Hair Loss Causes – Page 214

April 15, 2008

Femara and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

I’m hoping against hope that you have any suggestions for me. I’m 45, and I was diagnosed with stage 2 ER+ breast cancer 2 1/2 years ago. 21 months ago (after bi-lat mastectomy, chemo, rads, and a complete preventative hysterectomy) my oncologist started me on Femara, an aromatase inhibitor.

My hair grew back thick and full and normal after chemo and for 16 months after I started taking the femara — then suddenly 4months ago, it’s been falling out in massive amounts. Mostly in the front and crown. I’m at a loss as I know the femara is removing all estrogen from my body — and many of the hair loss drugs out there can mess with the work of the femara. I’ve started on Rogaine, but I’m not holding out much hope for that. Are there any other treatments that are safe for me? I’m desperate. Thanks so much.

Your priority should be the treatment of your cancer and with regard to your hair loss, you need to speak with your oncologist who has familiarity with hair loss with chemotherapeutic agents. I do not know enough to help you, sorry.

April 14, 2008

Alopecia Doctors – Dr. Vera Price or Dr. Richard Strick? – Hair Loss Information – Balding Blog

Hi,

I’m writing to you desperate for answers. About 6 months ago my hairline started to thin and recede rather rapidly after stopping ortho-tri cyclen birth control pills. My general doctor thought that stopping the pill was the cause. About 2 months after seeing the doctor I started to develop a round bald spot above my front hairline. It has slowing progressed over the last 6 months into a spot the size of a quarter with redness and tenderness along with some sporadic itching. I went to see Dr. Vera Price at UCSF in San Francisco. She had her derma pathologist review a biopsy that Dr. Kurgis of Templeton CA had taken and told me it was alopecia areata and not a scarring alopecia. However, this is where I get to my question, I wanted a second opinion because Dr. Kurgis thought it looked more like a scarring kind so I went down to UCLA to see Dr. Richard Strick who also reviewed the same biopsy slides. He said that neither he nor his derma pathologist could clearly read the slides to determine if it was either scarring alopecia or alopecia areata. Which doctor is more knowledgeable about these diseases? Who should I trust Dr. Strick or Price? Please help; I don’t know what to do at this point. Dr. Price said that having another biopsy again is unnecessary and might make it worse and she was certain it’s not scarring, but it keeps spreading every week, little by little and the redness spreads as well. I’m very worried I will have to wear a wig if this does not stop. Thanks for any advice you can offer.

Block Quote

I personally know Dr. Richard Strick, because he is in the Los Angeles area (where I am based), and can speak very highly of him and his work, but I only know of Dr. Vera Price based on her reputation. These are two terrific dermatologists, and I can’t make a decision for you on who to trust more in this situation. You should have asked Dr. Strick about Dr. Price’s recommendations, as he was the last doctor you saw. I wish I could offer you some advice, but these doctors are both highly skilled in dealing with conditions like these and are much more specialized with this than I am.

April 10, 2008

Diffuse Hair Loss – Hair Loss Information – Balding Blog

(female) Dear Drs,

I was told that I most likely am suffering from Diffuse Areata, the thing that directed my doctor to this diagnosis is diffuse all over hair loss, brow and lash shed and short tapered hairs shedding out. I can find nothing on the subject, nothing on the net and my doctor admitted he did not understand the disorder.

Could you provide me with information regarding the diffuse form leaving no bald spots but diffuse loss all over the head. What is the general prognosis etc?

Thanks for your help

Block Quote

First, I want to tell you that clinical medical science is a descriptive science in many situation. This is important because what we see is what we are reporting when we diagnose diffuse alopecia areata. What doctors are saying is that there is a diffuse form of the disease that mimics classic alopecia areata, except that it is found all over the head. Some doctors question if this is the same disease, but because it looks like the same entity when the skin is biopsied as localized alopecia areata, the conclusion is that the diffuse variant is different in ways that are not understood. Most people believe that it is an autoimmune disease and we see evidence in what we call chronic and diffuse alopecia areata of the microscopic changes seen in autoimmune diseases.

Second, I can point you to some sites of interest so that you can learn more (but hopefully not confuse you):

April 10, 2008

Diagnosing MPB By Feeling Hair Shaft Thickness? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman (or other contributing doctors),
I was wondering if for genetic hair loss (male pattern baldness), you can actually diagnosis yourself by feeling the thickness of the hair shafts on your scalp? So, if hairs that fall out daily look much thinner than your typical terminal hair, and the hair on your scalp also feels thinner, can you be confident of a diagnosis for genetic hairloss, or is a miniaturization test necessary? Thanks alot.

Feeling the thickness of the hair shaft is an art that I’ve learned over time. I can estimate the thickness of a hair shaft when it is rolled between my fingers. I have checked myself with a micrometer to measure my accuracy, and I can tell the difference between fine, medium, and coarse hair. I believe that the miniaturized hairs, when compared to the hair from the back of one’s head, can be felt to have less bulk. That being said, the ‘feel’ will not be as accurate as studying it under video magnification (miniaturization mapping of the scalp), which I promote often on this blog. If you wish, you can buy a micrometer at a hobby shop or over the internet for about $25 and make your own measurements of single hair shafts, but to have real value these shafts must be measured amongst many others.

Paid advertisements (not an endorsement):

April 9, 2008

Traction Alopecia or Trichotillomania? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I have been rubbing my scalp and playing with my hair at the roots since I was about 12. I’m noticing that my hair seems to be thinning now. I’m 30, female and have beautiful hair, but I’m concerned that my OCD behavior towards my scalp and hair roots is causing this hair loss. My hairdressers insist I don’t have thinning, but I can clearly see that I do when I look at old pictures.

In addition, my aunt on my mother’s side has experienced major hair-thinning. She now wears a “fall.” I think you should also know that a couple of years ago I noticed my hair to be thinning, so I abstained from “playing” with my hair. I saw regrowth (or, at least I perceived it) soon after. I realize I should never have restarted the behavior, but I guess I’m an anxious person…

My questions:

What is my chronic scalp-rubbing considered? Is it Trichotillomania or traction alopecia?
And, if I stop this behavior (which I’ve done as of yesterday), am I likely to experience regrowth like in the past?

Thanks!

Block Quote

Trichotillomania is a psychological disorder that makes oneself pull on the hair, causing traction alopecia. It seems you have this type of behavior. This problem is very difficult to control on your own. You may benefit from seeing a doctor or joining a support group.

If you have seen return of the hair from stopping your rubbing/pulling, then maybe it is not too late for some of your hair in the impacted area. Best try to stop… and stay stopped.

April 8, 2008

Acid Reflux Medication and Hair Loss – Hair Loss Information by Dr. William Rassman

I’m a 23 year old male with something like a Norwood II or III hairline. My family history is likely to blame, but I’ve also been on various medications for acid reflux, including omeperazole, protonix, nexium and prevacid for some time. My family Dr. noted that some of these drugs could cause hair loss before prescribing propecia. Do you think this is true, and is any one best?

Practically every day over the years, I’ve received questions asking whether a specific drug or drugs cause hair loss. Again and again, I must remind everyone that there are many drugs that MAY cause hair loss as one of MANY potential side effects. Protonix (pantoprazole), Prilosec (omeprazole) and Nexium (esomeprazole) have very rare instances of hair loss reported, but the most important thing to remember is that male pattern baldness (MPB) is the number one cause of hair loss in men. Drugs are the very very last on the list of cause for hair loss in men.

If you believe you are balding or losing hair you should have your doctor evaluate your hair (with a miniaturization study if possible) to see if you indeed have genetic male pattern baldness. Starting on Propecia (finasteride 1mg) just because you believe you are losing hair without a clear diagnosis is not a smart thing to do either — this is why Propecia is a prescription medication. If I may bastardize an old metaphor — when you are being charged by a herd of dancing elephants, don’t look at the ants that may get trampled.

Paid advertisements (not an endorsement):

April 8, 2008

Girls In Haiti Orphanage Are Losing Hair – Hair Loss Information by Dr. William Rassman

There is a wonderful ministry called “Love a Child” which has an orphange in the country of Haiti. The owner/manager of the orphanage is struggling to help several of her African American orphan girls who are suddenly suffering from hair loss. She has pictures of the girls on her site at loveachild.com

From reading various information on your website and others it seems the only options are:
1. Stop tight hair braids (but it’s too late now)
2. Costly hair implants

Any suggestions or advice you might have to help these precious children would be greatly appreciated.

From the photos in the link you provided, it seems the girls on the site have traction alopecia from wearing tight hair braids for long periods of time. Unfortunately, traction alopecia is permanent and there are no good treatment options. Hair transplantation surgery may help, but it cannot replace all the hair that was lost as even with a hair transplant, the supply of hair may exceed the demand for hair in the balding area.

Paid advertisements (not an endorsement):

April 8, 2008

Teenager’s Eyebrow Never Grew Back After Shaving It 3 Years Ago – Hair Loss Information by Dr. William Rassman

(male) I shaved a good bit of my eyebrow when I was twelve – I’m, fifteen now. In short, they never quite grew back right. Will rogaine work? If not, what can I do?

I don’t think that giving a 15 year old advice on medication should come from me. Assuming that you were of legal age to make such decisions on your own, minoxidil might grow back eyebrows… and then again it may not. See a doctor and have your problem managed. You should also get a parent/guardian involved in your situation.

Paid advertisements (not an endorsement):

April 8, 2008

White Bulb vs Darker Bulb on Fallen Hair – Hair Loss Information by Dr. William Rassman

Hey Doc,

What exactly are those white ‘bulb’ sort of things that are at the tip of hairs that fall out? Most of my hair that fall out have that white bulb sort of thing. What are those?

Also, somewhere I read by a noted hair doctor that a white bulb means that the hair fell out in it’s growing phase, whereas a darker bulb meant that the hair was already grown or such. Is that true?

The white bulbs are likely sebum, a remnant of your oil gland that happened to come out with your hair. The darker bulb just came out without the sebum.

Paid advertisements (not an endorsement):

April 4, 2008

Lost Chin Hair from Stress, Then It Regrew White – Hair Loss Information by Dr. William Rassman

Dr. Rassman, I read your blog daily and appreciate all the information you provide to hairloss sufferers.

ok, so 3 years ago I lost a large patch of hair from my chin, over the next 2 months it grew back stark white. I had to dye it with “justformen” for a year, finally it has began to grow in black. I feel this occurred form stress. is there a name for a condition such as this?

This is the first time I’ve heard of a case like this, so unfortunately I don’t have any experience to base any conclusions. Discuss this with your dermatologist.

Paid advertisements (not an endorsement):