Hair Loss from Pills for Menstrual Cycle?

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

hi! i’m already 25 years old. but then, i never had a normal menstrual cycle. when i had my consultation with an ob-gyne, he/she (since i’ve seen two doctors already) told me that all the tests given to me was normal and they prescribed me with provera pills. but then, as i started to use it for a long period of time, i suddenly felt that i’m starting to lose some of my hairs.i never thought that it can be a side effect of using pills. i went to my dermatologist and told me that my hairs will still grow back. Up to now, i’m having second thoughts on taking any pills that would help me regulate my menstruation since it seems that i’m going to have problems with my hair. can other pills like diane-35 can also cause hair loss? i’m planning to make another appointment with my ob-gyne for provera intake since my last menstruation was last october and then afterwards take diane-35 for my pimples. it’s just that i’m sick and worried of losing my hair. what can i do to prevent hair loss? is it also okay to use a horse shampoo for my hair and minoxidil regroe? they say that it can also make your hair thick. it’s just that i don’t want to lose any more hairs. thank you.

It sounds like you may have a genetic or hormonal cause of your hair loss. The absence of a normal menstrual cycle, which cause you to go on regulatory hormones, can cause hair loss. All of these hormonal supplements will have this as a potential side effect. You need to work with your OB/Gyn doctor to find the right hormones that meet all of your needs with the least risk to your hair.

Many people do use horse shampoos, and minoxidil may work to address some of the hair loss issues. Good luck.

Terrible Itch, Dandruff, Increase in White Hairs

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

Dear Dr. Rassman,

I am a 27 year old Korean female and have always had fair, sensitive skin on my face as well as my scalp. I’ve had slight acne since my teens but lately I have noticed bumps on my scalp that itch quite terribly, followed with dandruff. The dandruff comes and goes in my life, but lately it feels worse. In addition, I have noticed an increase of white hairs, especially near the crown. This is alarming considering I do not have thick hair to begin with. My initial reaction is to pluck the white hairs out but now there are too many to count. I don’t have any unusual stress in my life. I would like to see a doctor but do not know what kind. I am really worried because my hair loss, itchiness of scalp, increase of white hairs near crown, red bumps on scalp, are getting noticably worse. Because I am in South Korea, I am having a difficult time finding a qualified physician to help me at this time. Whatever information you can give me would be greatly appreciated.

I sent you my photos so you can take a look. It doesn’t look so bad at this time but I don’t want to wait until I am bald before I take action!

Please help!

The simple answer is that you may be causing some of your problems. If you are plucking out the white hair and your head is slowly turning white, it is a self-defeating process as eventually you will be completely white and then possibly you will pluck out all of your hair as you become balder and balder. Plucking will produce traction alopecia and the plucking problem may cause some of the bumps you are talking about.

If Hair Loss Products Work, Why Aren’t There Celebrity Endorsements?

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

If a hair loss product is really effective as it claims to be, in the case Scalp Med, why not give a well known baldy man in Hollywood like Bruce Willis a year supply and let the people notice if there is a chnage in his hair. Unless the Scalp Med do this or any other comapnies, I would remain skeptical.

This is not as easy as you make it. I am answering your question as a businessman, not as a doctor. The rich and famous value their time, privacy and endorsements, and they get big money from it, not a year’s supply of some menial substance that may or may not work. I suspect that you have good common sense and are applying it to things well beyond the movie watcher you probably are. I would do a hair transplant on some famous men for free just to get their endorsement 8 months later, as the world would see the transformation just like those hundreds of men posted on newhair.com. But the rich and famous are not interested in the money or any increased fame, what they are in most need of (if their hair loss bothers them) is the drive to research hair transplants and the courage to face their vanity.

Alopecia and Doctors In India

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

The Doctors in India dont seem to know about alopecia Universalis/ Totalis. I am losing, eyebrows, hair (not in patches). Although i have found lately that i can see gaps in my beard. I understand that this is caused by AUTO-IMMUNE diseases. Please can you list all the auto-immune diseases that i should get myself checked for. My father also has alopecia universalis but he actually dint care much, never went to a doctor coz for him it was never a big issue. Its a big issue for me though. He has thyroid. (i dont have).

So Please can you list all the auto-immune diseases that i should get myself checked for; since im not getting much help from dermatologists here.
Thank You

ps: Im not bothered by any hair loss except my eyebrows..

I understand you are at a junction where the doctors you have seen have not been helpful. I also admire your quest to find the cause of your hair loss condition. However, it is not my role to be your doctor or give medical treatment or diagnosis via the internet. At best, I can only give my opinions and thoughts. The medical treatment and plan is completely between you and your physician. That being said, it is my opinion that you may want to try visiting an immunologist for your condition, if indeed you are diagnosed with alopecia universalis. In the United States many dermatologists control the treatments, but as there is no effective treatment, only a few doctors are experimenting on medications for autoimmune hair disorders and these are done at major universities under FDA guidelines. There must be some doctors in India that have similar interests and you should try to find them. I’m sorry that I don’t have more info on where to find them though. I suspect if you are a healthy person with only alopeica universalis there really are no tests that will give you satisfaction.

Propecia Produces PMS in Men?

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

I feel that ever since I started Propecia, I was into wide fluctuations of emotions, mood swings, and hot flashes as if I was in Premenstrual Syndrome (PMS). I am a physician so I know what I am talking about. I stayed on Propecia for 6 months and could not take it anymore, so I stopped about 3 months ago. These symptoms went away within a week and have not returned since. When I saw this website, I thought you might be able to give me insights into this unusual symptom not reported in the literature I reviewed. Any thoughts? The website is well done, thanks.

There are effects of Propecia on estrogen and estradiol production, so what you are describing may ring true to this hormone’s action or inaction. See: High Estrogen in Men

Laser Brush and Fertility?

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

I am interested in investing in a laser brush for my hair, but wanted to know whether they were all more or less the same. Also, is there a possibility that this could affect fertility at all? Please advise. Regards

I doubt that the Laser Comb has any negative effects, including any effects on fertility. Low laser light is not like radiation, so its depth of penetration is very limited. Think of it like a flashlight, where it shines is where any effect may be. The major effect may simply be that it does not work. I believe that the portable devices are all similar to each other, so nothing stands out to me. They all may not work.

How Would New Products for Hair Loss Work?

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

Dr. R,

First off i want to say what a great site you have created. With all the nonsense out there on the internet, your site differentiates itself as being very informative and a trusted source for MPB.

A recent post said you were aware of two new drugs that are in the works to combat MPB. I understand there is a confidentiality issue, but is there any insight you can give as to how the product works and a possible viable timeline? I am aware of the length of drug approval from the FDA (5-10 years is your estimation) but a new product has not been released since 1997. Nearly a decade later and there doesn’t seem to be any progress which concerns me greatly. I am sure these drug manufacturers are aware of the multi billion dollar market there is yearly in the fight against MPB. If for nothing more than to make money, shouldn’t these companies be attacking the market as aggressively as possible? Those are just a few thoughts. Please get back.

Regards

The answers to your questions are almost impossible for me to relate them to you. On one of the drugs, the effect was found as a side effect of its use for treating another disease. Once they found that the same medication grew hair, they move it into a topical and speculated on mechanisms of action (looking for the science). One of the drugs is already in a clinical trial in another country and early indications have shown great results. The researchers told me that there were a few hundred people put into a double blind study and although they did not know who was on the topical medication and who was on the placebo, they did note that half of the people who were coming back for hair counts had good hair growth while others had none. They assumed (probably correctly) that what they were looking at was a remarkably strong hair growing medication. Until the study is complete, we will not know for sure, but the entire science will have to be understood and toxicology studies will have to be in hand in thousands of patients before the United States FDA will allow the drug come to market. Sorry, that is all I can say. Coming to market: A few years at the least, I would suspect.

It is interesting that minoxidil was first used as a medication for high blood pressure. It worked poorly and without consistency for blood pressure control but did grow hair on many men and women who took it systemically. As the drug already had some safety and other toxicology data, the move to a topical for hair loss was a bit easier. Propecia was originally used for men who had urination problems, but when taken for the prostate, some men grew hair. Again, another discovery by serendipity. Could you imagine what we would get if we found out about drugs by intent rather than serendipity?

Should I Take Breaks Between Minoxidil Treatments?

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

Dear Dr Rassman,

Thank you for this informative blog and your dedication to answering our balding questions.

My question is regarding rogaine or minoxidil and its effects after you have a break after several years of treatment. I for one am 25 and have used minoxidil 5% since I was around 22. My barber here in New York told me that for Minoxidil not to lose its long term effect it is good to have a break after a few years and then go back on it again so to keep its effectiveness. Is this true?

I for one listened to his advice and stopped using minoxidil 5% for three months and I could see an increase in hair fall out after two months specially in the templar areas where I had gained a lot of new growth. Now my second and more important question is will I once again benefit from using the minoxidil again? I went on minoxidil about 6 weeks ago again but havent seen any results yet.

so two questions:
1) Is it good to have breaks in minoxidil treatment?
2) Will the effects of the minoxidil come back after restarting the treatment?

Breaks in the use of minoxidil are disasterous, as you have already seen. So the answer to your first question is unequivocally, “no”. The hair may come back if your ‘rest’ period is under 2-3 months. Read elsewhere on this blog about Propecia and its appropriateness in young men losing their hair. Get a diagnosis and proper treatment.

I Urinate Frequently When Taking Propecia

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

After taking a propecia tablet. I urinate frequently. It seems I can’t control my bladder. This may seem like a strange thing to say but my penis looks smaller. Almost as if it is shrinking. I can’t get erect because I feelnothing. Should I stop propecia?

Free showerLet me get this straight:

  1. You cannot control you bladder.
  2. Your penis is shrinking.
  3. You cannot get an erection.
  4. You cannot feel your penis.

I would be at my doctor’s office now if these were my complaints!

If you are noticing increased urinary frequency (polyuria), you may have other serious medical conditions such as diabetes which can also produce neuropathies that can change your feelings from sensory nerves. You should definitely follow-up with your primary care doctor or the doctor who prescribed you the drug Propecia. I have never heard of a shrinking penis caused by Propecia nor any of the other symptoms you mentioned in combination.

The “take home message” is you need to go SEE a medical doctor.

Folliculitis Decalvans Specialist in Atlanta?

/by William Rassman, M.D./1 /,

Hi Dr.:
I found the previous blog on Folliculitis decalvans very helpful as I am a 23 year old of African descent also suffereing from the same problem. I am searching for a dermatologist with specific training in this area as you suggested but I haven’t had any luck. The listing of Doctors on the American Academy of Dermatology’s website is pretty basic. Do you have any specific pointers or referrals on this. I live in the Metro Atlanta Area. Thanks for your help.

Try to go to a major university clinic. They are bound to have those that focus in this disease. You have a number of good university medical centers in Atlanta.

For the readers of this blog, note the following references for clarification. This is a bad problem which in essence reflects an aggressive infection of the scalp hair follicles, amongst other causes.

What Is Retin-A?

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

Hello Dr. Rassman,
My question is not related to hair loss, but i figured you might know sth about it…What exactly is Retin A and how does it work? Does it come only as a facial cream or it can be taken orally as well? Does it cause vascularization when applied topically and why…as far as i know it stimulates collagen production, so capillaries should become less visible as skin fat increases…and one last question, my boyfriend is balding due to stress, what should we do? I would very much appreciate your answer/s. Thank you for your time

Retin-A (tretinoin) is the acid derivative of retinol, vitamin A. For much more on this, please see SFSU: Student Health Services.

As Retin-A is applied to the skin and can produce burns to the skin. It is believed that a light burn will make the skin more able to absorb other medications (like minoxidil for hair loss), because increased vasculatiry is induced by the burn. Because it creates an injury to the skin, the entire injury process induces the body to repair it. The skin irritation could be a problem and is a problem for many users. The formation of new collagen is part of the process of repair and replacement as the body regenerates the damage caused by the acid.

With regard to your boyfriend, stress does accelerate hair loss. I hope you love him enough to reduce his stress so that he remains young looking and hairy longer.

Clonazepam and Hair Loss

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

I currently take a medication called clonazepam (0.5 mg) once or twice daily as a muscle relaxer. I have been taking this medication since I was 19 or 20 (I am now 28). Could this be a cause in my thinning hair? I do not have a history of men or women balding in my family. My father has a full head (really full) along with both my grandfathers. My hairline is moving back more each year and my hair is all around is thinning and i am extremly worried. I do have a large amount of stress in my life and always have…but is it possible that hair from stress can grow back? I am extremly frusturated and baffled as to why my hair is thinning…If it is the medication, I am willing to get off of it with the consent of my doctor.
Thank you for your time.

Many drugs can cause hair loss, including Clonazepam. Before considering a drug as the source of your hair loss, you should also consider other medical causes. You should see your primary care doctor for a good examination and possible blood work to find a possible medical cause.

In address to the relationship between stress and hair loss, it is well known that stress can accelerate genetic hair loss as it unfolds over time. You discuss the movement of your hairline higher on your head, so I would wonder if this is the normal recession of maturing found in most men (the hairline goes up about 2/3rd inch in the middle and 1 or 1-1/2 inches in the corners). Sounds like you need an expert to evaluate the hair loss as well as your family doctor to assess your medication routine. The question an expert will is address is if you have a genetic component adding to the other factors causing hair loss or are you just seeing a maturing hairline in development. As you indicated you are in Los Angeles, you are invited to visit my LA office for a free consultation. You can call 800-NEW-HAIR to make an appointment, or request additional info via the NHI site.

Propecia Effectiveness Timetable?

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

Hi Doc, quick question regarding propecia if i could. Is there a timetable for its effectiveness, ie, 1-4 months slowing down of loss, 6-12 months possible regrowth ect. Also I have heard people mention that the younger you are the better you may respond but lets say you have minimal crown loss at 42, would you not be as good if not better a responder that a 20 year old with the same loss as his loss would most surely have started sooner. many thanks

Propecia seems to work better in more recent hair loss (miniaturization not frank balding), and in younger men than in older men this is often what is going on. The rule I generally use is that Propecia will impact miniaturization that is 2-3 years old. The longer the miniaturization is present, the less effective Propecia may be. It also seems that the drug works better in the crown, but this may be because crown miniaturization comes after frontal balding in most people and the crown miniaturization process is slower. You should see a response from Propecia in 8-12 months, but some people get another kick after another year. Rarely have I seen progressive benefits for growing new hair or a significant increase in fullness for longer than 1 year.

There are no hard rules and each person is different. I have seen the drug reverse frontal balding (highly unusual) and I have seen many patients who have had thinning on the top become much fuller. For the really bald man, I do not remember ever seeing a patient reverse extreme balding, but I have seen the progression slow down significantly from a Class 6 balding pattern headed to a Class 7.

Alopecia on Tyra Banks Show

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

hi my name is Tia and i am 14 for the last 2 weeks my hair has been falling out…then i watched the Tyra Banks show and this girl with alopecia was on…anyways it has been falling out alot like up to 45 pieces a day and i am really sacred i do not ant to go bald ….how do i tell what is wrong plz help me….

It is normal to lose 100-150 hairs each day for the average person. Unless you have some medical disease or have been losing a great deal of weight, you should not worry about it. I don’t watch the Tyra Banks Show, so I couldn’t specifically make references to things that were said on the program, but I did find this link about wigs shown during that episode.