Author: Dr. William Rassman

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I Have Seborrhoeic Dermatitis, Chronic Telogen Effluvium, and Possibly MPB!

Hello,

I am 25 and have been gradually losing my hair for a couple for years now. In addition to what I would confidently call MPB, I also suffer from seborrhoeic dermatitis and chronic telogen effluvium.

1. Is the chronic TE linked to MPB or seb derm? I’ve suffered from TE for over a year and a half now and always assumed that losing hairs in this way was part of MPB. It constantly gets me down as I am constantly shedding hairs. A small pinch from anywhere from the top of my scalp can produce up to 20 plus hairs. It’s as if 50% of my hair isn’t even attached to my scalp. Several websites state that chronic TE is due to illness, whilst others say that it is the early stages of MPB.

2. Will the seb derm cause any hair loss if left untreated? Even though the seb derm is quite bad (thick yellow, oily scales all over my scalp), the condition is not yet visible to others and causes me no discomfort. I am worried about washing my hair every day with the recommended treatments because I lose so many hairs due to the TE.

Please help me! I’ve seen two doctors regarding my MPB and both told me that nothing could be done. I only discovered propecia etc. through google. I have been taking it for nearly 4 months now.

Many thanks for an enlightening website

We are not, I suspect, one of the two doctors you have seen. I have no real experience in doing transplants on someone who has a pull test like you reported as evidence of chronic telogen effluvium. I am actually surprised that this has not come before me at an earlier time.

The seborrhea will not produce hair loss as long as you do not scratch or pick in involved areas. Transplants may be contra-indicated with a chronic telogen effluvium.

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Minoxidil 5% side effects, what to do

I started Minox around 2 weeks ago, putting up to 1ml of 5% generic liquid once per day on my scalp. Today, I experienced heart sides (chest pain, tightness in the chest, rapid heartbeat) for the first time after a few days of increased libido and headache.

An incident this afternoon, which I believe might have been a panic attack coupled with dizzyness, led me to look up ‘minoxidil panic attack’ on the internet.

The lower 2% minoxidil has less side effects when used topically, and works well with once a day applications. Yes, there are side effects for everything. You could get in a car accident, but will you stop driving if you have to drive?


2019-12-11 09:12:46Minoxidil 5% side effects, what to do

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I Have Thousands of Translucent Hairs on My Scalp

I have male pattern baldness, yet I have thousands of tiny translucent hairs on my scalp. They are short, and do not seem to grow much, if any. When light is shinning from behind me the hairs are very noticable and people look shocked, as I look bald when no back light is present. What are these hairs and why don’t they grow to full length? Have not been able to find anything written about these type of scalp hairs on the internet.

Polar bearCongratulations! You are a polar bear. A polar bear’s fur is translucent despite its apparent white hue.

Kidding aside, what you are describing seems to be vellus hairs that commonly grow all over our body (look closely at your face… its all over — except for our palms and soles). These hairs are not like normal hair on the scalp and will not grow to normal scalp hair length, and in each follicular unit (which normally has 2-4 hairs normally) there is usually one vellus hair (which is not seen with the naked eye). When there are translucent hairs on the scalp that do not grow (instead of full pigmented hairs) then that is often seen in advanced balding/thinning. These hairs are usually miniaturized and do not grow normally as the genetic factors come into play. You should have your hair mapped out for miniaturization to find out what is going on.


2007-02-27 09:35:39I Have Thousands of Translucent Hairs on My Scalp

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I have terrible scabs after my hair transplant. (photo)

These crusts should be allowed to shed with shampoo regularly, leaving the shampoo on the scalp for 10 minutes and then gently rubbing them until they come off. It may take a few days? but don’t push it. After 2 weeks, the risk of graft loss is minimal. Compare this man on the left 1 weeks from his surgery with the man on the right, just 3 days after surgery. The difference is good post-operative washing. The man on the right was our patient and nobody could tell he had a hair transplant done at any time so far, at least.


2020-09-01 12:36:10I have terrible scabs after my hair transplant. (photo)

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I Have Significantly Less Body Hair After Taking Propecia for Years

Hello,

I’m 29 and started taking finasteride (Propecia) three years ago, a couple of months before I turned 26. Since that I have seen a significant loss of body hair, especially on my legs. At first I didn’t pay much attention to it, but then I started getting comments from friends and relatives. Can’t say it bothers me too much, but you may find it interesting to know that my body hair loss has become rather pronounced.

One thing that might be relevant, is the fact that I have elevated estradiol levels. Part of the reason that I ordered a test to evaluate my hormonal profile in the first place, is this reduction in body hair. I suspected low testosterone, but my testosterone was actually quite high, which could possibly in turn explain the rise in estradiol. Anyway, I’m still on finasteride and have no plans to quit.

Thanks for sharing your story. Body hair growth in men is stimulated by DHT, and since finasteride inhibits DHT, reports of body hair loss after taking finasteride are not unusual. Having less leg hair is nothing you should be concerned about, unless of course you really want that hairy leg look.

Slightly elevated serum estradiol levels from finasteride have been noted as far back as 1999 — “Slight increases in serum estradiol levels were seen but, like testosterone levels, these remained within the normal physiological range and the ratio of testosterone to estradiol was unaltered.”


2014-05-15 12:05:36I Have Significantly Less Body Hair After Taking Propecia for Years

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I Have Thick Hair, But Not As Thick As 10 Years Ago

Hi Dr. Rassman, I am a 43 year old musician and I am very lucky to have thick shoulder length hair. However, although still thick, it is certainly not as thick as it was 10 years ago, and I am beginning to notice some slight thinning at the crown and although my hairline is still low, some very slight thinning there too. My question is, should I use Rogaine preventatively? Is it better to start Rogaine at the very beginning of what might be a problem? Will I see benefits from Rogaine if my hair is still thick? Or at 43, have I likely escaped a serious hair loss problem and just take some vitamins or something? Thank you so much for your help.

To me, thinning hair either represents a change in hair thickness (possibly aging) — something we see when a baby becomes a young child, and then often when a young man takes the turn into puberty -or localized miniaturization in the areas where you notice the hair being not quite as thick as it previously was. To make that diagnosis, as I have said before, you need to get your hair mapped out for miniaturization and then the microscopic analysis will be clear as to what you are seeing with your eyes. In men, miniaturization is best treated with finasteride (Propecia), not Rogaine (minoxidil) as the drug of first choice. I now have an office in Newport Beach, and since you indicated that you are in Orange County, why not get your hair mapped out and find out that is happening to you?


2006-08-25 13:43:44I Have Thick Hair, But Not As Thick As 10 Years Ago

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I Have Swollen Glands in Jaw and Thinning All Over the Top of My Head

Hello, I am very curious about the hair loss I have been experiencing. I’m 22 years old with no family history of male pattern baldness. Over the last 4 months my hair has been falling out at an alarming rate. You can now see my scalp through my hair. It is not at the rear of my head like most men, but all over the top of my head. I also have swollen glands on the inside of my jaws, however, I have no idea if that means anything. Do you think it could be male pattern baldness, or am I dealing with something else. Thanks for your time.

This appears to be two separate problems. The swollen jaw and swollen glands need medical attention. If you are balding, then it is best to see an expert on that as well. Male pattern baldness might be something you’re experiencing, but the swollen glands are unrelated.

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I have too much hair (photo)

He sent me an email complaining that he couldn’t get a hair cut and had to live with this hair uncontrolled. I think he was bragging. I had performed 3200 grafts one year before.

 


2021-06-11 12:28:07I have too much hair (photo)

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I have water retention from Minoxidil

Have any of you guys found a successful dosage that doesn’t give you puffy face, fat belly etc while still being effective for hair growth?

If you are getting these side effects, either the dose is too high or you should not be on this drug. Speak with your doctor

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I Haven’t Had Hair Loss in 14 Years, But I’ve Started Propecia Anyway

I am asking this question in regards to the rate of hair loss and the multiple minaturization studies conducted. I have had HT at [name removed] twice 1994 and 1996 (small procedures 125 total, they robbed and mamed me) but the next two were with [name removed] in MI. The latest in July 2001 and Oct 2007. Just started propecia again Sept 2007 (real good results on propecia) Dr. stated that my min study did not show thinning on the top sides and or upper part of the back of head (taken in 2004, 2005 2006 and 2007) / my stylist also stated the same thing by not noticing any changes for the several years of cutting my hair (*just a little in the front and crown but nowhere else). I still have a decent bridge in the middle (slight thinning) and my brother who started thinning in the same pattern at 28 has the same pattern which he is now 41 with no hair loss product (more hair in fornt of head though). My transplants were just in the front and hopefully my last.

I started thinning at age 24 and the top sides and upper back of head are thick with no signs of miniaturization even being off hair loss products for almost ten years. Is this a good sign that the patten will stay?

That’s an interesting history and some tough times you’ve had. If you have been off hair loss products for 10 years with no progressive balding, but you just started on Propecia (which is a hair loss product) and it is working nicely, then you should stay on the Propecia.

Honestly, I am surprised that you think that Propecia is already working for you, as it usually takes 8 months to see any benefit (the hair only grows 1/2 inch a month). If you stop the Propecia, then you will probably lose all of the hair gain benefits that the drug gave you. I gather from your letter that you are happy with where your hair is now, correct?