One Area Of My Hair Has a Different Texture

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

Like the guy who says that his hair grows to 1/2 inch then falls out I’ve also had the problem of my hair growing to a certain length then falling out. This only occurs on the lower left region of my head. I’m 22 now and began having this problem when I was about 14 or so. I went to a dermatologist about it 4 years ago who told me that it may have come from overprocessing and suggested that I cut my hair off and regrow it or wear lose braids. I chose the braids of course and now I have a full head of natural hair. Recently though, I’ve noticed that the hair in this lower left side is a little shorter and almost has a little bit of a different texture than the other sections of my hair. Also every now and them, I get an itching sensation in this area or it’ll feel a little sore. I want to go back to relaxers but do you think this would be ok or would it fall out again? I actually have an appointment to see a dermatologist again but what tests would you suggeest I ask them to run to see if its ok?

Wait until you see your dermatologist. It does sound like you are obsessing over subtleties in your hair. I wish I could add more, but I’d let your dermatologist do his/her thing and please feel free to let me know what the findings are. Please reference this posting when you reply.

Another Patient Returns (with Photos)

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

I met with a patient who had one procedure of 1,541 grafts a little over a year ago. We sat down and reviewed his pictures together and he completely forgot that the man from a year ago ever existed. I share with you his wonderful results and I thank him for allowing me to show his face and post these photos. Click the photos to enlarge.

Before:



After:



Here’s My Stats — Why Is My Hair Falling Out?

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

Dr. Rassman,

  1. 18 Year old male
  2. Hair loss started around the age of 13
  3. This was when i first started geling my hair
  4. This occured with dandruff
  5. After a while this stopped, although hair remained very thin and became see through when wet
  6. About 1 month ago, started to loose about 20 to 30 hairs every time i shampooed or brushed my hair (no dandruff)
  7. Individual hairs can be pulled out fairly easily
  8. Started using a new hair gel a few weeks before the problem started
  9. During the period between my previous hair loss and now, i used gel in small amounts but these did not have any effect
  10. My hair gets very oily and weak when my nails grow for more than a week without trimming
  11. I had a blood test done and this only showed a very mild iron deficiency which the doctor said was not enough to make the hair fall out
  12. I had a very high fever about 4 months ago (New Year’s Eve)
  13. No history of hair loss in the family

Can you think of any reason why this is occuring and if so, is it treatable?

  1. At 18 years old you may have the beginning of male pattern hair loss
  2. At 13 years old, as your puperty hit, you may have had some juvenile hair loss or a change in your hair character which is normal (not male pattern hair loss)
  3. Using a hair product, such as gel, does not cause or accelerate hair loss
  4. Dandruff is not associated with male pattern hair loss
  5. 20 to 30 hair loss during a shower is normal (we lose about 100 hair a day)
  6. Stop pulling at your hair, it will cause permanent hair loss
  7. Again, using hair styling products does not cause hair loss
  8. Oily hair is not related to hair loss (you can try using shampoo for oily hair)
  9. Your doctor was right — mild iron deficiency does not generally cause hair loss and it is easy to correct
  10. High fever on New Year’s Eve won’t generally cause hair loss. Any one day is no worse than any other day
  11. No, family history does not necessarily mean you will not have male pattern hair loss (there is no absolute rule)

If you had a complete medical workup and you are still concerned about hair loss, you should make an appointment with a hair doctor (a good dermatologist) to map your scalp hair with a densitometer to look for miniaturization and pattern of hair loss.

Kenalog and Female Hair Loss

/by William Rassman, M.D./4 /, ,

I’m a 32 year old mother of 3 and first noticed an increase in the amount of hair I was losing on a daily basis about 2 1/2 to 3 years ago. I had a lot of hair so I wasn’t too worried about it at first, but the hair loss continued and now I have a significant decrease in hair volume. I went to see two dermatologist. The first one told me it was hereditary and to use Womens Rogaine. He didn’t even touch or look closely at my scalp. He also said if I did’nt tell him what was wrong that he would never guess I was losing hair, which didn’t make me feel better because I can tell the difference. I never tried the Rogaine. The other diagnosed me with telogen effluvium and recommended I take a injection of Kenalog. Which after about a year of weighing the benefits and risks decided to get the shot. It’s been about three months now and haven’t noticed any decrease in hairloss or any regrowth. It sure has messed up my menstral cycle though. I really would appreciate any advice you might have. It is really depressing as a young woman to go through hairloss. Thank you for your time.

Telogen effluvium generally has a spontaneous recovery in 6 to 12 months. It is precipitated by hormonal, emotional, or medical stressors. Aside from seeing a dermatologist, you may want to get a complete medical physical to rule out other medical causes of female hair loss (such as eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics).

Kenalog is sometimes used for hair loss, however its efficacy is not well studied and I do not believe that it works unless the hair loss is in the autoimmune category. Telogen effluvium and steroids are poorly linked for benefits, and as you said, it is messing around with your hormone balance and menstrual cycle. Unfortunately, even with a good diagnosis, you may still find that there are no suitable treatments available. At least you will be educated and can then avoid ineffective medications or treatments so that you do not have to suffer from adverse drug effects. Don’t get ahead of yourself though. See a doctor to have other causes ruled out first.

“Knowledge is power.” –Francis Bacon

Hair Transplants or Propecia

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

I have been on Propecia for 6 years now and have decided to get off of it due to potential unknown long term side effects and even short term side effects that I seem to notice more as I age(Libido, minor Gyno, etc). My question is how long do you recommend I go before I consult for a potential hair transplant since it is difficult to say what my potential future loss will be right now since Propecia did have a positive effect on my loss and I would have almost certainly lost more. Im currently 30 years old and have probably a Norwood 3V and more of a Norwood 2ish in the Temporal/frontal region which hasnt changed to much since I started Propecia. Ideally I would love to get a transplant now to basically keep my existing hairline(which im ok with even though its receded a fair amount) and fill in some of my vertex while I can still conceal it with exising hair but Im worried about not being able to plan correctly since I wont be taking Propecia. Any advice will be most helpful.

Thanks

You need to be evaulated. If you density is good and there is miminal miniaturization in the top (area between front and crown), then you may be a good candidate for hair transplants. At 30, your pattern should be evident when your scalp and hair gets mapped out for miniaturization. From that a Master Plan needs to be developed which will take into account your worst case hair loss scenario and then the supply/demand for hair transplants becomes a measurement to base a safe decision in the long term planning for any transplant process that you undergo. Stopping the Propecia is something that you should think carefully about, a lengthy discussion with your doctor to see how this decision may alter that long term plan I am talking about.

Iron Levels

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

Hi, my hair has been falling out for a few months now and has become thin around the temples and forehead, I also get an itchy scalp. I went to my doctor who ordered blood tests which show low iron stores of 19ug/l range (20-160) my iron saturation is 15% range (20-45) I have been taking iron pills and multi-vitamins for a month now. How long will it take to build up my iron stores and see growth in the thin areas. Thanks

From the iron studies, it appears that you have an iron deficiency, which may lead to hair loss. I am assuming that you are a woman, so please forgive me if I am mistaken. Bleeding causes iron deficiency and with your monthly blood loss, the iron must be replaced. Meat offers iron and is a good way to add iron to your diet. Iron deficiency can be from malabsorption if you have anything pertaining to diseases of your digestive system. Make sure you drink orange juice and Vit-C with iron to help with iron absorption. You need to continue to take your iron pill and repeat the blood work to see if your iron level has become normalized. Even then, it will take many months before your hair follicles respond with fuller hair.