Balding Blog

I have had some surgery (face lift and hair transplants) and my face gets swollen from time to time. When it was swollen last, I went to my plastic surgeon who said that he did not see any swelling, but I know it is swollen because my hat is too tight when the swelling is there. Can you help me?

I suspect that you may be seeing a very subtle type of swelling. This is a condition more often seen in the legs or arms, called lymphedema. If it is very subtle and does not produce symptoms, leave it alone. If it is in the legs, then compression stockings may help. For leg swelling, you must worry about heart disease and dependent edema from right sided heart failure. This is not the case with lymphedema of the face or scalp.

Massage works and it feels good. Compression at night with a compression bandage will reduce the scalp component of it. Lymphedema can be a result of surgical or cancer therapy, and irradiation. It can also reflect tumors and metastases of tumors. I have seen patients present with lymphedema of the face and scalp as the first sign of tumors that invade the lymphatics of the neck, where head and neck tumors tend to migrate or even in Hodgkin’s disease (which are a type of lymphoma/cancer). If there are no cancers in consideration (you are not a smoker and have never been one, do not chew tobacco and never done that, have any other symptoms around the face, nose or neck, and no swelling in the nect and it is not bothering you) you might just wait it out. I am slightly concerned because you said you had a face lift and that would imply that you may be over 50, when these types of cancers are more common. Certainly, get yourself cleared by a good doctor because cancers of the head, neck and problems in the lymphatics of the abdomen sometimes present the way you are telling this to me.

I just realized recently that after wearing a beanie (all types…polyester, cotton etc.) for a long period, my head becomes all sensitive. My brother experienced this too…and hypothesized that because the hair follicle is ‘pushed’ into one direction for so long, it becomes sensitive. It made me think…perhaps they (hair follicles) are really fragile? But then I think…this never happens when I wear a regular hat…do you have any idea why this happens?

Many of the Jewish faith wear yarmulkes, and the Pope wears a zucchetto (both are skullcaps), and they keep it on most of the time. These are loose fitting and non-constricting. If your beanie is tight, then maybe it is putting pressure on the peripheral nerves and causing your problem. I do not believe that there is any connection to the fabric, because you have used caps with different fabrics and still experience the same reaction. I don’t really have an answer for you, unfortunately, except for the too tight explanation, but you know how tight it is on your head. Covering part or all of the head is essentially the same, whether with a skullcap, beanie, or even a baseball cap.

could my prescribed diet pills be the cause of my head fungus and breakouts on my face? the prescription’s name is phentermine. i took the pills for 1 yr and a year later my head fungus developed. could another possibility for my head fungus be my nerves and stress? should i get therapy?

Just so I’m clear, here’s the summary of what you’ve told me is going on…

1. Diet pills
2. Head fungus
3. Breakouts on the face
4. Nerves and stress

Perhaps you are on the right track of considering therapy.

Phentermine is a potentially dangerous diet medication and you should be under close medical supervision. I do not believe phentermine would potentiate head fungus. It may be multifactorial — including your stress level causing a depression in your natural body’s defense system.