Hair Loss InformationDoes Telogen Effluvium Act Like This…? – Hair Loss Information – Balding Blog

Thanks a lot for this site, good sir. I have a question related to TE and MPB. I have diffuse thinning on the top of my head. While I haven’t been to a miniturization check, I would say some (though hardly all) of the hairs that fall of my dome are thin. I went through a 2 month phase where I lost very thick and dark hairs, but this has stopped (I guess they’re gone?)… I am possibly a NW 2, but I’ve always had a high forehead. The hairline has receded, but there are still hairs at the base of what is basically the original hairline. Basically what I’m explaining is a very unclean hairloss at the top of the head…the hairline is more of an abstract idea than a line, if you follow me…it’s very irregular and uneven.

Does TE ever “act” in this way? Or am I just kidding myself and it’s MPB? Father with hair, mother with hair, mother’s father with hair, father’s father with hair…

Cheers

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I don’t think I quite understand what you are describing. I would be happy to examine you and then I will understand what you are talking about. As you state you have not gotten a miniaturization check, which could point to genetic balding. Moreover, it may be something very early, as you categorize yourself as a Norwood Class 2.

From what you describe, it sounds like you’re losing your hairline due to genetic causes and have a few remaining hairs that haven’t fallen out in the same area. A telogen effluvium likely won’t be focused at the hairline.

My Hair Loss Just Started When I Turned 50 Years Old – Hair Loss Information by Dr. William Rassman

Hello, I’m male and have just turned 50. There’s no baldness in the family and up until very recently I’ve had a full head of hair.

My hair started falling out considerably in the shower about six months ago (Oct ‘08) and has continued up until now, to the point where I just have to run my fingers through my hair and hairs will fall onto the countertop. Unfortunately I’ve now lost a good amount of hairline and have thinned all over the top of my head.

I went to a dermatologist and supplied eleven vials of blood for testing with everything coming back negative for hair loss – minerals, vitamins, hormones, dhea, thyroid, kidney, liver & bioavailable testosterone were all within range (the last two were slightly elevated, but still in normal range).

There hasn’t been any major stress events in my recent history, nor do I feel depressed. However, I have been taking prednisone since March ‘03 after being diagnosed with adrenal insufficiency (addison’s disease) after a bad bout with food poisoning. According to the medical association hair loss is not a side effect of prednisone, but I’m guessing it is the cause of my hair loss, or possibly an autoimmune disease attacking the hair follicle’s themselves.

I was given a dandruff shampoo (Ducray – Selegel) by the dermatologist but that hasn’t slowed the hair loss down, not sure dandruff could cause this type of hair loss anyway. I’m wondering if you might have any advice that could help as this is very frustrating to say the least.

Thanks

You can guess on the mechanisms for your thinning hair, but hair loss from genetic causes can start late in life (50s). I would need to know much more about your Addison’s disease and the impact of the steroid use before discussing your case further. Prednisone can cause hair loss (see here), but dandruff isn’t a cause of hair loss.

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I’ve Been Taking Propecia for 3 Weeks — When Will I See Improvement? – Hair Loss Information by Dr. William Rassman

My hair has been thin since I was 16 (now 26). But it was very gradual and with almost no progression. Recently I went through a period of extreme stress/depression due to relationship problems. This lasted for approximately 4-5 months. A few months back I noticed that my hair seemed to be thinning so I have started propecia. I was told I was not yet thin enough to have any cosmetic surgery. While I still have some stress (not nearly as much) I am noticing that the hair is seemingly shedding at an even more accelerated rate. I have been on the drug for about 3 weeks. When could I see some type of improvement? What should I expect as far as improvement? Also could supplements like creatine be playing a factor in all of this?

Stress induced hair loss could be temporary or it could precipitate your genetic hair loss (in other words, you might’ve lost hair anyway due to genetics somewhere down the line and the stress just sped it up). I’d give it 6-9 months (or longer) before you start seeing some benefits. Those benefits could be regrowth or they could just be halting the hair loss. Your doctor should’ve explained this to you when he/she prescribed it.


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My Doctor Doesn’t Know Why I’m Losing Hair In the Crown – Hair Loss Information by Dr. William Rassman

Recently I noticed that I have a slightly thinning crown. I went to the dermatologist and he said hes not really sure what is happening but said that it might be male pattern baldness. My father (an internest, who happens to be bald) looked at it, as did my pediatrician and they both said the follicles look healthy, and my pediatrician said hes not sure, could be alopecia areata or male pattern baldness. He didnt know. My pediatrician told me to use 5% monoxidil once a day for about 2 months and to come back to him. However i heard that if you do not know the reason of your hairloss you can cause permanent damage. Im really confused and dont know what to do

I am 18 years old. Is it true that if you use Rogaine on existing hair you can destroy that hair? I put it on my hairline, (norwood class 2. My oldest brother (26 years old) has the same hairline as i do and he doesnt show signs of balding, my other brother (23 years old) has a norwood class 1 hairline, but he has grey hairs – my mother started getting grey hair around that age, which is making me worry i have my fathers genes b/c i dont have grey hairs) and im worried that i might damage the hair. I also notice that when i put it on my head im coming back with alot of hair in my hand.

I went through a very stressful time and i also wasnt eating very well (im studying overseas now for the year…). I limited most of the food they gave us and mainly ate salads, and even then i would work out about an hour later to work it all off. – at first i thought might be telogen effluvium but its just in my crown so im a little worried. Thank you

Rogaine (minoxidil) should not destroy existing hair, but I don’t know that Rogaine would do much good at the hairline anyway. It might work, but I can’t say for sure one way or the other. If you’re experiencing hair loss in the crown, that should be where you’re using the Rogaine. Or even better, talk to your physician about a prescription for Propecia (which works wonders in the crown) if you’ve got genetic hair loss. I don’t want to guess if you’re experiencing hair loss due to genetic causes or stress or what… but if your primary care physician isn’t too sure, I’d try to seek out a dermatologist or even a hair transplant doctor (only because they know hair well, not because you should even consider a surgical procedure at your age). With early thinning in the crown, it certainly doesn’t sound like alopecia areata. If you saw bald spots all over your scalp, that would be a different story.

The hair loss gene can come from either side of the family and can even skip generations, so just because you lack grey hairs doesn’t mean you’re not going to inherit a hair pattern that someone else in your family had. There is no substitute for an expert who can examine your hair and tell you if you have genetic balding. There is even a genetic test for the balding gene that is available today for about $250.

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Hair Loss InformationIf Miniaturization Occurs at the Hairline, Is It MPB and Not Maturing? – Hair Loss Information – Balding Blog

dr rassman,
i include in this question a quote you made in a recent post which i would appreciate if you could clarify:

“As hair in the maturing hairline undergoes apoptosis (cell death, possibly because the number of hair cycles in the juvenile hairline may be limited and reached), it could just fall out without going through miniaturization.”

Does this mean that if there is minaturization at the hairline change then this is MPB and not the natural development of the mature hairline? or can there be minaturization without MPB at the hairline? I would much appreciate it if you could comment further on this as this relates to the difficulties i have had in getting a professional opinion on my own hairline- as to whether its MPB or just the development of the mature hairline.

regards

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If you have a maturing hairline, I would not expect to see miniaturization from the highest wrinkle of the furrowed brow. The leading edge of a maturing hairline, as a rule, does not show miniaturization. From the few cases I can reference (nephew and two of my sons), they lost their juvenile hairlines without miniaturization appearing, so I draw my conclusion based upon those three cases in my family.

Telogen Effluvium After Illness? – Hair Loss Information by Dr. William Rassman

my hair has been rapidly shedding since March within two months of being sick. I noticed little white bulbs at the end of the hair. The hair on top, sides and back become difussed, now all of my neck hair has receded. The Derm says I have TE. does it sound like TE? Derm explained hair cycle phases. Am I in the Telogen phase.. Hair stops growing and shedds? when does it stop shedding.?

Thank you

Telogen effluvium (TE) can occur after a stressful illness. It does sound like that’s what you’ve got, but without examining you for myself I couldn’t really say one way or the other with certainty. People with RE will often have a positive hair pull test. If you are going through TE, it will usually stop within 6 months after you are fully recovered from your illness. Learn more about TE at eMedicine.

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Hair Loss Information » Why is Hair on the Back and Sides of the Head More Resilient Than the Top? – Balding Blog

Just wondering what is responsible for the pattern of “male patterned baldness” ?

Why does the hair at the back and sides of the head seem to be more resilient than the hair at the top ?

Thanks Doc.

It is called genetic male pattern baldness. Keyword is “genetic”. Genes are responsible for it, but as to the reason it works out that way, I haven’t a clue. I posted a theory about it before — Why Does the Back and Sides of the Head Not Lose Hair?

How Likely Am I to Be Bald? – Hair Loss Information by Dr. William Rassman

My dad isn’t bald nor are his brothers or father. But my mom’s dad is bald but some of his sons aren’t. Could you tell me how likely i am to be bald?

It’s not that easy to tell. Balding can be passed down from either side of the family and can skip generations. There is some new science for genetic testing to let you know if you are carrying the gene for balding. If you test positive, then you could bald, but if you test negative, you will not undergo patterned genetic balding. Even if you carry the gene, it may not mean that you will express the gene and have balding. So the answer is that a negative test will let you know if you inherited the good genes from your family.

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I Pick off the Scabs from My Severe Scalp Flakes, Now I see Hair Loss – Hair Loss Information by Dr. William Rassman

Hi,

I have a problem of severe flaking, scabs, and an itching scalp. I am a picker so i often pick off the scabs, thinking that the dandruff will go away. Now I have a bald spot where I’ve been constantly scratching my head. It also seems I have hair loss in other areas as well. I’ve also moved from Canada, US to Jamaica. I am also under a lot of stress.

THe last time I was under severe stress and I had relaxed my hair and put a weave in I had extreme hair loss and extreme large flakes. Although my hair has grown back and my dandruff was under control and almost gone, I have had permanent hair loss around my hair line. I used to have braids in my hair for 7 years..so i think it was from that. That hair loss incident happened when i was 19. Since then I have worn my hair natural without any processing. I am 25 now. I am concerned.

The bald spot at the back center of my head – is it permanent? HOw can I stop scabs? how can I stop dandruff? If it is a stress trigger from high cortisone levels in my body what can I do to normalize this? Is it my diet, exercise? Please help? What can I do to restore hair loss?

Picking skin flakes is an OCD-like condition called dermatillomania (for pulling hair it is called trichotillomania). This picking produces traction alopecia, so there is little doubt that this is what is happening to you. If you stop picking and the hair returns, then you’re lucky… but if you continue to pick at it, the hair loss you are experiencing may become permanent. Braids can also cause traction alopecia. The solution may be simply get rid of the braids and stop picking (that might be easier said than done, though).

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I’ve Been Losing Hair for a Year and a Half – Hair Loss Information by Dr. William Rassman

I could really use some advice. I am 28 years old and started to notice my temples recedding about 1 1/2 years ago. I started using rogaine but after about 3 months I stated shedding alot of hair. I went to see a dermatologist and they did a hair pull test and told me that it was MPH and that I should use propecia. Once i started using propecia I started shedding alot of hair but I have stuck with it because I read that shedding occurs on these medications put generally the lost hair returns. Well after a year and half I lost alot of hair and none of the shedded hair has returned. I went from a NW 1 or 2 to a NW Va in a year and a half.

So I am thinking about see my physician again and I was wondering if there are any tests that I should have them do to help with my hair loss problem. If you know of any good hair loss doctors in the Seattle area I would appreciate any recommendations. I also may be traveling to the L.A. area next week for work and was wondering If you would be willing to meet with me.

I have to take your word on what you had when you first noticed the hair loss process. Usually, a 28 year old man does not ‘fast-track’ hair loss, especially when taking Propecia. I am humbled by the few people who show very rapid hair loss while using finasteride (Propecia) and find this phenomenon very, very rare. One of the genetic tests may show what you can expect from Propecia, so it might be worthwhile getting the test (see here), but it will not reverse the hair loss that you experienced. Of course, I would be pleased to meet with you, but it does sounds like you have genetic hair loss that has been fast-tracking its course. I don’t have any recommendations in Seattle at this time.

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