it is very rare. You need to have your scalp mapped out for miniaturization to make this diagnosis.