Tryptophan and Hair Loss?

/by William Rassman, M.D./0 /,

I am a 39 year old female experiencing hairloss all over, with more concentration in the frontal area. I became infertile with low estrogen in my early 30s, went on testosterone cream supplement for 8-9 months after that, but primarily suspect that my hair loss is due to the L-tryptophan I’ve been taking for the last 2 years for my mood, which has worked wonderfully for me as an antidepressant (from 1000 mg to 2500 mg.).

If I get off the Tryptophan will my hair grow back? Otherwise, I may need a referral for a doctor in the San Jose or San Francisco Bay Area, and to find another anti-depressant…that doesn’t cause hair loss???

Thank you

There are some suggestions that tryptophan can cause hair loss and yet other suggestions that it does not effect hair loss. As a metabolic intermediate in the conversion of tryptophan into serotonin (5-HTP), some believe that in selective sensitive patients it may cause hair loss in its derivative form. Chemotoxicity is not my specialty and this is frankly beyond my skills and knowledge. Your conclusions on finding a doctor that can manage your anti-depressant medications is appropriate, but I do not have a referral for you. Sorry I couldn’t be of more help.

Masturbation and Hair Loss

/by William Rassman, M.D./31 /

Im 20 years old and I am noticing my hair thinning on both the front left and front right sides of my head. Receding hair does exist in my family, however, for a while I had been excessively masturbating. This may have also been a cause, so Ive heard. What do you think? Is it possible for my hair to grow back thicker? And what would be the best thing for me to do?

Thinning hair does come from family genetics and I gather from your question that you have the genetics in your family history, which may point to the most probable cause of your hair loss. Genetic hair loss is caused by the interaction between your genes, your testosterone (and DHT levels), time, and stress. The young man has a great deal of circulating testosterone (which creates DHT, which causes hair loss and thinning on the negative side and hair growth in beard, chest hair, and hair almost everywhere else on the body, except the scalp). Because testosterone levels are high, the sex drive in young men is also very high. Frequent erections (in some teenage boys as many as 20 times per hour in some situations) produce a desire to masturbate (when the opportunity is right) to relieve the sexual drive. High testosterone levels and the desire to masturbate are a perfectly normal response to both your erections and the hormone levels driving them. As a culture, we hide our masturbating with some shame but the process is a normal process.

Your frequency of masturbation will not impact your hair loss; only things like genetics, hormones and hormone blocking agents like Propecia will impact your hair loss/thinning. You should have your scalp evaluated for miniaturization and balding patterns. If you do have genetic hair loss, you should get on the appropriate treatment (like Propecia), for if you do not treat it, the family pattern may prevail. It is said that men who are bald, are more sexually active than hairy men. I do not know if this is correct or not or if that means that bald men try harder. There are better statistics for hair loss than the masturbating habits of young, balding men. I would suggest that you masturbate all you want, just focus upon getting your hair diagnosis and treatment going in the right direction by taking action, rather than ignoring the proper approach to your problem. Keep hair loss and your penis agenda separate and give both, the attention they need. If you are able to come to Los Angeles, visit me and I would be happy to evaluate your hair loss and recommend the appropriate treatment for you.

Hair is Very Dry After Washing

/by William Rassman, M.D./0 /,

I’m 18 yars old and I noticed that my hair is thinning, turning dry, losing it’s silkiness and my hair density is a lot less than it was before. I don’t know how to say it, but my hair line is pushed back more than before. I also hair a couple of white hairs.

My hair used to be extremely healthy about 5 years ago, now after every time I use any shampoo or conditioner, my hair dries out and combing it is impossible.

My hair is just not the same as before and I would like to know what I can do to fix this problem. People have actually noticed me lossing hair!

You should be checked out for miniaturization to be sure that you are not developing male patterned balding (assuming you are a male). Sometimes, our hair does change in character as we move from being a teenager to an adult. The movement of your hairline upward is common in men between 18-29 and it may move about 2/3rd of an inch back for the normal childhood ‘boyish’ hairline to reflect the mature hairline in a Caucasian male. Most Caucasian males (95%) experience such upward movement of the hairline. Frequent shampooing may tend to dry your hair by washing out the protective elements of sebum which can cause the situation you are talking about. By all means, visit an expert doctor for a consultation to make sure that male patterned genetic balding is not occuring.

What is Sufficient Donor Hair?

/by William Rassman, M.D./0 /

what do you mean by “sufficient donor hair” …any link where there is a pic differentating between “sufficient donor hair” and “insufficient donor hair”?

Hair transplantation requires that the supply of hair is more than adeqaute to meet the demand for hair. The smaller the balding area, the less will be the requirement for donor hair. There is also a ‘must’ where the donor hair must be in adequate quantities (density) and adequate quality (healthy). Low densities or poor quality of donor hair (the presence of Diffuse Unpatterned Alopecia, for example) means that the donor supply is insufficient to support a hair transplant.

When Does Stress Become a Factor in Hair Loss?

/by William Rassman, M.D./0 /,

i am a 23 year old woman, who has always had VERY thick curly hair. I have noticed that my hair is much thinner and requires many more wraps of the hair tie to put it up in a pony tail. I am very upset and wondered if you had any clue what is going on. I do not have a receeding hair line or anything. how stressed out does a person have to be inorder to affect their hair? thanks

The internet is no place to get a good examination of your head, scalp, and hair. A good dermatologist should be a starting point. Some people get hair changes with age that is not necessarily diseased hair, and others get hair thinning and loss from medical problems (see Female Hair Loss on this site to see other posts that reference the many medical conditions that can cause hair loss). You need a good doctor to make an assessment of you and your problem. If you have genetic female hair loss, then hair loss can be a problem anytime you experience stress.

Revising a Scalp Reduction

/by William Rassman, M.D./0 /,

I had a scalp reduction and two hair transplants. I would like to see some before and after photos of a revised donor scar.

Scalp reduction repairs vary widely because of the types of incisions that was used, the number of surgical procedures that you had (I am assuming only one by the question you asked), and the damage to the underlying scalp. When a person has had many scalp reduction procedures, they often develop a deformity called a ‘Slot Deformity’ (see this article by Dr. Patrick Frechet) where the hair from the sides grow away from the scar and when this meets the hair in the back that point downward to the floor, a slot is created that looks most unnatural. You need to be evaluated in person. If you come to my Los Angeles office, I can lead you through the many types of repairs you need to know about. Alternatively, if you are not near either one of our California offices, let me know where you are, or send good photos to me (via mail or email) and I can try to address the question more appropriately over the distance.

Inducing Traction Alopecia to Unnatural Looking Grafts

/by William Rassman, M.D./0 /,

2 years ago I had a transplant, but near the hairline and in the temporal zone there’s some grafts of 4 hairs that do not look natural. Beyond the excessive number of hairs per graft, the thickness of the hair shaft is greater than the neighboring hairs and therefore visible. Some of the grafts seem to have pitting, but if I pull out the hairs in the graft, the pitting is not visible. I would want to know if the transplanted hairs will become gradually finer over time. If I continue to pull out those hairs, is it probable that they will regrow finer or some not regrow at all, inducing a sort of traction alopecia? If it succeeds, I think the look one will be better.
Thank you for your kind attention and reply.

I have seen people that have pulled their eyebrow hair out until they get traction alopecia. It sounds like your strategy may work, but I can not tell you how long it will take to get where you want to be. Every person is different. Alternatively, you can have these grafts thinned with an FUE procedure (fairly reliable) or perform electrolysis (a 30% success rate in many people’s hands). The costs for a limited number should be relatively small. The one advantage of FUE is that the grafts can be relocated with minimal effort in small numbers.

Using Tanning Products on Scalp

/by William Rassman, M.D./0 /,

I would like to shave my head but my scalp looks pale (im 23-male-Indian)…Someone suggested using Tanning product on the scalp…
Will i lose or stop the growth of existing hair if i do this?
ps: i suffer from MPB – (diffused)
pps: I cant use propecia due to liver probs…so am considering hair transplant after some years…Thanks
ppps: Minoxydyl isnt helping much..

The hair on our head does not allow the pigment of the scalp to fully express itself without some sunlight. That is why the skin under the hair is lighter in color than face skin. This is present in everyone with hair, but clearly more visible when a dark skin person shaves the head than when a fair complection person with white skin shaves their head. You can tan your head or go to a tanning salon, or it will tan on its own once exposed to some reasonable amount of sun.

Most tanning products should not impact or accelerate hair loss. Propecia is the best medication for preventing hair loss in young men, far superior to anything out there. Your doctor will be your best advocate for you while considering this option, because caution should be used in the administration of Propecia in patients with liver function abnormalities, as finasteride is metabolized extensively in the liver. It is possible that it can be taken at smaller doses if your liver has some dysfunction, but if your liver is working normally, you should be able to take Propecia at the normal dose. Careful monitoring is important and you should be under the direction of a good, caring doctor in approaching this medication’s use.

Stress and Alopecia Universalis

/by William Rassman, M.D./0 /, ,

I keep reading that stress is not a factor in Alopecia Universalis but my daughter who just turned 20 began losing her hair a year ago, a few months after her sister died in a car accident and now is totally bald, lost most body hair and eyebrows. We all know it is from the shock and trauma…why doesn’t the medical profession accept that and what is the prognoisis now that it has happened?

I can not comment on what you were told, but I know that such genetic conditions, which may occur normally in those with the impacted genes, can be accelerated by stress. You are correct, in a sense, that stress can precipitate what genetically would have come with time.

Smoking Cigarettes and Hair Loss

/by William Rassman, M.D./2 /

Does smoking cause hair loss, will smoking affect the success of a transplant? Best Regards.

There are known effects on blood supply to the scalp and other areas of the body when one smokes. This may or may not contribute to hair loss. Many hair transplant surgeons warn patients that if they smoke, they run the risk of losing hair from a transplant or reducing the yield from a transplant. I have not found that to be the case, but from a good legal position, I must warn you of that possibility.