How many times a hair must be pulled so that the follicle become damaged. After 3-4 times of pulling the hair can grow back?
I don’t know the answer to your question, but I suspect it varies with the individual. Patients with trichotillomania pull hairs over long periods of time. Those people who pluck their eyebrows may be able to give us an answer.
Hi, I am a 21-year-old female. I have always had seborrheic dermatitis, so my scalp has always been scrubbed during shampoos, with nails, until I was about 16, when I learned it was not alright to do.
Sometimes (about a few times a year) I scratch my seborrheic dermatitis if it is itchy, or run my fingertips through my hair (with a bit of pressure) to push out blackheads on the scalp. Hair rarely comes out. Today I was running my fingers through my hair (with pressure) intermittently all day, and ended up losing about 10-20 hairs (I did not comb or wash my hair for a few days, though). When I play with my boyfriend’s hair, I end up removing his blackheads too, through fingertip-rubbing, about a couple times a month. Did I cause any permanent damage to our hair follicles?
Thanks!
If you pick at your scalp and repeat the process in the same area, you may lose hair permanently (see Trichotillomania Learning Center). So while I don’t know if you caused permanent loss, it’s doubtful at this point. Losing 100 hairs a day is normal, and since you didn’t comb or wash your hair for a few days it’s entirely possible that those hairs were already fallen out and just trapped.
Seborrheic dermatitis is a common condition and there are many good commercial products out there that can address it with traditional shampoos like Head and Shoulders (one of my favorites).
My hairline is thinning FAST. It was just a few weeks ago I noticed thinning in the middle of my hairline now I have a bald spot on the middle of my hairline. My left side of my hairline is thinning too. Sometimes when I touch the top of my head it hurts real bad as if I had a deep cut. I went from my normal hairline to really bad thinning all over my head, noticeably my hairline in just 1 month. Its getting worse. What should I do? Im 20 years old male.
I can’t explain the pain you’re feeling at your hairline, but if you visit a doctor he/she should be able to address your problem. All of this change, assuming it is really a very short term problem, is a concern, and it sounds like you need immediate medical attention. Start off with your family doctor.
I am a 45 year old male and have had a bald spot on the right hand side of my head for about 4 weeks. There is no itching or discomfort, and its about the size of a 50p piece. I am a smoker and probably drink more than I should, my job is also quite stressful.
could you give me any advice please? thanks.
I cannot diagnose a bald spot without seeing you. In addition to stress, there could be many causes, such as a fungal infection, alopecia areata, etc…
I recommend that you see a dermatologist to diagnose the scalp condition you have.
Greasy scalp/itch and MPB. Are these all connected?
I went to see a trichologist recently who told me that she could see plenty of miniaturised hairs at my crown. She also commented on how greasy my scalp was and said that this was linked with my hair thinning and the itchiness which i’d reported was probably also to do with this grease.
Can you confirm if this is true? My hair is itching/greasier again this week and I notice that I do have more hair fall when it gets like this.
Male pattern balding is a genetic trait. Greasy scalp is just a greasy scalp (unless there is a genetic cause of excess sebum production from the hair follicles of the scalp). People who have a full head of hair can have a greasy scalp. Same goes for an itchy scalp. There can be numerous reasons for this, such as dryness, dandruff, hair products, lice, poor hygiene, etc.
I do not believe genetic hair loss, greasy scalp, and itchy scalp are connected. In my opinion, it is a old wives’ tale. If you’re scratching your head and pulling your hair out because of it, that might explain the thinning. Otherwise, I don’t know of a proven correlation.
I am a 58 year old male who is generally in good health. I do have controlled blood pressure, on 5 mg of Bystolic, and type 2 diabetes, controlled on metformin, and I also take 10 mg of Crestor for lipid control.
My hair loss problem started around 20 years ago but now it is at the point where the hair loss is just past the crown on the top of my head. I have a thick head of hair on the sides and back but just scraggly hairs on top. What treatment options would you suggest to try and either grown some hair on top of my head or keep what I have now. I have looked at Minoxidil, Rogaine to name a couple but never actually used anything. I asked my personal doctor but since he is bald as well did not have any suggestions.
I would appreciate any help you could offer.
Thanks.
There is not much I can suggest based on a few lines of description alone. Many men have hair transplants for crown loss with good results, but each patient is different. You need an examination, discussion with a doctor addressing your goals, and a meeting of the minds addressing expectations and limitations.
Rogaine and minoxidil are the same medication, available over the counter. I don’t know of any interactions between minoxidil and the medications you listed, but talk to your doctor before adding any medication to your routine. Bald or not, your doctor should be able to tell you more since he knows your medical history.
I know what mpb and TE and CTE is but can there be other involvement with miniaturization of a follicle? Like toxins, emotional stress for a long period, extreme lack of nutrition etc.
Add to your list: aging (senile alopecia), a deficiency of various vitamins (vitamin A, vitamin B6, vitamin B12, beta-carotene, biotin, vitamin C, calcium, vitamin D, inositol, iodine, iron, magnesium, niacin, pantothenic acid, selenium, zinc), and a series of many autoimmune diseases.
The list goes on and on.
Hello,
I am wondering if I am beginning to undergo male pattern baldness. I am 29 years old and have never noticed any hair loss until recently. I have been shedding like crazy, and can see my scalp, mainly around the top of my head where the hair “swirls” around my part.I saw a dermatologist and he said he didn’t think it was male pattern baldness (there is no significant recession around the front of my hairline…I have been looking at old pictures and feel like there has maybe been a minimal amount in the past year…hard to really say for sure). He did a pull test and said it was not telogen effluvium, unless it was the earliest stages. The increased shedding started a little over a week ago. I’m kind of depressed over this.
I have noticed that some of the hair that has come out is of the finer variety and I feel like my head as a whole has finer hair than it did say a year ago, but once again since I don’t have any hair samples from then to compare it to, I can’t say for sure. The hair around the swirl has taken on a more light colored tone than that on the rest of my head. I can send pictures if you would like.
A photo alone is not likely going to help me determine what your hair loss is, especially after a doctor you saw in person stated you likely do not have genetic balding. You are more than welcome to send us a photo for all the readers to comment, or visit our BaldingForum.com site and post photos there. You could also just get a second opinion from another local doctor.
Otherwise you can make an appointment to see me at my office in Los Angeles for an in-person, private consultation. At that consultation, I will look for miniaturization on your scalp hair and I will perform bulk analysis of your hair in various parts of your scalp.
When the thinning that precedes balding occurs, the bulk of the hair in the impacted area has hairs that are thinner than the hair from the back and sides of the head. The pattern of this thinning hair is measurable and that will point to the diagnosis of male pattern baldness. You need to have these tests, and have them done in the hands of an expert hair doctor.
My neighbor is in his 50s with no known history of hair loss until about 5 years ago when he first noticed he was developing gray hair. He had his wife pull out every gray hair he could see daily, and it could’ve been as many as 20-30 hairs a day over the years! His daughter researched the condition of trichotillomania and does not feel he fits the diagnosis as the pulling was not done by him.
He claims he is not compelled or driven to have his hair plucked, and that as soon as he realized he was visibly thinning, he had his wife stop doing it. At that time he began to color his hair at the suggestion of his daughter. He states there has been no plucking for the past 2 years now and he has more hair on his head now than 2 years ago, when the plucking was stopped.
This sounds like maybe trichotillomania by proxy (like Münchausen syndrome by proxy, a well known phenomenon)… but I’m not sure that would fit either.
It usually takes quite a few “pulling sessions” to produce the traction required for permanent hair loss, often over years. So if his hair has regrown over the past 2 years, it sounds like he was lucky that the loss wasn’t permanent.
Hello,
After having a bald spot on the left side of my head for 28 years, I’d like to do something about it. The bald spot is circular in shape and 2cm in diameter, about 7cm directly above my left ear. The hair fell out when I was 2 and the bald spot has remained the same size for as long as I can remember. I am able to cover it with hair surrounding it, but it does take an emotional toll on me as I see it every day and I have to be very careful every month when having my haircut.
I saw a dermatologist about a year ago who told me it’s triangular alopecia. He was not able to locate any hair follicles under the skin, and told me the chance of regrowth is slim to none, especially as there has been no hair there for 28 years. He suggested we first try cortisone injections which did not work, and then referred me to a specialist. I went to see a specialist and he recommended scalp reduction surgery given the small area and lack of hair follicles.
I’ve done some reading on scalp reduction surgery, on your blog and others. The risks seem to be significant (stretchback, slot scaring, hair angled incorrectly, etc.) and it’s clear you’re not a proponent. I’ve also been unable to find any success stories/testimonials online. I’m going to ask the specialist to share more information (# of surgeries he’s done, before/after photos, # of surgeries I’ll need, risks, type of incision, etc.), but before doing so I’m hoping to get your advice.
Given the small area (2cm in diameter) and being able to cover with existing hair, do you think this is a case for a successful scalp reduction surgery? If not, are there any alternatives you’d suggest (e.g., Rogaine, hair transplant)? Both my dad and grandpa have full heads of hair, so I’m not really worry about the hair on the left side of my head receding back to the site of the bald spot.
Thanks for your help!
Scalp reduction surgery, in my opinion, generally carries more risks than benefits. Small scars such as you describe do not do well with scalp reductions, as I have seen many patients for consultations over the years with failed scalp reduction / scar revision surgeries and difficult scars that result from the surgery.
Triangular alopecia is best treated with hair transplant surgery.
For a better assessment diagnosis and treatment options, please follow up with your doctor. Or if you are in the Los Angeles area, you can also visit me for a consultation.
