Burning Pain in Scalp

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

For the past 18 months I have had severe hair shedding/thinning all over my scalp. I also have had scalp burning pain for the same amount of time. I have seen 3 dermatologists and 2 neurologists who cannot explain the pain. I have been taking propecia since this first started and the hair shedding just keeps speeding up. All of my blood test results were in the norm for known hairloss associated problems. There is no family history of hairloss. Any suggestions would be greatly appreciated.

I don’t know of any disorder causing hair loss and scalp pain. Use of the Propecia can not explain this condition either. Inflammations of the skin can cause acute hair loss or anticipate the male pattern baldness in affected patients. I am not aware of all the actions that you had for diagnosis of your condition, but if I were you I would stick to a good dermatologist. You may need more tests and follow up visits to rule out rare situations that may present with these signs and symptoms.

Tags: burning scalp, pain, shedding, hairloss, hair loss, propecia, finasteride

Hepatitis B and Propecia

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

Hi i have Hepatitis B and it is InActive so i would like to know if it is safe for me to use Propecia?

If your hepatitis is inactive and your liver function is normal, then is should be safe to take normal doses of Propecia. Of course, check with your doctor… as I am not your doctor for purposes of medical advice to your situation.

Tags: hepatitis, propecia, finasteride, hairloss, hair loss

Steroids and Hair Loss

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

Does hair loss from steroids effect just the back of the head or the front hairline as well? Any idea what steroids are the easiest on the hair?

Steroids are bad news, not only for your hair, but for your body as well. It accelerates genetic balding where ever you are going to lose the hair. Most people lose hair in the front, so steroid acceleration may impact your frontal hair faster. I will not recommend one steroid over another.

Tags: steroids, steroid, hairloss, hair loss

Volumizing Shampoos

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

Hello

Could volumizing shampoos (increase of hair diameter) decrease the size of the passage down to the root and then make usage of other substances such as minoxidil penetrate less?

I’d say it’s probably not a problem as you’ve outlined it.

Tags: shampoo, minoxidil, hairloss, hair loss

Loose Anagen Syndrome (LAS)

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

Loose Anagen Syndrome (LAS), also known as loose anagen hair, short anagen syndrome, easily pluckable hair.

Loose anagen syndrome is rather a recently described hair loss disorder affecting predominantly (not exclusively) blond female children. It was first described in 1984. This disorder is characterized by easily and painlessly pluckable anagen hair, which have abnormal morphology. The mechanism of this disorder is not known, but abnormal keratinization of the inner root sheath is suggested. Its incidence is not completely known due to the under-reported cases, but it seems to affect Caucasian people more.

The disorder usually present as general thinning that haircut is never or infrequently needed. Clumps of hair could be removed painlessly during kid playing. This condition is not associated with any nutritional deficiencies and the growth of the affected patients (usually children) is otherwise normal.

In physical examination, sparse growth of thin fine hair may present as diffuse or patchy hair loss. Although hair is not fragile it could be easily and painlessly removed. Hair is usually unkempt and difficult to style. Hair in the other parts of the body is not affected. In microscopic examination the extracted hair are generally in anagen phase. Hair bulb is usually twisted with an acute angle from the shaft. The cuticle has a characteristic of rippled or baggy appearance.

Currently there is no treatment and regrowth is usually spontaneous although hair may never reach its normal length before it is shed.

—
References:

  1. eMedicine
  2. Tricological Society
Tags: las, loose anagen syndrome, hairloss, hair loss, pluck

Minoxidil 5% Regrows More Hair than Propecia?

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

Hello Dr,

I understand that you recommend propecia. Just for the debate i wanted to know does propecia regrow more hair or rogaine in those people these drugs work. I found the below article which shows that minoxidil 5% beats propecia in number of hair regrown hands down. Can you comment on it please.

https://www.haarweb.nl/forum/showthread.php?p=61654
Please scroll down in the thread.

Thank you for the blog

Thanks for the insightful link. I have been swinging to using a combination of minoxidil 5% and Propecia for men. It does appear that both is better than just one. I like Propecia because it ‘hits’ the underlying DHT component for hair loss in men, but one can not deny the building evidence of the value of higher concentrations of minoxidil. Clearly the use of both medications have issues of compliance. Twice a day use of minoxidil is the right approach, but this alone may be a problem for busy men, while Propecia in the morning is easier to use.

In conclusion, I believe that using both is best.

Tags: minoxidil, propecia, rogaine, finasteride, hair loss, hairloss

Hair Loss Near Area of Brow Lift 2 Years Earlier

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

(female)
I had an endoscopic brow lift approximately 2yrs ago, and now my hair has started to fallout in the area of the endoscopic surgery. I am also experiencing extreme tightness and a burning sensation under the scalp in this area of the surgery with hairloss. What can I do to stop this from occuring? Does this mean that there is nerve damage? Is there medication that I should review with my physcian that could alleviate the painfull sensation under the scalp and hopefully stop the hair from falling out? …Help!

Scarring and hair loss from a brow lift is something I see often. I may see more of this problem, not because it is common, but because I specialize in this problem. Hair loss and detectable scars are amongst the problems I treat. Small nerves are cut with certain types of brow lifts and these small cutaneous nerves which can produce pain usually disappear in less than a year (usually weeks to some months). Minoxidil may help hold the hair that is presently falling out. You might want to see me considering that you are in San Diego and Beverly Hills is only a couple of hours away.

Tags: hairloss, hair loss, brow lift, scar, endoscopic

Shedding from Rogaine Foam?

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

I started using Rogaine Foam 3 weeks ago and I’m concerned with the amount of shedding I’m experiencing. I’m well aware that shedding is supposed to take place when starting rogaine for 2 weeks to 2 months but it’s hard to look at the sink and instantly see 50 to 75 hairs sitting there each time I use rogaine. Which is twice a day. I have a mature hairline so I’m not really bald. I have always had really fine hair so that’s why I get concerned. I know people lose something like 50 to 150 hairs per day who aren’t having any hair loss issues but I’ll shed 100 to 150 hairs a day from the use of rogaine and that’s not counting the hairs that shed that I don’t see. When I look at my scalp, it don’t feel like it looks any different now with the shedding going on. But maybe that won’t be the case in another month. So I was just wondering if you think I’m shedding TOO much. Thanks

First, I would want to know what you are treating and if it is necessary to use the Rogaine. Minoxidil is reported by users to have a short shedding period that lasts up to a couple of months and it is believed to be the result of an acceleration of the hair cycling process. I can’t help you further without examining you.

Tags: minoxidil, rogaine, foam, hairloss, hair loss

Aggressive MPB vs Normal MPB?

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

Hello,

I was hoping you could explain to me what exactly is “aggressive” MPB versus “normal” MPB? How would you diagnose or differentiate between the two?

Thanks

You may be relating the rapidity of the loss that occurs with genetic balding. Some people bald faster than others and this is mostly a genetic process. To make sense out of your question, I would have to see you and examine you myself.

Tags: aggressive, hairloss, hair loss, mpb

Hair Growth Rates on Different Sides of the Head?

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

i notice the left side of my head including facial hair, even my sideburns grows slower than my right side. i shaved and i noticed more hair on the right side and significantly less on the left side… whats going on?

Honestly, I don’t know. It is not unusual for hair to grow at different rates, but… the entire side? Wait out time and see if it is a temporary problem. Quite interesting, and I wish I had more to offer.

Tags: hair growth, rate, facial hair

Scratching My Dandruff

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

age 27 Male
Hi, i have dandruff and when i go for my jogs my scalp really starts to itch, it gets intense sometimes… so i scratch all around my head really hard and fast which usually relieves the annoying hot itchy sensation. my question is, by scratching hard and vigorously on the irritated sections of the scalp could this cause any sorts of hair loss? right now its the only remedy that works and it feel good too.

Scratching at the same point can produce a form of hair loss called traction alopecia. See a good dermatologist and find out why you are itching soooooo much.

Tags: alopecia, traction alopecia, hairloss, hair loss, dandruff

Rogaine Questions

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

Hello Doc

I have a few questions about Rogaine,

  1. I know when I first start using it, I would suffer from a small cycle of hair loss, but do you think this lost hair is reversable once the medication starts to work??
  2. Do you think Rogaine is effective in stopping hair loss in the front?
  3. Would I be less likely to get a scalp irritation if I go for Rogaine 2% instead of 5%, and do you think they are almost the same in effectiveness?

Thanks for help

The hair loss that sometimes occurs with the use of Rogaine / minoxidil is believed to occur from the “resetting” of the hair cycle. This does not occur all the time.

I believe Rogaine is as effective in stopping hair loss in the front as it is on top or crown, but the drug company only studied the crown. The crown in many ways is a better target for it is often slower to lose hair there. Shorter term hair loss responds best to medications such as Rogaine or Propecia.

Scalp irritation from Rogaine may be due to two factors — the active ingredient in Rogaine itself (minoxidil) or the inactive ingredient in Rogaine. If you are allergic to the active ingredient, 2% or 5% would not make that much difference. If you are allergic to the inactive ingredient, you can try using Rogaine Foam, which has a different base formulation (with the same active ingredient).

Tags: rogaine, minoxidil, hairloss, hair loss, irritation, scalp

I Have Early Hair Loss at 19 Years Old — Should I Start Propecia Now?

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

I am 19 year old male, probably a Norwood 2-2.5 but not yet badly noticeable. If I start propecia now what are the chances that sometime in the future it will lose it’s effectiveness? I want to do somthing about my hair loss but I feel if I start propecia now, by the time I’m in my mid twenties it may lose it’s effectivness. Would it be wise to wait a few years before starting treatment due to my young age?

You need to see a doctor before starting any medication. I sympathize that hair loss can be emotional and stressful, but you will not know what you are treating without a good exam and a miniaturization study. I have an office in Newport Beach (where you indicated you’re from), so I’d suggest that you set up an appointment to see me or come to one of our free open house events and you will learn a great deal about the process and get examined. Assuming that you have the genetic hair loss gene(s), the earlier you start, the better. Propecia does not exactly lose its effectiveness, but what you see is that the progressive nature of hair loss just gets worse with age and even Propecia will eventually not stop the progression.

Tags: propecia, finasteride, hairloss, hair loss

Please Clarify Some Hair Loss Rumors…

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

Hi, I was wondering if you could put some rumors to rest that people always talk about in relation to hairloss. Thank you very much!

  1. Does hair gel, palmaid, etc.. cause (more) hair loss?
  2. If someone starts balding at a young age such as 18 or 19, is it almost certain that they will lose all their hair?
  3. When Propecia/rogaine cause cause initial shedding due to beginning the medication, will the shedded hair grow back if one stops the medication?

Thanks again doctor. I’ve heard a lot of rumors and wanted to clarify!

  1. Pomade (a greasy or waxy substance for hair styling) should not produce hair loss. Neither should gel.
  2. For those who start balding early and want to know what the future holds for them, if they get their hair mapped out for miniaturization and it shows a Norwood class 7 pattern of thinning, then the prospects for advanced balding would be a good bet. But if you have only frontal miniaturization, then you may not have evidence of going bald. Get yourself assessed by a good doctor and build a Master Plan (it sounds like a broken record as I keep advising this in all young men).
  3. For those people who go through a shedding phase with minoxidil or Propecia, the hair that is shed should grow back as the hair cycle completes into the anagen phase.
Tags: hairloss, hair loss, pomade, gel, propecia, rogaine, finasteride, minoxidil, norwood

I Was Told Hair Transplants Wouldn’t Grow in Scars from Severe Burns

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

Doctor:
I am a 17 year old male. At the age of 2, a boiling pot of water fell all over my body and left significant scars in my arms and head. About 1/3 of my hair is missing on my scalp; hair fails to grow in the maturing scars of my burn. Consultations with different doctors have concluded that it is not possible to get hair transplants in scars caused by severe burns because the hair will fail to grow. The only option I have is tissue expansions, but this seems like a lengthy and discomforting process. I would like to verify if it is true that hair transplants will not continue to grow overtime on scars caused by burns. Is this true? Does it depend on the scar? Are there other factors? Thank you.

Hair transplants will grow in some scars better than other scars. It depends how much infrastructure is in the skin (fat, blood vessels, stem cells, etc..) I have seen remarkable results from tissue expansion for large areas of scalp burns. The results are better with tissue expansion and as such has no comparison. Also, the course for tissue expansion is much shorter than transplants. Be open minded.

Tags: scar, burn, hairtransplant, tissue expander, expansion, hairloss, hair loss