Female Hair Loss After General Anesthesia

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

I am a 64 years old African American female. I had a Esophagogastroduodenoscopy procedure with general anesthesia on Jan. 13, 2014. Two weeks ago I noticed that my hair has started to thin so much that you can see right through it. My hair is already cut short because of Alopecia, however it was not thin in the places that grows. Now it is very, very thin all over. I am so disappointed because I already keep it barber cut in order for the thinner patches to be hidden. The last couple times I went to the barber, it took him 45 minutes to cut it because he had to take the time to try to get it blended enough to look decent.

Is there something that I can do to stop the thinning before I get bald patches again? Thank you for your help.

General anesthesia causing hair loss is unusual, but it does happen for some people. The hair loss could also perhaps be caused by the stress from the EGD procedure, which has been known to produce a temporary thinning called telogen effluvium.

You should really see a doctor who specializes in hair loss for an examination and a diagnosis.

Tags: anesthesia, hairloss, hair loss, telogen efflivium, stress hair loss

I Can’t Put Eczema Ointment on My Scalp, Because My Hair is in the Way

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

Hi, I’m a 20 year old Korean female. I’ve experienced some Trichotillomania but have recently been pretty good about not pulling. I also have eczema but that too is under control thanks to a few medicines. However, I cannot put the creams/ointments on my scalp due to my hair and that is causing problems.

My scalp is very itchy and flakey and when I brush it or even run my hands through it, more hair than usual comes out. Is there anything I can do to stop this?

If you’re looking for tips on how to apply your eczema treatment, I suppose the National Eczema Association would be the place to start. They have videos and other treatment tips here.

Tags: eczema, shampoo, ointment

Over a Month After My Hair Transplant, I Have Dried Pimples and Possibly an Infection (with Photos)

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

Hi Doctor,

I have been reading your blog and it is really informative, Awesome job by you. Coming to my concern, I had my HT done back in India in January 23rd 2014 and I see dried pimples like thing from last couple of weeks and they don’t heal. I am attaching two pics of my scalp. Can you please look at them and tell me if any infection has happened or does it look normal. If you examine pic_2 attached, I see some fluid like thing at couple of places near the graft. As, I can’t see the doctor back in India now, I need your help.

Thank You Very Much

Click the photos to enlarge:

 

It looks like you have crusting from the transplant (this is usually gone on our patients in a few days) and the crusting has caused an infection. You need to see a doctor and get this treated, even if it is not your transplant surgeon. You should wash your hair gently and get the crusts off, for as long as it takes to get a good wash.

Cleanliness is critical following a hair transplant surgery, and what I see is not a clean post-operative wound.

Tags: hair transplant, post-operative, infection

Will 5% Minoxidil Foam Work for Frontal Female Hair Loss?

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

(female)
I have intense itching from minoxidil 2%. A previous message by a woman said she had spots and fluid-filled blisters using 2% minoxidil. You recommended 5% foam. I looked at the box of the 5% foam and it is for the back of the head, not for the thinning in front. Will it work for frontal thinning?

Rogaine Foam may work on the frontal scalp, although the FDA recommends it strictly for the crown because it was shown to work best there.

If you have an allergy to an ingredient in the liquid that isn’t in the foam, that might alleviate your intense itch… but otherwise, if you have a sensitive scalp, the 5% concentration might not be the answer since it is stronger than the 2%.

Tags: rogaine, minoxidil, foam, scalp itch, hairloss, hair loss, female hair loss

Not Hair Loss News – Filth in the Spice Rack

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

Snippet from the article:

Some spices contain ingredients you won’t find in any recipes. The Food and Drug Administration recently found that spices entering the U.S. are nearly twice as likely as the average fda-regulated foodstuff to contain Salmonella pathogens or unacceptable amounts of filth. Roughly 12 percent of spice imports, which make up the bulk of the U.S. supply, exceeded federal limits on the “maximum levels of natural or unavoidable defects,” such as insect body parts and animal hair. In sufficiently small amounts, the fda reasons, such defects “pose no inherent hazard to health.”

Read the rest (and see the nifty visual aid) — Spice Imports Carry Lots of Filth

Around 170 insect fragments or 25 rodent hairs is the level required to be recognized as adulterated. I guess we should think twice before eating spice imports.

Tags: filth, spices, animal hair, insects

I’m Obsessing and Stressing Over My Hairline (with Photos)

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

ok, here is my situation. i am a 23 year old male. i am black and mexican and have naturally thin hair like my parents. about two years ago i noticed that the left edge of my hairline looked a little thin while looking in the mirror. i never really noticed it before so i began to obsess over it. i spend every day examining my head not really noticing any change some days. then other days i begin to think i’ve lost a lot of hair. i’m not sure what to look for in terms of a receding hairline. my dad is 48 and my grandfather is 76 and they both have normal looking hairlines for their age as well as my grandmothers on both sides of my family including my mother.

i have been obsessing and stressing non stop over this and its beginning to get depressing. i’m losing sleep over this every night because i cant keep my mind off of it. also the part of the hairline that runs downward on the sides of my head have always been at a slant for as long as i can remember. i’m not sure if that’s even normal or not. i’m not sure if i’m just making things up in my head or if my hairline is really receding.

please help me find some answers, please! here are photos of my head.. feel free to post them

Click the photos to enlarge:

 

Unfortunately, the pictures do not help me to help you. Even with the short haircut, it appears that you have a normal young man’s hair density, but a good examination for miniaturization (with a hand microscope) will show if there is any early balding.

What you might be noticing is slight hairline maturation, which is completely normal and nothing to stress about. You could do yourself more harm by stressing over possible loss, as stress could cause thinning.

Tags: hairline, mature hairline, stress

Reducing from 1.25mg to 1mg Finasteride

/by William Rassman, M.D./3 /

Hi Dr,

I have been taking 1.25mg of finasteride daily for about 5 years. My wife and I will be trying for a baby in the next year or so and I don’t want any chance of her coming into contact with finasteride powder while pregnant. For that reason I wish to switch from splitting a 5 mg pill to taking the 1 mg propecia tablet instead.

I have two questions:
1)Should I stop taking finasteride while trying to conceive?

2)Will reducing my daily finasteride dosage to 1 mg per day affect the management of my hair loss?

Many Thanks for your great blog.

Your first question is often asked of me (examples: here, here, here). There is no evidence that a man taking finasteride will produce an abnormal child as a result of taking the medication. I only know what I read and what the FDA publishes, so I can not advise you beyond that.

Your second question is an easier answer. There is essentially no difference between the 1mg Propecia pill and the 1/4 of a cut 5mg pill (1.25mg). The switch should be easy and seamless.

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

Transplanting Patients with Low Donor Density

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

Can clients with a low donor density get a hair transplants above 70% of their donor density? I for example got my first transplant and my donor density was only at 60 grafts per cm. Therefore the doctor transplanted 30 grafts per cm. For my second procedure, instead of focusing on the crown I want to increase the areas of where hair transplants has been already transplanted. So I want 45 grafts per square centimeter. Would I able able to add 15 cm per grafts in the same area or would that cause a failure ?

My crown is already bald, but I don’t care about that getting that area fixed. I just want more density.

You can add more density if the donor supply is there. People with low donor density can not cover large balding areas, as they just don’t have enough hair. I always warn patients not to be overambitious when it comes to filling in a bald area.

Tags: donor density, hair transplant, hairloss, hair loss

SMP Expectations — Touch-Ups and Fading

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

We received some Scalp MicroPigmentation (SMP) questions:

1) The results pictures on the website all seem to show everyone with shaved heads. Should I expect the ability to cut my hair that short after the procedure and not have the scar visible? or are those atypical, “best case” scenarios? I know there will always be some irregularity but the pictures show it being very difficult to discern. This isn’t a make it/break it question. I’d be happy to cut my hair down to 1/8″ without the scar visible. I just want to make sure my expectations are in line with reality.

2) Must I shave my head for the procedure itself?

3) If I do have my head shaved and I expose the SMP’d scar to the sun, will it fade?

4) Is the SMP permanent? Permanent as in, I do this once (the 3 sessions) and it lasts for 50+ years? Or is there an expected life span for the SMP?

1. The photos on the SMP website show most people shaved, because that is what makes the scar blend in with the stubble of hair and the flat pigment of SMP underneath your skin.

Keep in mind, if you get SMP for a scar, it is not hair and that there will be a “step” in the hair where there is a scar. SMP will only make the scalp darker so you wont notice the white line. If you keep your hair 1/8 inch long you may see the step of where the hair starts and ends. Most patients shave or buzz their hair around the scar with an electric shaver set at zero guard or they keep their hair long enough to cover the invisible scar. Everyone is different in their degree of how they hide the scar, but you must remember that you will always still have a scar. SMP only helps hide it to most casual observers. No matter how good we get your SMP, you will always notice the scar in certain lighting and certain angles… and you will notice it more because you know how to look for it.

2. You don’t have to shave, but if you are ever going to shave later it will help us blend it in better. We work with longer hair all the time (this is not an issue). It is when we finish the job with long hair and later you decide to shave it, you will notice some areas that don’t look perfectly blended in. So if you are ever going to shave it, we recommend you have SMP done with the area shaved, because that is how we get it almost perfect. If you are never going to shave, then it is not an issue.

3. SMP will fade with or without sun. UV light makes it fade a bit more, but it won’t erase. If you ever need a touch-up in the future because you think it has faded too much, the fee is $300.

4. SMP is permanent just like a tattoo is permanent, though you may want a touch-up in the years to come. In our experience over the last 4+ years, most people do not return for touch-ups. When we follow up with our SMP clients, we find that most say it has not faded to a degree to warrant a touch-up.

We’ve answered many more SMP questions on our FAQ.

Tags: scalp micropigmentation, smp, pigment, hairloss, hair loss, scarring

Xandrox Sales Stopped by FDA

/by William Rassman, M.D./7 /

Hi Dr. Rassman. How are you?

I don’t know if you have heard of Dr. Richard Lee from Regrowth LLC (www.minoxidil.com) but apparantly the FDA shut him down for selling what they consider ‘dangerous and illegal drugs’ aka: his Xandrox Line of specialty Minoxidil Products. I wonder how he could be forced out of business since he is a medical doctor, and correct me if I am wrong, but can prescribe drugs for off label usage. And why after 25 years of doing this they all of a sudden come after him???

What is your opinion on this and do you think it is the shape of things to come with regards to the FDA cracking down on buying drugs online or do you think that the makers of Rogaine saw him as a threat and applied pressure on the FDA to shut him down? (Conspiracy theory thinking I know! LOL)

Just curious as there are other MD’s doing the same thing as he did and yet they haven’t been touched…yet..Knock on wood!

Personally I think the FDA, in this particular case, are doing the public (balding men in general) a huge disservice because I believe thousands of patients relied on his products to keep their hair.

FDAI believe the issues the FDA had are with claims that Dr. Lee made about his products. Claims are under FDA control and every claim has to be backed up with good science, effectiveness, and safety testing. I think that playing by the rules just serves the public, helping to limit false representations and scams which are on the internet by the bucket full. Just because a doctor says it is legal, does not necessarily mean it is.

Minoxidil in itself is available in generic form, so I’m not sure the makers of the name brand Rogaine would make a stink about Dr. Lee selling it. Perhaps it had something to do with mixing prescription finasteride into a topical and selling it online? Perhaps it was the other ingredients and the claims attached that the FDA didn’t like? I have no idea. The shutdown isn’t a total shocker to me though, as I even mentioned that I thought there was a violation of the FDA rules well over 2 years ago (see here).

Tags: xandrox, richard lee, minoxidil, fda

Not Hair Loss News – UK Researchers Working on Test to Predict Deadliest Prostate Cancer Risk

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

Snippet from the article:

DNA testing can predict which men face the highest risk of deadly prostate cancer, scientists say. The team at the Institute of Cancer Research, in London, say men could soon be offered genetic screening in a similar way to breast cancer in women. They have shown 14 separate mutations can greatly increase the odds of aggressive prostate cancers, which could form the basis of a test. Prostate Cancer UK said such testing could “revolutionise” care for men.

Prostate cancer is the commonest cancer in men in many countries, including the UK – where more than 40,000 people are diagnosed each year. But not every patient has, or needs, invasive therapy that results in severe side-effects. Identifying which men will need treatment – those who are likely to develop the most aggressive and deadly form of the cancer – is a huge challenge.

Read the rest — DNA prostate test ‘will predict deadliest cancer risk’

Tags: research, cancer, prostate cancer

Permanent Redness in the Recipient Area After a Hair Transplant?

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

Have you ever encountered a situation where an FUT patient developed persistent redness in the recipient area after surgery that never went away? Have you ever encountered a situation where a patient developed Rosacea and/or Telangiectasia as a result of surgery which caused permanent discoloration of the scalp?

If this happens, what is generally the cause? And what is generally the ultimate outcome for these patients?

No, I’m not familiar with this occurring. I have never encountered a situation where a patient developed permanent discoloration of the scalp, such as rosacea (facial redness) and/or telangiectasia (spider veins) as a result of surgery.

When redness occurs it usually reflects sensitive skin, but it always goes away. Redness rarely lasts longer than a few weeks in the worst of cases. The one exception that I can recall was a patient that had redness to some degree last around 6 weeks, but that was unusual.

Tags: redness, hair transplant, rosacea, telangiectasia, skin discoloration

Do East Asian Women Have a Greater Chance of Developing Hair Loss?

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

Is female genetic hair loss/hair thinning more likely to start in early 20s if you’re of Asian (Korean) heritage? I’ve read that East Asian females have a greater chance of developing diffuse thinning than Caucasians.

No. I’m not aware of any good scientific studies that investigated women with hair loss by ethnic groups. We generally believe that hair loss does not discriminate race, sex, or ethnicity. In other words, it is mostly the same for all populations. You’re not at any greater risk than a Caucasian woman is if the genes are present.

Tags: asian, korean, hairloss, hair loss, female hair loss

Not Hair Loss News – More Than 120 Papers Published in Scientific Journals Were Gibberish

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

Snippet from the article:

The publishers Springer and IEEE are removing more than 120 papers from their subscription services after a French researcher discovered that the works were computer-generated nonsense.

Over the past two years, computer scientist Cyril Labbé of Joseph Fourier University in Grenoble, France, has catalogued computer-generated papers that made it into more than 30 published conference proceedings between 2008 and 2013. Sixteen appeared in publications by Springer, which is headquartered in Heidelberg, Germany, and more than 100 were published by the Institute of Electrical and Electronic Engineers (IEEE), based in New York. Both publishers, which were privately informed by Labbé, say that they are now removing the papers.

Read the rest — Publishers withdraw more than 120 gibberish papers

Great, now spam has infiltrated the science journals.

Tags: science, scientific journal