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Please do not use my real name. I’m female, aged 54. I was born with a very high wide forehead. 8 years ago I had a scalp advancement which brought my scalp 1/2 inch lower. Two years ago I had hair transplanted from the back of my head to my my hairline. The transplanted hair became infected. Some of it fell out & never came back. The hair that stayed is course, dark, kinky & curly. It doesn’t resemble the rest of my forehead hair which is fine, straight & medium in color. Why is the transplanted hair so different from my natural hair? I also have lumps & red irritated skin where the transplanted hair grows. Did my doctor do something wrong?

Generally, if the technique of transplanting hair is done correctly, the frontal hairline should blend in with the rest of your hair. That being said, on occasion it may grow out a bit more wavy and on rare occasions it can become kinky or frizzy (very rare). Your prior surgery on your forehead and the complication of an infection may have played a part in the overall result. A good examination of the hair with thickness measurements may help understand what you think you are seeing. These are subjects that you need to discuss with your doctor who performed your surgery. If that is not possible, you should seek out another doctor for a formal medical opinion.

I’m 18, female and I had my hair backcombed for dreadlocks. They were very tight and after four days I combed out my hair. Both the backcombing and combing-out process made me lose some hair. Do I have traction alopecia and will my hair grow back like it was before?

I would doubt that traction over a 4 days period will cause hair loss. If you lost any hair, it may take a few months for the hair to grow back in.

Comments of Accutane inducing hair loss raised my concern. I’ve been through two sessions of the drug, the first round 5 years ago and the latest last year, and have experienced recession of the hair-line. Attributing the hair loss to genetics, I began splitting Proscar (Finasteride) tablets 3 years ago. Since then, progression of hair loss at least isn’t significant, but may still be worsening. Photos from years ago are difficult to compare to the present. If the hair loss I’ve noticed is along temples in the normal MPB fashion, could the problem be a result of Accutane? If Accutane were the culprit, wouldn’t it cause an overall thinning of scalp and not be so localized at the temples? Further, if the balding is from Accutane, is Finasteride a proper treatment?

Thanks!

If it quacks like it duck, it probably is a duck. If your hair loss is in the pattern of Male Pattern Baldness (MPB) and there are characteristics typical of MPB miniaturization, then your hair loss is probably be due to MPB. Hair loss from Accutane may persist after stopping the drug and may precipitate patterned hair loss in men and generalized decreased hair bulk in men and women.

To have a correct diagnosis, you need your scalp hair evaluated for miniaturization and be able to quantify the “thinning” or the hair loss. It is the best way to follow the effects of finasteride.

Hello. I’m a 32 year old african american.I’ve read your artical about braids and pulling of the hair and I do understand.I love to wear braids cause it is easier to maintain with my busy schedule. I have noticed that there are small white specks at the end of my hair where it is braided. Possibly the root i guess. I was wondering if it is the root will my hair ever grow back.

Sounds like you are pulling out the hair with the braids. They will grow back, but if the hair continues to be pulled out, then it may not grow back one day. I’ve treated many African American women for traction alopecia with hair transplants.

Hi. I’m 14 years old (female) and I think I have Traction Alopecia. My hair is thinning on the top of my head but the rest of my hair is okay. I have been wearing my hair in a ponytail since the 4th grade and now I’m going into 9th. Do you think my hair is going to grow back? what do I do? Also I noticed this about a month ago and stopped wearing it in a ponytail. But will It ever be the same again? Please Help!!!

First, be sure not to continue using a tight pony tail. It is tight pulling, not the pony tail itself, that causes traction alopecia. Second, get a good doctor to look at the hair count and the degree of miniaturization in the area of your concern. With traction alopecia, the count should be down. The good news is that it will probably get better provided you take away the ‘insult’ to your hair. Wait about 6 months for reversal if that is traction alopecia.

If the half-life of Propecia is only 8 hours (or whatever it is…less than 24 hours anyway) I’m just wondering shouldn’t it be taken at least 2-3 times a day? I know it wouldn’t be viable given the cost, but technically speaking, is this a reasonable assumption?

Also you speculated a while back that it may be better to take Propecia in the mornings as testosterone levels are highest at that point. Even though it was pure speculation, I was wondering: are testosterone levels highest in the morning or when you wake up (which may not necessarily be in the morning).

Your assumptions are reasonable. However, Merck (the makers of Propecia) has determined through extensive human clinical testing that once a day dosing of Propecia (finasteride 1mg) had the best effect on male pattern hair loss.

Male testosterone levels are generally higher in the morning if your body is in a regular circadian rhythm following a normal wake/sleep cycle. If you are a night-shift worker or sleep at different times, your testosterone levels may peak at different times.

(female) I have been on Topamax 200mg twice a day for over a year now, I have also been taking Ritalin 20mg twice a day for the same lenght of time, and taking Xanax 2mg three times a day and Baclofen 20mg three times a day for about six months. I have also had a problem with anorexia and Bulimia for quite a number of years now and been up and down on my weight from about 72 pounds to around 145 to being stable at around 90 pounds for quite awhile now. I am a strick vegetarian and am now taking 65mg of iron twice a day and drinking a protien drink every morning. But for about the last four months my hair has been falling out all over the place, it falls out when I shower,in my sleep, when I run my fingers through it, blow dry it, brush it, on my clothes, ect..I am taking all the vitimans I can think to take but it just keeps falling out…and I had stopped taking my medications to see if that was the problem but it hasn’t helped. Could you please advise any helpful information on what I can do to stop the hair loss and get it to regrow, your help would be greatly appreciated.

You have “been there and done that” with things that are known to cause hair loss, including the medications, severe changes in diet with weight loss, and dietary problems that could lead to a variety of vitamin deficiencies (too many to list here). These stem from your weight problems. Looking over your list, I would not know where to start. I think that you should find a good doctor that you trust and can form a bond with, and then tackle your hair loss problem as a matter of focused attention. This is not something for internet medicine. I wish I could offer more, but I’m limited to what I can do through text on a screen.

Thank you for your forum…. it is so helpful. My question is I had a HT of 1480 units about 2 weeks ago. How long should I wait to start using Rogaine again? As a female can I use any oral medication to help maintain the hair I have?

You can start using topical Rogaine after about 1 to 2 weeks after a hair transplant, and it may be a good idea to use it at least for the first 4-5 months after surgery. To date there have been no FDA-approved oral medications available for female hair loss. Propecia is not recommended for women.

My hair has been thinning since I was about 18. But it seems to have accelerated in the last year or so since i grew my hair long. (I am now 23) I decided to shave my head, and boy did that reaffirm my receding hairline. When it grew back it looked a little bit odd to me. My left side had no border; it has basically a 2 1/2 by 2 1/2 inch patch of thin hairs (with more density towards the top) with hugh gaps between them from my “peak” in front to the side areas. On my right side it is thinning but there is a border and it is a lot thicker and less receding. There is a major difference. How many years could have stress and growing it long accelereated my hair loss, if what I described is normal. Secondly, I used a straight razor to shave my head thinking that would stimulate hair growth, eventhough i was told about it scarring and or killing the follicles.

I do not believe using a straight razor will stimulate hair growth. If that is true, I would be in the hair shaving business!

You make an interesting observation of being able to see the pattern of hair loss with the short shaved head. What you are seeing is the miniaturized hair, which has less bulk than normal hair. This is fairly difficult to see in patients with average men’s hair lengths. That is why I often write about mapping your scalp for miniaturization with the densitometer that we routinely use at New Hair Institute. Alternatively, if you can not find a doctor able or willing to map your head for miniaturization, you can get a very short hair cut and see with the eye where the miniaturization is.

I have a client who really needs a soft perm for the summer and has “bouts” of scalp psoriasis. I want to provide her the best information possible before creating this new style for her and we are currently in the midst of a remission so I need to act fast. I know a patch test and a test curl would be helpful but I was wondering if you could give me any overview advice on what her needs are in this situation and what precautions I could take to make her feel and look her best. I was thinking of using ISO or Aveda perms and clarifying her hair shaft with Redken PreArt and Hair Cleansing Cream prior to the service. What are the PH issues I am faced with and how can I position myself accordingly for the best result possible? Your advice would be most appreciated as this is a tough subject to find good information on. Thank you

Psoriasis is best treated by a dermatologist. There are many degrees to Psoriasis. I have this disease and I can tell you that there are few things that work well when the disease gets in its more advanced phases. I do not believe that there are any non-prescription items that really work for treating this problem. I often advise patients to keep the scalp skin soft and if the inflamation gets very active, try some topical steroids (hydrocortisone cream) no more than three applications 12 hours apart each week that the problem persists. Continuous use of steroids can be absorbed through the skin and into the body.