Hair Diseases – Page 27

October 1, 2008

DUPA vs Senile Alopecia – Hair Loss Information – Balding Blog

Hi dr Rassmann, What is the differance between dupa and senile alopecia if any. Also my nape of the neck hairline has always been very high, my son has the same. Never been able to cut my hair really short at the back hair line, looks abit funny if i do. question is my father had senile alopecia, is the high nape of the neck hairline a symptom, or problem, when you look for dupa in a patient. Currently im a norwood 3 to 4 with good donor dominence, on meds,at 39 years old. Thanks great blog.

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Both diffuse unpatterned alopecia (DUPA) and senile alopecia take on the same appearance. The former is a diagnosis made in younger men while the latter is in older men. The hair loss on the nape of the neck reflects a genetic factor present in some family lines. You can try to see if minoxidil helps with the loss of hair in the nape of the neck.

September 29, 2008

Hair Loss InformationDUPA and Propecia – Hair Loss Information – Balding Blog

In earlier posts you mention that half of men with DUPA receive benefits from propecia, but in more recent posts you seem less certain. In the past few years have you seen DUPA patients receive worse results with propecia, causing your optimism to diminish?

Also, you mention that propecia MAY have a better chance if the underlying cause of DUPA is genetic-what does this mean? In your experience, does the presentation of DUPA differ when “the underlying cause is genetic”?

(My brother, only two years older than me, is losing his hair in a traditional MPB fashion, while I am experiencing DUPA in a presentation similar to FPB). Any insight, at all, would be helpful. Thank you.

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With more and more exposure to diffuse unpatterned alopecia (DUPA) patients, I am less convinced that Propecia works for them. If there are no side effects seen though, maybe there is value in taking it. Other industry experts tend to have adopted that view as well.

September 29, 2008

Yeast and Seborrheic Dermatitis – Hair Loss Information by Dr. William Rassman

Hi Doc,

I have been suffering from seborrheic dermatitis for the last 1.5 years. I read somewhere that yeast containing food aggravate the problem. Is it true? Are there any specific food items that I should avoid?

Thanks!

There appears to be an association between yeast and seborrheic dermatitis. There’s a great article on the American Academy of Family Physicians website that says:

“Pityrosporum ovale, a lipophilic yeast of the Malassezia genus, has been implicated in the development of this condition. It has been suggested that seborrheic dermatitis is an inflammatory response to this organism, but this remains to be proved. P. ovale is present on all persons. Why some persons develop seborrheic dermatitis and others do not is unclear. The colonization rate of involved skin by this organism may be lower than that of uninvolved skin. Nonetheless, the fact that seborrheic dermatitis responds to antifungal medications is strongly suggestive of the role of yeast in this disorder.”

Read the rest of the text at American Academy of Family Physicians

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August 22, 2008

Macular Degeneration from Propecia? – Hair Loss Information – Balding Blog

Dear Doctor,
I have a question about possible serious side effect of using Propecia. I am 23 years old male and I have started using Propecia one month ago. After already two pills I noticed some small defect in my vision which becomming worse in time (I was seeing crookedly by one eye). The diagnosis is macular degeneration. My ocularist thought it was caused by Propecia though there were no information about this side effect in the label. I was said that if macular degeneration appears by youth it is in most cases caused by using steroids and its interference to hormones. I have never taken steroids and so doctor thinks it is a result of Propecia’s hormones changes. I would like to ask you have you ever seen similar case of Propecia side effect? Could Propecia theoretically caused it (already after two pills)? And do you recommend me to continue with finasteride in the future? (I stopped after 15 pills and now I am much more worried about my vision than my hair).

Thank you very much.

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Eye This is a question you need to ask of your ophthalmologist. A short course of Propecia should not cause any problem and macular degeneration from Propecia is not defined as a known complication of the disease that I could find. I’ve certainly not had any patient mention anything like this to me over the years.

For more about macular degeneration, see Wikipedia.

August 19, 2008

Multiple Sclerosis and Hair Loss? – Hair Loss Information by Dr. William Rassman

(female)
I have noticed that my hair is breaking off. There are several pieces of hair that are only two inches long on the top of my head. I color my hair to cover the gray, but I am also on several medications. I was diagnosed with MS in 2003. Do you have any thoughts on what could be causing this?
Thank you.

Look at the medications that you are using for the cause of your hair loss. Some medications used in treatment of multiple sclerosis (like mitoxantrone) can cause mild hair loss. Speak with your doctor about them.

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August 15, 2008

Seborrheic Dermatitis After a Hair Transplant – Hair Loss Information by Dr. William Rassman

Hello Doc. can you please answer this question please. Can a flare up of seborrheic dermatitis during the growth period (3-9 months)following a hair transplant procedure,in the recipeint area(itching,redness,swelling, etc..) lead to poor results of the transplant?? Also if the scar from a strip harvest is still pink and tender 6 months after procedure, will it always be like that or will it eventually toughen and turn all the way white? thx

Seborrheic dermatitis should not impact hair growth from a hair transplant. Scars can be judged by their width, and scars that are greater than 3mm may cause a problem. The pink color is usually gone in less than 6 months, but it can be delayed. The pink color has really more to do with the way your body heals the scar (appearance) than on the actual strength of the healed wound at six months.

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July 30, 2008

Clarify About Folliculitis Decalvans and Hair Transplantation – Hair Loss Information by Dr. William Rassman

In your post here you say: “This is your worst case scenario. I have had 3 such cases over my years in practice.”

Can you clarify what you mean here? Are you recommending not getting cosmetic surgery if the disease is under control? Or, are you just saying that as a general warning of what could happen if one did get cosmetic surgery? Have you only had 3 cases of this disease to treat with a hair transplant?

My areas are I guess you could say small, but they feel like they are the size of a baseball on my head. Right now, only one area is really noticeable. How long should one wait, to consider the disease under control to have any type of cosmetic surgery? I have not had any activity in a few months now. Three doctors have recommended that because my areas are “small” a doctor may be able to just remove the scared area and fuse my scalp together. Is this a viable option?

If the areas are smaller, what are the typical prices for hair transplant?

The medical field is not clear about the cause of folliculitis decalvans. It is thought to be an autoimmune disease that presents like an infection of the hair follicles, but it does not respond to traditional treatment. The disease can be aggressive and destroy many hair follicles and badly scar the scalp. Hair transplants into this area may likely fail and may reactivate the disease (bad news when this happens). I always want to know if the benefits will significantly outweigh the risks.

The decision to have another surgery within less than a year from a previous episode may not be a good decision, but you and your doctor are in the best place to make that determination. I haven’t treated you, and I couldn’t make any recommendation without examining you at the very least. Our fees are listed here.

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July 8, 2008

Man with Female Pattern Hair Loss or DUPA? – Hair Loss Information – Balding Blog

Hi,

What could cause a male to have slightly thinner donor zone hair than on the top of his head. Most people can’t tell I have thinning hair, but the top is a little thicker than the sides. Even my barber has said so. The only strange thing is I have been buzzing my side and back to a number three every 2 weeks for 15 years.

Also, there was a post a few days ago about questioning if dupa was real. I’m confused: what exactly is the difference between a male with a female pattern and someone with dupa? I mean they are discribed exactly alike. Diffuse thinning throughout the whole scalp, but you said fpb is NOT dupa?

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If you have thicker hair on the top than on the sides and back, well, I would assume that you were born that way. We could record the differences in densities and confirm that observation if you like, but measurements are the key to the validity of that observation.

Diffuse unpatterned alopecia (DUPA) is generalized thinning of the entire scalp hair and presents that way in men. Women also may have diffuse unpatterned thinning as a presentation of their genetic balding and it may look similar to DUPA in men. Female pattern hair loss may not be uniformly diffuse, while DUPA is more uniformly diffuse (though still unpatterned). Both men with DUPA and women with classic diffuse genetic unpatterned hair loss may have similar mechanisms behind it, but the science is unclear to me as an expert. It is easy to get confused, and I’ve rewritten this response twice trying to make myself more clear. Medicine is a descriptive science and therein lies the problem.

June 18, 2008

You Are Making DUPA Up and Here’s Why… – Hair Loss Information – Balding Blog

I think you are making DUPA up to have people come to your office for a miniaturization study. Here’s way….

I have spent a lot of time looking into balding and watching balding people. Your last post said that you don’t think DUPA has anything to do with DHT. You also mentioned that FPB is not DUPA even though FPB most of the time has miniaturized hair in the donor area and entire scalp.

Also, if you look at probably 80% of all balding people I bet they would have SOME miniaturization in the donor area. I for one have thinner donor area then I did when I was 20,(I’m 42). You also mentioned that FPB & DUPA don’t respond to drugs when we know the cause of miniaturization is the effects of DHT. Science has proven this.

I think that a lot of men can have hair loss in both a MPB & FPB patterned combined. Thus resulting in a slightly thinner donor area. (less than 30% miniaturization throughout the whole head). Maybe some people just miniaturize throughout their whole heads and never progress from there.

I understand the importance about evaluation someone for miniaturization in donor area to avoid a disastrous transplant scar. I applaud you for it. My problem is the fear of god you have imposed on some people about this thing called DUPA and how nothing can diagnoses it accept a miniaturization study, which you and a few colleauges provide. I think it is just a male with a female diffused pattern. This in theory should response to DHT blockers. Unless you can think of another cause for miniaturized hair throughout the entire scalp other than MPB/FBP or as you call it DUPA.

I doubt you will post this but I felt it important to express my personal opinion.

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I am posting this just to allow other opinions.

Less than 1% of the men I examine in my office have DUPA. There is always some appearance of miniaturized hair all over the head, but I believe that we are looking at are the vellus hairs in the follicular unit which may account to about 20% of the hair in the “permanent zone”. Medical science is a descriptive science and DUPA is a description of what we are seeing — diffuse unpatterned alopecia (alopecia without a pattern to it that is diffusely found all over the head).

I guess if you were a blind man, you would doubt the existence of something that is clearly visible to a sighted person.

June 18, 2008

My Doctor Says There’s No Way My Female Hair Loss Is Thyroid Related! – Hair Loss Information by Dr. William Rassman

I am deeply troubled with my recent hair loss. I am a 62 year old female and have been on synthroid for 2 1/2 years at 88mg.I have just had a blood test that came back at a level of .087 and told by my doctor that I am in the normal range. He said theres no way my hair loss is thyroid related and has set me up to see a dermatologist. I cant get in there for 3 more months and I’m experiencing a very high level of anxiety over the amount of hair I’m losing. I’ve started with thioxin and am taking a hair supplement purchased on the internet called hair genisis that I;ve been taking for a month but hasnt improved. I started reading everything I could re: hairloss and am now wondering if its my adrenal glands. I have gotten beyond obbsessive about all this feel like I have no where to go for help. I dont know if I’m taking too high a dose or too low a dose of synthroid or if is the synthroid itself causing the hair loss. How do I know if the t4 is converting into t3 properly. I’m afraid I’ll go completely bald before anyone listens to me. Can you give me some advice???

I would trust your doctor to treat your thyroid issues with the dose of medication that he prescribed, but Synthroid (levothyroxine) does list “mild hair loss” as a possible side effect (see Drugs.com). While hair loss from a thyroid issue is possible, it is unlikely to continue as you are being treated for your thyroid issues. Without the benefit of knowing your medical history or being your doctor, I’m guessing that the Synthroid is not the cause, as you’ve been taking it for over 2 years and your hair loss started just recently. An interesting post with more links can be found at WomensHairLossProject.com.

If you do not believe you are being adequately treated you should express these concerns to your doctor. Also, I don’t know that you should wait 3 months to get medical attention. I either would call your doctor’s office to find out what he can recommend to speed up the evaluation process, or perhaps get a referral to a different dermatologist.

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