I am sure you guys see a lot of patients, and I just read an article on CNN about a site that lets doctors complain about pushy patients. Do you have any horror stories about patients that gave you a hard time? Here’s the article: Are you giving your doctor a headache?

From my regular reading of this blog I can tell there are plenty of people out there that fancy themselves as “experts” when it comes to hair loss and love to show off their armchair medical degrees that they earned by surfing the web for a few hours. Its great to try to learn as much as possible about various problems one might have, but at what point does it become a headache for you when the person insists a medication is causing their issue or insists that their hours of research are more accurate than your many years of treating patients in person?

Thanks and keep up the great work!!!

People are people and they come in all personality traits. As a doctor, you expect to see a wide variation of patient personalities, and if you didn’t, you should not be a doctor. I demand that doctors treat every patient with dignity and respect. If a patient does not behave properly or is disruptive to the goals of a first consultation, I use my people skills to try to end the interaction with a frank discussion that maybe we (doctor and patient) are not compatible. This has been very rare for me to find such a patient.

What usually happens is that if there is a patient who is upset about their hair loss circumstances, or afraid of an uncertain future, or were treated with less than proper respect, or achieved less than the results than they expected from a surgery with another doctor, then my job is the communicate with them. Many times what is thought to be a difficult patient, actually turns out to be a patient who is just afraid and if I take the time to listen to them, I almost always calm them down.

I believe that all people deserve the best efforts I can manage and I approach everyone that way. Sometimes I look back upon the interactions with patients and laugh to myself at the happenings. I remember one patient, for example, who had a hair transplant with me and the next day came in with a poster sized blow-up of his transplanted scalp with individual pins placed into every graft in the head that he could see. He claimed that I cheated him and overcharged him for the number of grafts that were given to him the day before. I sat down calmly with him, showed him grafts that he did not see (no pins in the picture) and suggested that he come in another day so I can show him a live surgery and demonstrate why the picture did not really show the actual hair graft count. He did just that and everything was fine after. Especially difficult patients produce difficult challenges and it is the doctor’s job to address the needs of the patient, always.

Hi,

I’m a 22 year old male, for the last 6-7 years I have been losing a lot of hair per day. For example, when I go in the bath it’s absolutely filled with hair 400-600+ strands when I get out, same in the bed every morning. It’s much more than the “50-150” people estimate as normal loss.

I’ve always had a receded hairline but overall it doesn’t look any thinner or more receded than it did when I was a child (even pictures when I was 6-7 it looks the same as it does now). My hair started greying when I was 12 and I’ve been dying it every few months for the last 9 years.

Once hair loss speeds up to a rate I’ve been experiencing is it likely to ever slow down again, either naturally by itself or any medication? It’s rather embarrassing staying over at somebodies house and waking up with their bed covered in my hair. I’ve been to a dermatologist twice, the only advice they offered was to stop dying my hair for a year (which I did and it made no difference) and that they wouldn’t recommend I take propecia. Any advice would be appreciated, thanks in advance.

I can’t give you any advice, because I do not know what is going on with your hair loss. You need a good physical examination and a diagnosis. Miniaturization studies and bulk measurements at different areas around your scalp may shed some light.

You’ve already been under the treatment of a physician, so I’m not sure what I could offer. Why wouldn’t your doctor recommend Propecia? If you’re a young man with hair loss, Propecia might be your best shot. With respect to greying, I do not believe it has any association with hair loss.

You can not lose 400-600 hairs per day without becoming bald quickly. Just do the math. The average man has 100,000 hairs on the scalp… so that means that you would lose every hair on your head in 167 days if you have an average hair density.