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Could Hair Loss Be Due to External Causes, Rather Than Internal Causes Like DHT?

I read an article a while back that said resaerchers had found that acne was actually caused by a bacteria or fungal infection within the pores not an internal cause as previously thought.

Could it be, with Hair loss that resaerchers are only focusing on internal causes such as the DHT and actually overlooking other external causes like some kind of Fungal Folliculitis of the scalp that eats away at the folicles? Where does the DHT come from and why can’s we stop it?

Anything is possible, but the explanation you offered has not come to the forefront. I would not be surprised if there were other mediators for hair loss that make hair loss show up in one person and not another. We are not well informed enough to go there just yet.

This is what we know (taken from an article by Dr. David Whiting, a widely acknowledged leading researcher/dermatologist): “Testosterone and dihydrotestosterone can circulate systemically to follicles, or be manufactured locally in the follicle from circulating weak androgens (dehydroepiandro-sterone and androstenediol) via complex enzyme-mediated processes involving specific dehydrogenase and reductase enzyme pathways. All of these enzyme reactions are dependent upon specific pyridine cofactors. It is clear that reductase, dehydrogenase, and probably aromatase enzymes are of major importance in hair growth as they mediate the complex interchange of sex hormones implicated in anagen activity.”

That is the biochemistry of DHT (dihydrotestosterone).


2007-09-11 14:33:08Could Hair Loss Be Due to External Causes, Rather Than Internal Causes Like DHT?

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Could Hair Cloning or SMP Work for Someone with DUPA?

Hi Dr. Rassman:

Once again, thank you for contributing to a great blog.

I am a 32 yr old white male with dark hair. Approximately 2 years ago I first noticed thinning hair on the Crown (about the size of a ping pong ball). I went on propecia and have been on it ever since. There has not been any visible progression (at least to the naked eye). In terms of family history, all of my immediate family members have their hair except once uncle in his 50s has a bald spot around his crown. My one deceased grandfather buzzed his hair but according to my Dad, still hair hair (not completely bald).

I went for a consultation with a hair transplant doctor who advised me that I would need around 2000 grafts to cover that space but since I have an unstable permanent zone (i.e. miniaturization) he did not recommend it.

  1. The doctor did not use the acronym “DUPA” but is that what he was essentially saying?
  2. I have had fine hair since I was in my teens. Is DUPA progressive or stable? I have what appears to be a full head of hair – will it stabalize here or continue to progress?
  3. Dr. Bernstein states that those with DUPA can look “fine” if they keep their hair very short. Does he mean short as in the same look achieved through scalp micro pigmentation?
  4. Can scalp micro pigmentation be of use to someone with DUPA?
  5. There has been a lot of discussion about hair cloning/manipulation being available commercially within 10 years (according to Dr. Bernstein). In your professional opinion, do you think such an advancement be of any use to someone with DUPA?

1. Genetic male pattern baldness doesn’t include the permanent zone, so diffuse loss there could be DUPA.

2. DUPA is often progressive, but it can be stable for a number of years. These conditions tend to be unstable if it is associated with genetic balding.

3. No, not that short. I am sure Dr. Bernstein means clipping it to 1/4 or 1/3rd inch.

4. It can be, but I do not like to generalize on this without examining your scalp and hair loss.

5. That 10 year mark has been moving every year. There’s no use speculating on what cloning can or can’t do for treating various issues, as it won’t be commercially available in the near future. If hair cloning becomes closer to reality, I’m sure the answers will come.

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Could Getting a Perm Trigger Genetic Hair Loss?

Big permI’m a 19 year old guy who has had a moderately high hairline and slight recession at the temples since the age of 15. It seems to progress VERY gradually and I have no hair loss anywhere else. I always dye, style, tease, crimp and straighten my hair and it doesn’t seem to effect it, but I’m after a bigger style and am considering a perm. My hair is fine, but not extremely so.

Is it safe to get a fairly loose perm done at a good salon? Will it speed up my hair loss?

If you’ve got the genetics to lose hair, any number of things (including chemical damage) could trigger an earlier onset of the genetic process. You’ll have to decide if it’s worth the risk. I doubt you’ve got much risk based on what you described, but if you do decide to have the perm done you should try to minimize the risk by having it done by someone professionally trained.

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Could Gabapentin Be Responsible for My Female Hair Loss?

I have been taking gabapentin for years and just started to notice increased hair loss, more than would come out naturally. I’ve had chemo and all my hair came out, but that was about 6 years ago and my hair came back, but not all the way. A lot of women told me that when their hair came back it was their natural color, most women color their hair so didn’t even know what their natural color was, plus their hair came back thicker and glossier. They were all delighted.

Mine didn’t come back like that. I was taking gabapentin then and ever since. My hair came back weak, very fine, some gray in natural ‘mouse brown’, limp, awful looking and very easily broken. It was workable but I didn’t really notice it being really thin. Just in the past year and a half it has really been disappearing. I’m now wearing the wigs I used when my hair all came out with chemo.

I’ve had both knees replaced, one last July,2011 and the other last January, 2012. I thought it might have been caused by the anesthesia or the high doses of demeral? or the oxycodone I was taking for back pain. Also, beside the demerol? in the hospital the first time and then morphine the second time. But I don’t take any of that stuff since about April, 2012, around eight months ago and my hair seems to be coming out worse now. I’ve checked out all of those drugs and none of them seem to have hair loss as a side effect. Then I accidentally came across this blog and I have been enlightened. I never would have thought of gabapentin, but it sure makes sense. Is there a different medication to take the place of gabapentin? Someone help me out here?

I’m female, 64 years old, some baldness in the male side of the family, none on the female side. I take gabapentin, prilosec, atenalol?, effexor, Flexeril, Claratin, metformin, and Lantus, oxycodone/acetaminafen? when my back goes out. I take a multivitamin, vitamin C, magnesium, and iron beside the other prescription meds. What am I doing wrong? Can I be helped?

I really think you should see your doctor for your issues. Based on your medication list, you have a significant number of medical issues. You cannot just point to one drug as the source of hair loss. I wish it was that simple, but it does not work that way. In most cases the medical condition itself may be the cause (not the medication). Your issue is beyond the scope of a simple blog post. Sorry.

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Could FUE Move Hair and Skin to Eliminate Scarring?

Dear Dr Rassman, please excuse my question if it is stupid. I’m not medically trained!

What is normally discussed is the movement of hair follicles *from* the donor site *to* the recipient site. And this inevitably leaves some form of scarring in the donor area. But is it technically possible (in FUE) to also implant skin *from* the recipient area *to* the donor area, in such a manner to “eliminate” scarring? i.e. for every follicle the surgeon would swap tissues A and B, where A would be the tissue originally at the recipient site, and B the tissue originally at the donor site.

I’m sure this would be more costly for the patient, buy I’m wondering: has this ever been tested? And would it eliminate scarring?

A number of years ago, a well-known doctor preached that small punch extractions of scars would produce “mini-scalp reductions”. It never worked. This sounds like what you are asking about, and if one removes scar from a scarred area, you just get scar to replace it. Not such a good idea.

By the way, there are no stupid questions. Your question reflects an inquiring mind.

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Could FUE Make My Linear Non-Transplant Scar Worse?

I have a small, linear non-transplant scar above my ear. It has healed pretty well, and is looking more and more like normal skin each day. I’ve been thinking about transplanting hair into the scar by an east-coast doctor, about 100 grafts is my guess. If this were to be done with FUE, is there a huge risk that the scars produced from such a small FUE procedure will be worse than my linear scar? I want to be able to wear a buzz cut (somewhere around #2) as I believer my hair is thinning and short hair is a better look. Should I be very worried about moving just 100 grafts from the back of my head into this scar to minimize it?

Follicular unit extraction (FUE) is a good way to fill in a scar, but not all FUE is the same. Different doctors use different techniques and instruments. As long as the FUE instrument is less than 1mm (ideally 0.8 of 0.9mm diameter), you should be OK.

I am flattered you would ask me, but I would ask this question to your doctor since you need to trust the surgeon that will be performing the procedure on you!

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Could Flixotide for My Asthma Accelerate Hair Loss?

Hello,

I’m using flixotide 100mcg 2 times a day. Flixotide contains corticosteroid that works against inflammation for my asthma. Because it is a steroid, could it accelerate androgenetica alopecia? I can’t find good answers about this subject.

Hopefully you can help me. Cheers.

Chronic use of steroids can negatively impact hair loss, but I don’t see anything in the literature that shows hair loss as a side effect of Flixotide (fluticasone). There is little I can offer here.

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Could Finasteride Be Affecting My Sperm?

Dear Doctor,
I have been taking Propecia for years. My wife and I are trying to have our first baby. She has gotten pregnant twice, however both have resulted in her getting a D & C. There have been problems with cell growth after conception in that an empty sac forms with nothing inside. Could finasteride be affecting the genetics of my sperm?

There are many potential reasons why your wife may have trouble conceiving. There are two issues that are known with regard to sperm while taking Propecia —

  • Reduced semen volume is very common, but usually the presence of sperm is good.
  • A recent report in the medical literature suggests that Propecia may cause reduced sperm counts, so I would have your sperm tested for this.

I would think that Propecia is low on the list of many more common possibilities.


2008-07-03 14:41:39Could Finasteride Be Affecting My Sperm?

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Could Fasting 2 Days a Week Slow Down the Pace of Hair Loss?

Dear Dr

There has been a lot of interest in the UK about intermittent fasting where an individual eats normally for 5 days a week and then fasts for two (not on consecutive days). There was a BBC horizon programme where it was shown to reduce IGH-1 (growth hormone) and improve insulin sensitivity. It is claimed that when a body goes into fasting mode the body starts to repair itself better by repairing cells rather than producing more cells. It was suggested that this may be beneficial to age related diseases, cancer etc.

Do you think this would slow down the pace of hairloss if insulin sensitivity improved and/or IGH-1 was reduced? Has research been done on this approach? Your thoughts would be appreciated

Genetic hair loss is not a disease. Balding is a genetic trait, like your height, body build, hair color, the way you look, etc. Even if this ‘fasting’ has value (which I would doubt), it will not change your genetics. Significant fasting can actually accelerate hair loss. You are what you are and although your patterned balding can be modified with drugs or transplants, your balding pattern is fixed in your genetics.

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Could brushing hair when wet damage my hair?

I know you’re not supposed to brush wet hair after the shower, but I didn’t know that until today… After I’ve been doing it for years… Thankfully, currently, I have a pretty full head of pretty thick hair and I’m obviously prepared to stop brushing my wet hair indefinitely. However, I’m worried that I’ve done damage that can’t be undone that could eventually lead to severe hair loss in the future. Should I be concerned?

When people brush hair roughly, then they can pull out miniaturized hairs easily causing evident balding in those men or women with genetic hair loss and significant miniaturization. I tell people to use gentle brushing or a wide tooth brush or comb to minimize the pulling effect on these miniaturized hairs.