Author: Dr. William Rassman

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Hair Loss from Propecia

Hey. I’m 20 years old and I have also had a further back hairline, but only on the side. it looked fine. A year ago i asked my doctor about it because it was a little thin on the right side and he prescribe propecia. Well i had been taking propecia for about 8 months every other day, when all of the sudden my hair was coming out like 15 hairs at a time. when i ran my fingers through my hair tons came out. I lost about an inch and a half on my hairline in 2 to 3 months. My hairline was fine before but it was just thin on the right side. It crazy its bother me alot. So i quit taking the propecia a little less then a month ago. I mean i cant even grow facial hair. so it feels weird that im losing my hair. PLease help. Could this be temporary?

Dealing with someone like you over the internet is very difficult or almost impossible. As I have said many times on this blog, you first need a working diagnosis. Getting your hair and scalp mapped out of miniaturization should at the least establish a proper diagnosis. Having someone with my experience, for example, is critical in making the judgments you need. Questions that stand out for me include:

  1. Are you going through accelerated hair loss?
  2. Do you have other causes of hair loss?

I would want to go through an extensive history on your overall health and the family tree in terms of balding, hair growth (when and where), etc. Get a good doctor and do not treat yourself. It has been said that “A person who treats himself, has a fool for a doctor”.

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Hair Loss from SSRIs

Hi, I would like to request clarification on something. I saw a post where you mentioned Sertraline causes hair loss as well as Zoloft. I also saw on some posts where SSRI’s are said to cause hair loss. The questions is how common is this? I have seen different sources use different percentages to represent how rare or often this can occur. I ask this because online it appears as a significant amount of people have voiced their concerns about Sertraline or Zoloft possibly contributing to their hair loss. However, there have to be many people who simply will never come to these forums because they are not affected. Also, how long does the hair loss take? Some posts mentioned period from 2-8 days, while some people blame the meds after they have used them for 4-6 years.

I have been told by several physicians that hair loss with SSRI’s is simply an alergic reaction which is rare. Do you agree with that? Thank you for your help.

Hair loss from SSRI (selective serotonin reuptake inhibitor) drugs are relatively uncommon, but they can occur. First and foremost you need to find out if there is a pattern to your hair loss. Is the hair loss everywhere or just confined to the front/top (in a pattern)? If the hair loss is happening in a pattern like those shown here, then it is most likely not from the drug. Hair loss from drugs will often impact the donor area, which is what we generally refer to as “permanent” hair not susceptible to genetic factors.

Most doctors (and even the doctors that treat hair loss, such as myself) do not know the exact mechanism of why some people lose hair from certain medications. We must believe the patient when they say that they are noticing some correlation with the timing of starting these medications and the hair thinning, but these things are often very difficult to narrow down. It is just not that simple, as the patient may also have underlying genetic hair loss as well. Remember that more than 50% of the population have some form of genetic balding which has nothing to do with SSRIs or other medications! I do not think hair loss from SSRIs (or other medication in general) is an allergic reaction, but more of a rare side effect. If hair loss is caused by a medication, I do not think it would happen in the time frame of a few days, but more likely several weeks to months.

Finally keep in mind of the big picture, rather than focusing only on hair. You are taking a certain medication for a reason, such as the SSRI to treat depression. What you are experiencing with respect to hair loss may or may not be related, but the reason of WHY you are taking the SSRI or other medication is real and the pros and cons (risks/benefits) need to be discussed with your physician before taking any action.

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Hair Loss from Radiation

I had a brain tumor when I was a child. I was cured but the radiation I received left me missing much of my hair on my left side. Can hair transplants help?

Yes, hair transplants will grow nicely in radiated scalp skin most of the time. I recently had such a patient come in after about a year from his transplant session with us (post radiation from a childhood treatment of a malignant brain cancer). He was Korean with black straight hair, olive complexion skin and one side of his frontal area almost completely hairless. His results with about 1500 grafts was wonderful and that included his hairline. He may elect to do another session, but frankly the results were outstanding and I did not think that he would push for another session. Clearly, he was happy and his hair ‘greed’ was taking over. Hair transplants work well for many scars and scalp conditions beyond simple genetic balding.

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Hair Loss from Testosterone Replacement Therapy?

Dear Dr. Rassman,

I have been under the care of an anti-aging doctor for two years. I have been taking testosterone (TRT). I have had hair transplants 10 years ago. I have been recently experiencing
more hair in my comb. Can Testosterone replacement cause transplanted hair to be lost?

Testosterone replacement may cause androgenic alopecia, but it should not cause hair loss in the permanent hair that was transplanted from the back and sides of your head (these hairs are not affected by DHT). You may be experiencing hair loss from your native non-transplanted hair.


2007-09-24 10:36:16Hair Loss from Testosterone Replacement Therapy?

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Hair Loss From Stopping Minoxidil

No question this time, but I wanted to share a quick story…

A 58 year old patient of ours was transplanted in the corners of his frontal hairline. He had used minoxidil for years with what he thought was no effect. After his corners were transplanted, he stopped the minoxidil and in time, lost hair behind the transplanted corner on his right side. In hindsight, this complication could have been avoided had he gone back on the minoxidil, but neither he nor I realized the dependence of the minoxidil over the previous years.

As a rule, men in his age range do not suffer from shock hair loss (very, very rare), but in this case, minoxidil was far more effective than we thought. He is now only 2 months post surgery and was immediately restarted on the minoxidil. I am hopeful that the drug will regrow the hair he lost behind the transplants on his right side, but only time will tell us. The lesson here is that when you are a long term user of minoxidil, you really do need to stay on the drug for life.

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Hair Loss from Straightener?

(female) Can you permanently lose some of your hair if you straighten your hair too much with a straightener? If so, is there a home remedy or a cheap way to grow it all back?

You can permanently damage the hair with chemicals and it is not uncommon when people continuously straighten their hair and experiment with the chemicals used for this. The 2nd part of your question is a little ridiculous to me — if there was really a magic formula to grow back all of your hair (and cheap, too), I highly doubt we’d see half of the population with some form of hair loss. In other words, no.


2007-10-10 11:32:08Hair Loss from Straightener?

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Hair Loss from Tuberculosis?

My 17 years old daughter was diagnosed with inactive tuberculosis about 8 months ago and has been taking INH. However, about 18 months ago she started losing her hair. Could this be caused by the tuberculosis alone?

I have written on this medication with tuberculosis before (see Tuberculosis Drug and Hair Loss). The disease itself is a wasting disorder which is known to produce hair loss, as with other wasting disorders. The same recommendations I made before apply: good diet and appropriate vitamin therapy. A full work-up for female hair loss is in order here as there are many diseases that cause hair loss in women (see Female Hair Loss category). Read these pages carefully and seek out a good doctor to follow through with a thorough examination of your daughter. Also, you might want her to see a hair specialist who will study her for female genetic hair loss and assess the miniaturization of her hair to see if the pattern is typical of female genetic hair loss.


2006-01-05 10:24:30Hair Loss from Tuberculosis?

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Hair Loss from Steroid Use

Your office is not that far from the famous Muscle Beach. Do you get many of the hardcore bodybuilders in for hair transplants? And taking all of those steroids…wouldn’t it be courter productive or should I say maybe a waste of time to get the hair transplant for those prone to baldness anyway or do they just take of more and different drugs of the estrogen blocking nature?
The reason I ask is that when I was in my younger days when I first really started loosing my hair( after two knee surgeries by the way???)I started weight lifting/bodybuilding to conpensate for my emotions concerning my hair loss, I had a rough time dealing with it. So I was tempted to take them (back when they were legal)but after reading about the hair loss side effects I changed my mind. Does the transplanted hair suffer from heavy steroid use or does it stay protected? Thank you

I believe that the permanent zone hair (the hair we transplant) is protected from steroids. The other hair that is not the rim hair around the sides and back of the head can be ‘killed off’ with steroids in those genetically prone to balding.

Yes, we see many, many weight lifters who have accelerated their hair loss and like you, panic when they see it falling out. The high they get from the steroids and the benefits in the sport, seem to offset the liability for most of them.

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Hair Loss from Weight Loss

In a recent news article from Central Florida’s Local 6 News, the relationship between hair loss and dieting was emphasized. Although I have always included weight loss as a contributing factor in hair loss, I was reminded by this article of the obesity problem that is confronting the American population and the degree to which people are willing to go to lose excess pounds. Sometimes, starvation diets are employed and are just not a subject that anyone wants to talk about (short of bulimia in a movie staff), but the problem is real and weight loss can accentuate any hair loss that may be present, if not precipitating its onset if it is not present but within the genetic cards of that person. For more info, see the article link here.


2005-11-16 16:58:53Hair Loss from Weight Loss

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Hair Loss from Zoloft, Surmontil, Xanax, or Temesta?

Dear Dr. Rassman

I am 33 and suffered from depression and anxiety attacks over a period of years and took numerous antidepressants including Zoloft and Surmontil. In addition I took sedatives such as Xanax and Temesta. During that time I did not notice any hairloss, even though I experienced a huge amount of stress. I am on the way to recovery now and stopped taking the antidepressants over 6 months ago and am weaning myself off the Xanax. For the last 6 months I have been experiencing mild hair loss, especially noticeable on the front hairline. Gaps are appearing in the hairline, which was normally full. I wash my hair about 4 times a week and comb my hair when washing it. In total I notice about 20-30 hairs on my hands and comb every time, which I never did before. I have no family history on either side of baldness. I have the following questions:

1) Is it possible that I could be experience temporary hair loss as a result of a history of using antidepressants and huge stress, and am having something of a delayed reaction? If so when can I expect hair to start growing back, if at all?

2) Does hair generally become thinner and recede in any case with age?

3) How can the loss of 50-100 hairs a day be normal? It seems like such a huge amount. Even given that new hairs are growing, that is around 30,000 hairs a year.

Thanks for any advice.

Kind Regards

Stress and antidepressent medications can cause hair loss. In some people, the hair shafts become finer (rather than coarser) and develop less densities of the hairs themselves with age. Most people lose about 100 hairs per day and they grow back about the same number of hairs each day.