Category: Other

I suffer from occasional razor bumps/ pimples on my scalp. One website recommended using a mild facial cleaner one or twice a week on the scalp. Would you recommend this course of action if this is folliculitis?

Would also like to thank you for recommending Propecia back in February (Is It Ever Too Late to Start Propecia and Minoxidil?). Have been taking Propecia since then and am really pleased with the results seen in such a short time. Crown is
really beginning to fill in progresively!

From your description this sounds like it may be a form of mild folliculitis, but I can not tell without properly examining these lesions. I would recommend you be examined by your physician.

From the folliculitis article at eMedicine — “For recurrent uncomplicated superficial folliculitis, use of antibacterial soaps and good hand washing technique may be all that is needed. For refractory or deep lesions that have a suspected infectious etiology, empiric treatment with topical and/or oral antibiotics that cover gram-positive organisms may be of benefit.”

For the above reason you need to have your physician make sure you do not need more aggressive treatment.

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Dr. Rassman,

If propecia has been successful treating my Diffused Patterned Alopecia, should I still have a positive result from the Hair Pull Test (i.e., still find hairs after conducting the Test in the balding areas)?

Thanks.

The hair pull test should be done by the physician, and not by the patient, as it is more complex than the name makes it out to be. Just pulling on some hairs and seeing clumps of hair fall out does not mean you have a positive hair pull test. The hair pull test is performed by taking a few strands of hair between the thumb and forefinger and pulling on them gently. Hairs in anagen (growing) should remain rooted in place while hairs in telogen should come out easily. You then figure out what percent of the hair is in the telogen stage. For more information on the cycles of hair growth, see Hair Follicle Cells Growth Stages.

Shedding of hair can be variable from day to day and is greater in certain seasons (spring and autumn). Washing you hair prior to having a hair pull test can also affect the results. Genetic hair loss does not cause a positive hair pull test. And it should go without saying, but the image to the right is NOT the actual hair pull test, and you shouldn’t have to worry about your doctor doing this to your head when conducting the test.

Is leg hair made up of the same organisms that head hair is? Can leg hair be cleansed of toxins the same as head hair?

What toxins in your hair? I do not understand what you are asking.

Scientists and doctors sometimes use hair samples to detect drugs (marijuana) or lead, as your hair “records” the exposure. Sort of analogous to the rings in the trees or coring ice samples. I do not believe there is a process to clean or rid of these toxins — short of cutting your hair. Remember hair is dead tissue, so any toxins in the hair like lead, will have already harmed your body. You leg hair or body hair should act the same way as scalp hair, but your leg hair is not constantly growing to the lengths as your scalp hair is and it may not record the exposure to the chemicals as for the historical time frame you took toxins like lead in the scalp hair.

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Snippet from the article:

The study identifies a key signaling molecule that tells hair follicles to start the hair-growing cycle.

“These are very complex molecular signals, and the authors have very nicely shown that there is one molecule, laminins 511, that is a very important signal to tell the hair molecule to move through the process. It’s part of a basic biological understanding,” said Dr. Ronald Crystal, chairman of genetic medicine at New York Presbyterian Weill Cornell Medical Center in New York City.

The researchers, reporting in the Aug. 1 issue of Genes & Development, feel the findings may one day hold the key to treating male-pattern baldness, as well as hair loss from chemotherapy or even to restore hair on burn victims.

But, as so often happens, the study was conducted in mice and, as Crystal pointed out, “Mice are not just little men and women. They are different than us and also different in their hair.”

Read the full article at US News & World Report — Mouse Study Finds Molecule That Tells Hair to Grow

This is a terrific story which shows an important step to the process of hair growth. Could it explain why some men of one race have no body hair and others get much? Following that thread of thinking can be fun. Could it be that genetic balding is caused by a mutation on that particular gene?

I have pretty much a receded hairline like Johnny Depp in the picture links below. I’m almost 22 and from that pic it looks more then a Norwood 2 scale. But if Johnny’s temples were so receded since like almost 20 years ago how come he can still have such great hair and no balding? Is it normal to have temples like him in those pics?

Photo 1  –  Photo 2  –  Photo 3

Based on all the photos I’ve seen, actor Johnny Depp is not suffering from genetic hair loss. This is his mature hairline and is normal. Some have speculated that he might’ve even had hair transplants, but I don’t think that is true. I’ve written about Johnny Depp before — here and here.

I’m hoping someone can help me! I am 49 years old and had a hysterectomy 5 years ago and am on HRT. I also had a partial thyroidectomy about 30 years ago and do not take any medication. It has always functioned ok for what I need. I have it checked yearly and all seems to be ok. Here is my problem about 3 months ago I noticed near the nape of my neck my hair was like pubic hair. I got a hair cut and most of it was gone, but now it’s in my bangs!! It is AWFUL!! I have seen about 5 or 6 different hair stylists and they have never seen anything like it! That’s scary. What can it be or what can I do???

Unfortunately, I do not understand what you are telling me. Please send me pictures of your hair from the front and at the nape of the neck where the problems are. I don’t recall hearing of anything like this before.

I find your responses to be irritating. Specifically, they take on a condescending tone, are pointless as most recommend seeking medical advice. What is the point in this forum if that is the pat answer. Of course they should seek medical advice.

Sometimes people just want encouragement and hope. Not a …”you should do this… you need to do that… Not helpful at all. Sorry, that is just my observation.

I have not been able to find many (if any) articles on the internet that indicate relief of symptoms and offering a solution.

We just want a solution, not a lecture.

Your point is well taken, but please recognize that many people who write to me want a medical opinion on their condition, something that I can not give without examining a patient and without being able to ask questions. Also, many times my hands are tied by legal restrictions (I am a doctor, but not the doctor of those writing in) and therefore the best suggestion I can give is to visit their doctor. 95%+ of patients seen by the doctor can have a diagnosis by taking a careful history with good observation. This is particularly the case in diseases of the skin and hair where x-rays and blood tests are generally not needed, just experience and skills in the art of diagnosis. Telling me in an email that “my scalp itches” does not tell me much that I can use in diagnosis or offering relief. For example, last week I posted a question from a reader that said it felt like something was crawling around his scalp and I suggested that he might have head lice. In a situation where I could do a face-to-face examination, I would have seen the head lice crawling around his scalp had that been the right diagnosis.

You asked for solutions that bring relief. If that was so simple, then the doctor’s role of history taking and examination would have no value. I offer 2-3 hours a day to the blog to help when I can (sometimes more, sometimes weekends), and many, many emails are screened. I wish it was an easy task, and if only life were simple! As you can see, I volunteer my services on this blog and do not make my living from doing it, but what I do get from the effort was a way to stay in touch with people and a reason to research many of the questions that had great value to my learning experience. Even at 66 years old, I am still a student.

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