UV Rays on the Scalp

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

Dear Dr,

I am having UVB treatment for chronic eczema on my body. Should i be protecting my scalp from the UV rays? The sessions are short and only 15mins max. Right now i am on 54 seconds.

AustraliaUV exposure does impact the skin. Dr. Richard Shiell in Australia believes that he gets less hair growth from transplants on the right side of the frontal hairline in his patients due to sun exposure from those who do a lot of driving. In Australia, they drive on the left side of the road and therefore get more sun exposure to the right side. If he is correct in his observation, UV exposure can damage the skin. There are two areas of potential damage:

  1. To the skin and the growing parts of the skin
  2. To the blood supply of the scalp

At the dose you are taking, it may not be a problem, but I would check with your doctor and find out from the source.

Tags: scalp, uv, ultraviolet, hairloss, hair loss, eczema, uv rays

Dutasteride and AndroGel

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

Hello Doctor!

I have recently been diagnosed with having low testosterone and my doctor has prescribed androgel (I think that’s the name). I am currently taking .5mg of Dutasteride. Will the Dutasteride reduce the chances of hair loss from the Androgel? Thanks!

AndroGelIt may, but I would discuss your concerns with your doctor, as it seems you have other medical conditions that need to be addressed.

Dutasteride will decrease your DHT level and may compete with the 5 alpha-reductase enzyme that the DHT attacks, but AndroGel will increase your testosterone level, which may increase your DHT level. So what does this all mean? To me, it means that the block created by the medication will still work, but in medicine, things are not so simple and binary so I can not tell you the degree of offset that the AndroGel will cause.

Tags: dutasteride, avodart, dht, hairloss, hair loss, androgel, testosterone

In the News – Glaucoma Drug Grows Long Eyelashes

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

Snippet from the article in the NY Times:

Call it the Great Eyelash Coup. In November 2007, at the request of the Food and Drug Administration, United States marshals seized 12,682 tubes — about $2 million worth — of Age Intervention Eyelash, a lash enhancer then sold by Jan Marini Skin Research. The F.D.A. considered it an “unapproved and misbranded drug” in part because it contained bimatoprost, which is approved for glaucoma treatment but not for cosmetic use.

Since 2001, ophthalmologists have found that hair growth was a side effect. Others included optic-nerve damage and blindness — hardly worth the risk if you didn’t have glaucoma.

Read the full article — Longer Lashes in a Tube? Maybe Not

The price we pay for unapproved drug experimentation may be more that you ever thought possible. There was another article about bimatoprost (which is the active ingredient in Lumagen) back about 8 months ago that I mentioned. And there’s another drug, latanoprost (Xalatan), that seems to have similar effects on eyelashes (see previous post here).

Tags: bimatoprost, eyelash, glaucoma, lumagen, latanoprost, xalatan

My Hair Fell Out After Brow Lift Surgery and Regrew With Different Characteristics

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

(female)
Dr Rassman,

After having a brow lift type surgery ( no lift but same incision ) a lot of hair all over my head fell out. What grew back were strange hairs. Some are very fine only about 3 cm long, and look crimped. Others are thick coarse hairs that look like afro or pubic hairs. Together these hairs are all over the crown and have been growing this way for about 4 years now. My Dr said these hairs have nothing to do with the surgery but they all started a few months after the surgery.

I am 99 % convinced that they are related and would appreciate any information you might have. Also some of the coarse hairs have are less so closer to my scalp, that would indicate that time is possibly helping a bit. The very fine ones have not changed.

With Kind Regards

I have not seen this type of change associated with a brow lift incision. I have seen hair loss with a finer hair appearing in front of the brow lift incision, but I have not seen someone change variable parts of the scalp hair and not other parts. I would have to examine you to make sense of the process you are discussing. The use of good conditioners after washing should minimize the kink in the hair.

Tags: hairloss, hair loss, brow lift, surgery, regrowth, kink

Head Fungus is Now Gone — How Long Until Hair Grows Back?

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

My daughter has recently recovered from head fungus. The spot where the fungus was is bald. I would like to know if the hair will grow back?

It seems the fungus was serious enough to cause hair loss. I would give it a good 6 months to a year before the hair grows back. Generally, it should grow back if the underlying infection has been treated.

Tags: hairloss, hair loss, fungus

It Feels Like Bugs Are Crawling on My Scalp

/by William Rassman, M.D./22 /

My scalp consistently feels “weird” (i.e. like bugs are crawling around on it). I know this might sound strange, but I am always having to itch my head because it just never feels normal anymore. This has been going on for the past three years and sometimes I can deal with it, but most of the time its annoying me. Do you have an explanation on this?

Any response is greatly appreciated.

Maybe there are bugs crawling on your scalp. For example, head lice or mites can be small enough where you may not notice by just looking in the mirror. I would see a doctor for a good examination.

Tags: bugs, lice, mites, hair, scalp

22 Year Old Man Woke Up With Half an Eyebrow Missing!

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

Hi there,
Ive had a look through your website and found some of the information useful, however, most of it seems to be directed to women (regarding eyebrow hair loss). im a 22 year old male who woke up one day to find half of my right eyebrow missing (unfortunately not due to some prank by my housemates) its been like it for about 3 months and is really concerning me, im thinking its probably apesia but im not sure, what can i do to reclaim my precious eyebrow??

EyebrowsI do not know what “apesia” is. Google search shows it is a place in the country of Cyprus. Perhaps you meant alopecia — which just means hair loss.

Hair loss in an eyebrow may be caused by such diseases as alopecia areata along with a variety of authoimmune skin disorders. The most common cause is trichotillomania. You need to see a dermatologist and wait out the process.

With respect to hair transplants to the eyebrow, it is a good solution for people with eyebrow defects (hair loss), but in your case as the history makes no sense, treating it without a diagnosis is not appropriate. Could your housemates have pulled out your eyebrow while you were drunk? Start there! Perhaps the biggest prank they pulled was not telling you it was a prank the first time you asked.

Tags: eyebrow, hairloss, hair loss

Can Hair De-Miniaturize?

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

Hey Dr. Rassman,

I like your site and all the time you devote to it to help the readers. I have a little bit of miniaturization going on at my temples (I’m 20). I went and saw a hair transplant doctor and he explained to me the process of the “mature hairline” (although he didn’t call it that). He also said that sometimes hair can miniaturize and then come back again (de-miniaturize) healthy on its own in young men as they grow. I was just wondering what your professional opinion was on this statement. Would you agree? Have you seen that happen? Thanks for your time.

Generally when miniaturization occurs in men, it is permanent if it is associated with genetic hair loss. If the miniaturization is part of the maturing hairline, then this too should be permanent. Miniaturization caused by DHT and genetic balding will not reverse on its own, but may reverse with finasteride (Propecia). I do not believe that there is spontaneous reversal of miniaturization in the genetic process, at least not in most of the miniaturization seen in men. With regard to women and miniaturization, the same rule may apply, but we unfortunately do not have enough information to make certain one way or the other.

Tags: miniaturization, dht, hairloss, hair loss, hairline

Preliminary DHT Sensitivity Test?

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

Dear Dr Rassman

I have read with interest your website and would be keen to ask you the following.

You state that if hairs are not DHT sensitive, medications such as Propecia will not help. Effectively the most probable medication a doctor or dermatologist does prescribe is right Propecia or Minoxidil. But at this point I wonder whether there are some preliminary tests on the scalp or the hair someone might do before even trying with these medications. In fact, if someone wants to know whether his hairs are DHT sensitive and so whether a medication like Propecia would work, what kind of tests would you recommend?

Thank you for your time. With kind regards

There are no tests that I am aware of to test for dihydrotestosterone (DHT) sensitivity or to test for effectiveness in DHT blocking with Propecia (finasteride 1mg). If you are a male and balding with a typical male balding pattern, DHT is likely responsible and Propecia will likely help… but I suspect DHT is not 100% responsible for male pattern baldness, as genetic and biological processes are not so simply constructed. More importantly, try to look at the problem more practically. You may be very sensitive to DHT or not very sensitive to DHT, but even a little finasteride is worth a shot at slowing the balding process when you have nothing but hair to lose.

Tags: propecia, finasteride, hairloss, hair loss, dht, sensitivity

My Newly Placed Grafts Are Itching Like Crazy!

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

I have just had a hair transplant on Tuesday 1st July, so only 2 days ago. I am itching where my grafts are placed and i know it takes about 7 days before i can touch them incase they come out. it is driving me mad, with this itching, is there anything i can put on or you can recommend please. Thanks

While I am flattered you’d turn to me for advice, I am also shocked how there seems to be no relationship between a patient (you) and his doctor. This is a perfect question for the doctor that performed your surgery!

In general, you can touch your head or lightly tap on it to alleviate the itching. Please follow up with your doctor. There may be other issues (aside from general itching) that may be causing your problem. I really don’t know, as I was not your surgeon.

Tags: itch, hairtransplant, hair transplant, hairloss, hair loss, graft

Tattooing Your Scalp to Get a Buzzed Hair Look?

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

Hi, I was wondering if it would look natural if a person with a norwood 5, shaves their head and tattoos the balding portion of the head (in an attempt to regain a shaved norwood 2 look.) Also, when you tattoo the balding portion, would it promote hair loss in the non-balding parts?

Most people who have their scalp tattooed just can not replicate the appearance of a crew cut head of hair. I’ve seen this tried before, and to be honest, the majority I have seen look distinctly abnormal, with one exception: a patient that was able to artfully replicate a short hair cut with a temporary tattoo which he reapplies every few days. While tattoos could potentially cause hair loss (if there’s infection, for example), they more than likely won’t.

Tags: tattoo, scalp, shaved, hairloss, hair loss

Prescribing Propecia Online?

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

Hello,

I was wondering if you are able to prescribe Propecia to people such as myself who are far away. Thanks for your time.

I need to see you and examine you before prescribing Propecia (finasteride 1mg). I believe that what you are asking of me is against the law, at least in California and thirteen other states. See FDA.gov – Buying Medicines and Medical Products Online FAQs for more.

Tags: propecia, finasteride, online, prescription, doctor, hairloss, hair loss

In the News – Testing Hair to Detect Breast Cancer?

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

Snippet from the article:

An Australian company called Fermiscan is in the process of developing a test that could possibly identify a person with breast cancer using about 20 strands of their hair.

The Fermiscan test has shown a 69% accuracy in detecting breast cancer. A study published in the Journal of the American Medical Association showed that mammograms or ultrasounds showed no greater than a 50% chance at detecting breast cancer, and a 78% detection rate when the two were combined.

Read the full article at InventorSpot.com.

Tags: fermiscan, breast cancer, cancer, hair

Man with Female Pattern Hair Loss or DUPA?

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

Hi,

What could cause a male to have slightly thinner donor zone hair than on the top of his head. Most people can’t tell I have thinning hair, but the top is a little thicker than the sides. Even my barber has said so. The only strange thing is I have been buzzing my side and back to a number three every 2 weeks for 15 years.

Also, there was a post a few days ago about questioning if dupa was real. I’m confused: what exactly is the difference between a male with a female pattern and someone with dupa? I mean they are discribed exactly alike. Diffuse thinning throughout the whole scalp, but you said fpb is NOT dupa?

If you have thicker hair on the top than on the sides and back, well, I would assume that you were born that way. We could record the differences in densities and confirm that observation if you like, but measurements are the key to the validity of that observation.

Diffuse unpatterned alopecia (DUPA) is generalized thinning of the entire scalp hair and presents that way in men. Women also may have diffuse unpatterned thinning as a presentation of their genetic balding and it may look similar to DUPA in men. Female pattern hair loss may not be uniformly diffuse, while DUPA is more uniformly diffuse (though still unpatterned). Both men with DUPA and women with classic diffuse genetic unpatterned hair loss may have similar mechanisms behind it, but the science is unclear to me as an expert. It is easy to get confused, and I’ve rewritten this response twice trying to make myself more clear. Medicine is a descriptive science and therein lies the problem.

Tags: dupa, diffuse, alopecia, hairloss, hair loss

23 Year Old Running Out of Donor Hair After 3 Hair Transplants!

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

Hi i started balding when i was about 19 and now i am 23. I have had 3 transplants within that time period and have got some coverage on the front of my scalp, but it still is thin and it makes my forehead look big. My problem now is the crown is balding and i don’t think i am going to have enough donor hair for the crown. Is there something else i can do or what do you think my best option is because it still is thin in the front but is getting alot worse on the crown. Thank you

You may be in big trouble. I would want to know things like:

  1. What was your Master Plan for hair loss?
  2. Did your doctor tell you about the possibility of running out of your donor hair?
  3. Were you led to believe that you could get all of your hair back with good coverage?

Regular readers of this site may notice that I’ve written time and time again about the problem with transplanting younger men with early hair loss — and it is for precisely this reason. I am concerned about a 23 year old (who is probably still balding) asking me a question like you did. If you ran out of donor hair (or are about to), then you need to sit down with a really good doctor (hopefully you have one) and get some basic answers to questions about your future. An in-person exam with an expert is key for you right now. You should be worried.

Tags: hairtransplant, hair transplant, hairloss, hair loss, age, surgery, donor