Son Was Born with a Bald Spot on Side of His Head

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

My son was born with a 2″ diameter bald spot on the side of his head (near top). He’s 5 years old today and still has the spot. I’m concerned that this spot will soon be the object of curiosity and teasing by his classmates. What’s the best way to help him with this little difference? Is he too young for transplants?

Small bald areas such as a birth mark or a scar can easily be addressed with hair restoration surgery. Hair transplants or expanders may be appropriate for him.

From a long term perspective, the surgeon who fixes this must also take into account (since he is a boy) whether he will ever be affected with male pattern (genetic) hair loss when he is older. While looking at his father/mother/grandparents may offer a clue, it is difficult to predict male pattern hair loss at such young age since the genetics don’t follow predictable patterns. At best, he should have a formal consult with a qualified surgeon.

Tags: hairloss, hair loss, scar, bald, spot, child

Any Theories About MPB?

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

Hi,

I understand there’s a lot to be discovered about MPB, which is demonstrated by the effectiveness of certain products that can regrow hair in some and not others. Obviously everyone reacts differently but I dont think it’s an overstatement to say something is missing from the equation. Do you have any theories or guesses of your own for what the medical community has yet to prove or discover about MPB? Thanks.

You are correct, there are missing pieces of the puzzle. With years of research and billions of dollars spent on finding a cure for thinning and balding people, we have little to show for it in either new treatments or a better understanding.

Tags: hairloss, hair loss, mpb, research, funding

Left Corner of Hairline Maturing Faster Than Right Corner

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

dear docter,
I am an 18 year old male who noticed a “somewhat” maturing hairline. I took the measurements you stated and the front part of my hairline and right corner match (1-1 1/2 in.) My concern is my left corner is possibily thinning. When i push up the left corner of my hair i see some thinned hairs and some scalp because the hair weaves in oppisite directions when i push it up. I am concerned if the left corner will continue to thin and shed and lead to MPB thank you docter

We do not bald symmetrically and it is not unusual for one side to go faster than the other. The same is true for the maturation of the hairline — initially more on one side than the other. Eventually the slower side will catch up. You should get your hair mapped out for miniaturization to get a diagnosis and find out if you are balding or just maturing your hairline.

Tags: mature, hairline, miniaturizaton, hairloss, hair loss

Safe to Take Accutane and Propecia?

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

Please help! My doctor advised I take accutane for severe acne and Propecia for hair loss. Is it safe to take both of these medicines at the same time? Thank you!!

The use of these two medications will not interact with each other. Be aware that Accutane does have hair loss as one of its side effects.

Tags: accutane, acne, hairloss, hair loss, finasteride, propecia

Traumatic Event Kick Started Hair Loss in My 30s?

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

I am a 32 yr-old male. No one in my immediate family has any signs of baldness. I experienced a traumatic event about 9 mos ago, and have noticed hair loss since, including fast recession/thinning on the front left side. Is it possible for one event to kick start balding which doesn’t stop even long after the event?

You probably have some genetic defect producing hair loss that has skipped generations. Stress is known to kick in the balding process. First, of course, you want to be checked out by a doctor to be sure that there are not medical conditions behind it.

Tags: stress, hairloss, hair loss, trauma

DHEA in Multi-Vitamin

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

I saw on your site that DHEA can trigger baldness. I did not realize the multi-vitamin I took had it. If I stop taking the vitamin, can I stop the new baldness (if indeed DHEA caused it) or am I doomed forever for those few months I took the vitamin?

Stopping it won’t hurt. I doubt that your short run with DHEA will cause long term effects, but what you lost may not come back.

Tags: hairloss, hair loss, dhea, vitamin

Hair Loss is Causing My Depression

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

I had beautiful hair my entire life. I received compliments weekly on it; it was that nice. I took SYNTHROID for 6 months when my thyroid problem was only borderline and I should NOT have taken it. 99.9% of the subsequent doctors said I should not have taken it. My hair changed completely. I took the drug MAY 05 through NOV 05. It changed the texture, the thickness, I now have a see-through head of hair (especilally on top) and I am depressed. I saw 35 doctors, 2 trichologists and 1 supposed “expert” who said I was in the shedding phase and it would stop. After 16 months, he said it was “long” but would go back to normal. Not true. Has not happened. My life is not the same and I quit my job over this. I haven’t worked since. I have been taking sulfur and fish oil gels every day – the hair was holding steady but still bad until OCT 2006 when things hit the fan and the top got super thin and fallout was twice as bad. I am scared I will be bald and never have a life again. I feel like a monster. My marriage isn’t too great either due to my unceasing depression. I need to be in a study group or with a group of scientists who study hair. I cannot go on. Please…help. Thank you.

Synthroid could be a cause of hair loss. If it was the only cause of hair loss in your case, it should have been reversed with stopping the medication by now. Since you stopped taking it more than a year ago and did not grow your hair back, you must have some other factors involved and thus need a thorough evaluation.

It is proven that hair loss can increase the level of anxiety and cause depression in several studies that have performed in Europe (see PubMed – Psychological aspects of hair disease). The only thing I can recommend is a medical evaluation to have a proper diagnosis. You need to get started on appropriate treatment with a hair specialist. Diagnosis of hair loss is not always simple and it takes a great deal of patience on your part to work through diagnosis and the slowness of treating the problem. You must have a good doctor to do this with. Good luck.

Tags: hairloss, hair loss, depression, synthroid, depressed

My Father Started Receding at Age 50

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

I read your comment reccommending a 15 yo guy to wait until he’s 30 to see if he has hair loss then decide on a hairline lowering surgery. I am 31 and am considering the surgery to shorten my long forehead. I am not really sure if it is receding (must be really slow if it is), though my father’s did not until he is 50. Did you imply that hairline is not likely to recede (at least not quickly) after the age of 30?

Thanks a lot!

A receding hairline after the late 30s is unusual, but it happens. You may take after your father and recede later in life. Using Propecia is one thing that allows you to be more proactive about hair receding, rather than waiting for completion of the hair loss, but you must have a proper diagnosis so that you know what you are treating if you elect to do something about it. This way you can prevent future hair loss to some degrees, at least on the top and crown area, and take care of the frontal hairline with a hair transplant.

Taking medication before the process starts on the expectation of hair loss is certainly not something that I would recommend for my young readers who worry about what might happen to them. A long forehead (high forehead) is easy to treat with hair transplants and wonderful results are a reasonable target. You can see many, many patient results in the New Hair Institute Patient Photo Galleries.

Tags: hairloss, hair loss, hairline, photos, hairtransplant, hair transplant

Sores on Back of Head

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

In the last 6 months my dad, age 62, has developed sores on the back of his head. They get very sore and drain some kind of puss that smells and he just keeps getting them. It starts around the occipital bone area and goes up to the parietal bone area. I have discovered one bald area about in the middle of parietal area, which has only occurred in about the last 2 months.

I would really appreciate any information you may have. Thanks so much.

Your father needs to be seen by a physician. By his history, I would guess that he may have had an infected sebaceous cyst. A skin cyst can get infected and turn into an abscess cavity. The infected cysts usually drain on their own if not treated. Any kind of infectious or inflammatory process can cause reactive hair loss in the immediate scalp skin. In most cases, hair loss is reversible and does not need any intervention, but I have seen the hair defect permanent in a few patients. Your father needs to first ‘see a doctor’, then expect to wait a good 6 months before findoug if the balding spot clears up. If there still is a bald spot after 6 months of observation, he may see a hair specialist for further diagnosis and treatment, including a limited hair transplant by the end of a year with no hair growth.

Tags: sore, cyst, hairloss, hair loss

Hair Loss After Anesthesia

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

Dear Dr. Rassman,

Im a 22 year old male from San Jose. I went to your NHI office when I was 22 and I was told to start taking Rogaine and propecia. It worked. However, in november of 2006 I had eye surgery under general and local anesthesia. Since then my hair has been falling out like mad. I was wondering what is the average time for this fall out to cease and will the hair I regrew on rogaine and propecia come back?

Hair loss is caused by four factors:

  1. genes (for the genetic defect)
  2. hormones (produced normally from the testicles)
  3. time (the longer the hair follicles are exposed to the hormones, the progressive nature of the hair loss will demonstrate itself)
  4. stress

Your surgery and anesthesia cause enough of a stress to accelerate your hair loss. If you are on Propecia and it still happened, you are now entering another phase of the hair loss process. It may not come back, but you should come back to see me and we will analyze this together.

Tags: hairloss, hair loss, stress, anesthesia, propecia, finasteride

Hair Damage from Hot Straightening Iron

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

Hi, I have caused extensive damage to my hair through the use of a hot straightening iron. I am a 31 year old male who had minimal recession at the front and thick hair all over. My hair is now damaged and thinned all over from the hot iron and has recessed at the front dramatically in 6 months due to the damage. I have regrowth coming through but not really at the front from the damage. Is it wise to start propecia at this point I’ve stayed off using it waiting to see where the hair may grow back but after 6 months have not seen much at the front.

Thanks

You need a diagnosis as to the degree that genetic balding may be present. I would want to know where the damage is — is it limited to a particular area? There are many things that an examination of your scalp would show me, so rather than shoot from the hip, I would suggest that you go to a hair expert or dermatologist to work through the problem with you. It sounds bad, too serious to be treated over the internet.

Tags: hairloss, hair loss, damage, burn, iron

Hair Loss Starting Sooner Because of Stress

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

Regarding the possibility that genetic hair loss can be induced to start sooner because of stress…

Ok Doctor Rassman, But is that a fact or just a guess from you??

I have been through a psyicological problem a few month ago and had hair loss as a result, I thought it was male pattern hair loss and I was about to start using a medication (and i’ve contacted you before asking for medications), I went to Egypt to see a good dermatologist named Dr. Mohamed Nada, and he strongly recommended that the hair loss I had was due to that psycological problem and was because I was stressed and depressed and he also told me that this hair would reverse in 6 months ( im not losing hair like before now and im getting over that problem). I told him I have a family history of hair loss but my father went balding in mid his 30s and im 21 now, thus he was like your male pattern hair loss will start at the same time your father went balding ( assuming that if i have it in my genes), and this hair loss can never be helped by your genes so no need for any medications.. Im really confused about what to do now cuz your reply was totally different to what he told??

any suggestions about what to tell him on my next appointment, I will see him in 4 months from now.

Thank you

Inheritance does not always follow your father’s or your mother’s father’s pattern. But let’s assume that you do have the genetics for hair loss. Stress will accelerate the process. When you have genetic hair loss, what you lose will not usually reverse, so I disagree with your doctor from Egypt. You need to make a diagnosis by mapping your hair for miniaturization and then if you do have hair loss, the use of finasteride 1mg/day is probably the best way to slow it down.

Tags: stress, hair loss, hairloss, inheritance, genetic, gene, finasteride

Using DermMatch and Couvre with Seborrheic Dermatitis

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

Dr Rassman

I’m considering to try “Dermatch” and “couvre” . My concern is that i have a chronic seborrheic dermatitis condition on my scalp . Do these two products have a negative effect in conditions such as mine ? Let me also tell yoy that i shampoo daily using Nizoral 2% , ,a salycylic acid shampoo( Node Ds) and occasionaly Betadine.

I would deeply appreciate it if you could mail any reply

Thank you very much for your time

There should be no problem with the use of both of these cosmetics with seborrhea.

Tags: dermmatch, couvre, dermatitis, seborrhea, hairloss, hair loss

Loestrin and Female Hair Loss

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

I’m confused about birth control – please help! I started taking Loestrin 5 weeks ago and noticed 2 weeks ago I’m losing lots of hair. I figure it’s due to the start of the birth control. So I’ve been reading up on it and find conflicting information. Can you tell me if I should stop the birth control or stay on it, hoping the hair loss will stop on it’s own (that’s what my doctor recommends). Does birth control CAUSE hair loss or does it HELP to keep it from happening? I can’t decide if I’m making it worse by continuing my birth control. Currently, I’m taking it, recovering from having a baby 9 months ago, and taking Rogaine per the advice of my doctor, to speed along hair growth. She feels it’s temporary and it will grow back. Any advice?

Birth control pills contribute to hair loss in some women. The decision to take it with that side effect, should be something between you and your doctor. Sometimes, other birth control pills may have less hair loss effects, but you need to discuss this with your doctor.

Tags: bcp, birth control, hairloss, hair loss, loestrin, female, women, woman

Experiencing Propecia Side Effects for All 9 Months of Use

/by William Rassman, M.D./5 /

Hi Dr. Rassman,

I am a 26 y/o male who has been taking propecia for about 9 months now. I have been experiencing sexual side effects for the whole time I’ve been taking the medication. I have read in blogs/articles that the side effects tend to go away after prolonged use. If they were to go away, would they be gone by the 9 month point?

If they should have been gone by now, I have no choice but to decrease the dosage to .5mg. Why do you recommend being off the drug for 2 weeks before switching to the .5mg? I understand that its b/c you want to side effects to go away before switching….but will the side effects not go away if you switch immediately from 1mg to .5mg and continue to take daily?Can you please explain the rational behind this b/c I am afraid of losing more hair by not taking the medication for 2 weeks. Please respond Dr. Rassman, these sexual side effects are depressing me quite a bit. Thanks for the help.

BananaThe sexual side effects associated with Propecia are generally temporary. Taking 1/2 the dose may also alleviate the side effect. Taking 1/2 dose is 70% as effective and it is certainly better than taking no finasteride.

Before considering changing any drug regiment you need to discuss this with the doctor that prescribed you the medication. You may have another medical problem unrelated to the use of Propecia that is causing your sexual side effect. Some men can not get over this sexual side effect problem and then for a good sex life, they would not take this drug. Minoxidil is a reasonable alternative in such situations.

The purpose of stopping the medication for two weeks is to determine if Propecia was what was causing your side effect. In theory even this method is flawed, because of the placebo effect.

Tags: finasteride, propecia, hairloss, hair loss