Hair Loss and the Immune System

I recently read a posting on baldingblog where a women suggested the use of Visine to stop hairloss. I’ve heard of using visine to help sooth razorburn an ingrown hair as I assume it has antiflammatory medication.

I’ve read other places that some people think hairloss is a type of immune response of our body, where DHT causes the structure of the hair follicle to change. At some point our own immune systems reject the changed follicle and attack it, ultimately causing the phenomenon we see as balding. Somewhere else I read that in cases, such as people getting transplants take immune suppressing drugs such as Cyclocsporine, to stop organ rejection, actually noticed hair regrowth.

Going back to the woman who earlier spoke of the Visine treatment that she heard, this woman said that her hairloss got worse after she moved. Speaking from my own experience, I have noticed that certain immune responses happen when one changes environment. For instance, I grew up in New Jersey and never suffered any real allergies or medical problems. When I moved out to California when I was 16, notice an increase in my hyper-histamine.. or histamine positive response. I believe thats what you called it. In particular, I developed an allergic reaction to heat.

Anyhow, its interesting to think that environment may have a small role in a complex immune response that results in hair loss.

Is hairloss a more modern occurrence? I mean, does hairloss occur more in modern society? I remember reading an article recently in Wired that said that when comparing lab mice with sewer rats, the sewer rats had “better” immune systems because of their dirty environment. The immune systems of the lab rats tended to overreact to stimuli. On the other hand, the sewer rats immune systems better defended against real threats while not overreacting to things such as allergens. ( https://www.wired.com/news/wireservice/0,71185-0.html)

Anyway, thx for your blog, Dr Rassman. It’s always interesting and entertaining!

I agree with you that although hair loss is caused by genes, it can be influenced by the environment where chemical products, drugs, malnutrition, and stress can induce the expression of balding genes. Hair loss is not a modern society occurrence. Men have been bald since the beginning of recorded time. Hats and wigs have been around since the earliest records in the history of civilization.

Are we more self conscious with hair loss today? Somehow I doubt that, but we do have better communication (like this blog and the internet in general) to share what is happening to us with others. We do know that autoimmune diseases can cause hair loss by creating antibodies attacking the hair follicles, but that may not mean that hair loss is always an immune modulated disorder. A famous doctor told me once that sooner or later (he predicts) that we will learn that every disease entity will arise from either infection or genetics. At this point though, who really knows?


2006-06-23 14:59:11Hair Loss and the Immune System

I was transplanted 1 year ago (photo)

It was a 1,000 graft FUE surgery when I was 22. I experienced severe shock loss post surgery and lost plenty of native hair all around especially from the top. However, I did see some results in the front. I want to do another surgery to improve my situation but fear the loss of more native hair. I don’t want to be on medication such as Finasteride due its side effects. Can you’ll suggest me what to do?

Part of the reason I don’t do surgery on 22 year-old men is that they often develop shock loss, lose more native hair (a normal evolution but accelerated from the transplant when you were 22) and then you have to chase it. The real question is what will be your final hair loss pattern and will you have enough hair to follow the loss to its normal completion? I can usually answer this in young men under 26, but not in men 22 or 23. I consider doing a hair transplant on a 22 year-old like you, malpractice on the part of the doctor.

transplanted at 22, now 23

Hair Loss from Ambien?

(female) I have been using Ambien for about 4 years. I am losing my hair and get tingling feelings and sometimes my scalp feels sore in places. Can Ambien cause this, it seems to have gotten worse since June when I had an MRI done of my head to rule out MS. What can you tell me. Thanks

AmbienI’ve not read anything that says Ambien (zolpidem tartrate) can cause hair loss. There are a couple of unverified reports I found online, but nothing in the official literature.

I can not comment on your other symptoms. Sounds like you already have an expert working with you, but based on the information you stated, your doctor must think there is something going on (since you were screened for multiple sclerosis) and you need to have a down to earth discussion with your doctor on the differential diagnosis here.

Transplanting a Tight Scalp?

For somebody with a tight scalp is a FUE procedure really the only hair transplant option?

If you have a tight scalp, you can “work” your scalp with an exercise program for 30 minutes per day for 3 months. Most people will succeed in getting more laxity with these exercises. We made a video of this here.

Hair Loss From Poor Nutrition?

my hair is falling out dramatically. i have suffered very poor nutrition and stress along with some drug use. what should i eat, take, and/or do to stop the loss?

The reason that we do not see hair loss from dietary causes in the United States is because we are well nourished and generally without vitamin deficiencies. In your situation, with a history of poor nutrition and stress, these alone can cause hair loss. To correct this, a proper diet should be followed with a professional dietician. If your hair loss has a pattern to it (front, top, or crown), it may be genetic — in which case, Propecia combined with a good diet correction might be your best bet. If the loss is generalized, the malnutrition and vitamin deficiencies (as well as other causes of this) must be properly investigated and professionally treated.


2005-10-04 14:50:24Hair Loss From Poor Nutrition?

Transplanting into Donor Scar

Hello,
I had surgery with NHI back on 01/24/2002, no problems, then had more grafts placed by a surgeon closer to home about 1 year after. Having been a trauma nurse for 6+ years, I told him to please be very careful around the donor area as there was not much elasticity. Post op had very bad infxn and after 10 days of oral abx I now have very large scars at the donor areas behind both ears and have to wear my hair long to cover these scars.

Since this is already heavily scarred, can anything be done to place hair here?

Yes, I know, I should have just gone back to you to get my second one done. Thanks

You are more than welcome to pay us a visit and we’ll see what we can do. We can address the scar and also transplant into the donor area if that is what is needed. There may be a better solution, but until I examine you, I can not render an opinion. It is interesting to note for the readers of this blog, I have not seen an infection in the donor area for more than 10 years. As you may know, we are an accredited facility through the AAAHC and during the last accreditation process we were told that amongst accredited facilities we were in the top 1% with regard to the incidence of infection. I believe that we are the only accredited hair transplant facility in California and possibly even the entire USA. This accreditation process inflicts the highest standards on its participating facilities and includes many if not most of the hospital-level outpatient surgery facilities in the nation.


2006-06-03 10:42:22Transplanting into Donor Scar

Hair Loss from Zoloft, Surmontil, Xanax, or Temesta?

Dear Dr. Rassman

I am 33 and suffered from depression and anxiety attacks over a period of years and took numerous antidepressants including Zoloft and Surmontil. In addition I took sedatives such as Xanax and Temesta. During that time I did not notice any hairloss, even though I experienced a huge amount of stress. I am on the way to recovery now and stopped taking the antidepressants over 6 months ago and am weaning myself off the Xanax. For the last 6 months I have been experiencing mild hair loss, especially noticeable on the front hairline. Gaps are appearing in the hairline, which was normally full. I wash my hair about 4 times a week and comb my hair when washing it. In total I notice about 20-30 hairs on my hands and comb every time, which I never did before. I have no family history on either side of baldness. I have the following questions:

1) Is it possible that I could be experience temporary hair loss as a result of a history of using antidepressants and huge stress, and am having something of a delayed reaction? If so when can I expect hair to start growing back, if at all?

2) Does hair generally become thinner and recede in any case with age?

3) How can the loss of 50-100 hairs a day be normal? It seems like such a huge amount. Even given that new hairs are growing, that is around 30,000 hairs a year.

Thanks for any advice.

Kind Regards

Stress and antidepressent medications can cause hair loss. In some people, the hair shafts become finer (rather than coarser) and develop less densities of the hairs themselves with age. Most people lose about 100 hairs per day and they grow back about the same number of hairs each day.

Transplants in Young Men Under 25 (from Reddit)

I hope that you are not under the age of 25. Men who have hair transplants at, for example, age 21 will most likely continue to bald which means that the area behind the transplant will also bald. Then, if you transplant that area at age 22, the area behind it may also go, so that will require a third hair transplant. This can continue year by year, putting you in a difficult situation. If, however, you are over age 25-26, then it gets less likely that the balding will go fast behind the hair transplant. This surgery looks good, but I am talking not about the surgery; I am talking about you and your age.

He Got a Hair Transplant in KOREA! [Part One] from tressless


2018-09-19 06:24:26Transplants in Young Men Under 25 (from Reddit)

Hair Loss Medication Side Effects

Hello Dr. Rassman
I have always thought about doing something for my loss of hair which is mainly in the front. I hear about all these products (propecia, procede, avacor) they all sound so great but it’s hard to trust on any of them since they don’t mention any possible side effects. I read about the gentleman who loss a lot of his hair when he used procede and I’ve heard that propecia may cause low sperm count. Are these side effects common? Is there any place where I can find such information? I guess most products (like medicine) have possible side effects. I just need to know how common this occurs. Thank you

I have no direct knowledge about ProCede. Avacor’s main active component appears to be minoxidil, which is cheaper if you buy it as generic minoxidil. Propecia does not reduce the sperm count, but can reduce the volume of the ejaculate that goes with the orgasm. Your sperm count should be as potent for getting your lady pregnant as before you took Propecia. The good news about Propecia is that it stays in your body less than a day (90% is out of your system in a day and effectively 99% is out in the second day). Keep priorities, do your research, and get a good examination by an expert doctor.

Treatment with finasteride? (photo)

You reported one year of treatment. The photo shows a perfectly normal hairline. The presence of the widow’s peak and the flat hairline to the sides suggests that you have a left-over component of your juvenile hairline still showing. I have seen or treated many men like you. If you want a consultation with me, my email address is williamrassman33@gmail.com. Please send me your post before you started treatment so I can understand what was reversed after a year of treatment.