Sarcoidosis and Female Hair Loss

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

I am an African American female who has been diagnosed with Sarcoid of the skin. I have since lost 85% of my hair and it is NOT growing back. When I was first diagnosed, I would see these scaly flaky spots which would peel away (along with my hair). By the way, I am also taking Prednisone to treat my Rhumatoid Arthritis. I would however like very much to have my natural hair as the wigs are hot, unnatural and unattractive.

There is no cure for sarcoidosis. Treatments sometimes exploit the use of systemic and topical steroids. Local steroid injections into specific lesions sometimes help; the use of methotrexate (an immunosupressive agent) also helps in some people. I have little experience in this awful disease. You need an expert in this arena for treatment, but don’t blame your doctor if the treatments do not work.

Tags: sarcoidosis, sarcoid, hairloss, hair loss, prednisone, steroid, female, women, woman

Chemical Relaxer Causing Itching and Scaling of Scalp

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

I am an African American female, and I used a chemical relaxer on my hair. Within a few days I had excessive itching and excessive scaling. The results are all over my head. Can you tell me what this could be? Chemical burn? Dandruff? Not sure. I applied Sulphur 8 to mu scalp to control some of the itching. It has helped a little, but if I tough my scalp the itching starts up again. The itching seems to get bad about 3-4 days after I wash my hair.

So, my questions are: What could this be, and how should I remedy the situation? Also, does this seem sever and should I get a doctor involved?

Thank You.

A chemical relaxer is, well, a chemical. Any chemicals can cause local skin irritation or an allergic reaction. I would suggest that you see a primary doctor or a dermatologist if this problem persists. Burns from chemical relaxers are quite common.

Tags: chemical, relaxer, chemicals, itch, scaling, scalp, hair

Can NHI Help Balding African American Men?

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

Hey, I came in last summer for a consultation and I had a miniaturization test. The doctor confirmed that I was probably a class 2-3 on the Norwood scale. At the time he prescribed finasteride, which I have taken daily ever since. It’s been about a year now, and although my hair loss may have slowed down, it certainly hasn’t stopped. My hairline is a little suspect at this point, and I’m nervous that if I wait much longer people will really start to notice I’m “losing it.” I am biracial, with relatively coarse hair, and I’ve been able to get away with styling it so that no one can tell, however I think I’d like to solve the problem while I still have a relatively large amount of hair on my head. I’ve heard that there are doctors who specialize in treating African American hair loss patients. I’m wondering if this is true, or is NHI capable of generating the same results? Also, I’ve heard that micro-grafting is the least noticeable transplant procedure, do you perform this procedure at NHI?

Thanks for your help.

We are as experienced with African hair types as any medical group anywhere. We also stand by all of our results. You should be seen yearly, so I would hope to see you again.

The most natural way to transplant hair is with individual follicular units, as these are the natural groupings of hair in your scalp. A micrograft is not the same as a follicular unit and you need to be aware that the gold standard for hair transplantation in any race is follicular unit transplantation (FUT). Propecia (finasteride) is probably working for you, as it is slowing down what would probably be more dramatic hair loss. You are welcome to come back and have one of us take a look and further answer any questions you have.

Tags: finasteride, propecia, african, african american, hairloss, hair loss, micrograft, micro-graft

Pigtails and Braids Resulted in Missing Female Hairline

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

I wore pigtails as a young girl and braids on my hear in my late teens and early twenties. Now I am stuck with no hair in the front or one the sides.

This question came from a woman that I just met with. It is a complicated case, mostly because the missing hair covers a large area. Her donor density is slightly higher than normal for an African hairline, but there is some miniaturization in the donor area which may impact the total graft yield. Nevertheless, she is committed to having transplantation surgery, even as I explained to her that the result might be less than a full, thick hairline area. Her response to that was, “Any hairline there will be fine”.

Tags: pigtails, braids, hairloss, hair loss, hairline, african american, black, alopecia, density

Did Chemical Relaxers Permanently Damage My Hair?

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

I am a 25 year old African American male and I have been relaxing my hair since I was 15 now my hair is very thin and I know its because of the relaxers because baldness does not run in my family, I have been wearing my hair natural for the last 4 months and i’ve bought Rogaine and have been using it for the last three days do you think it will work for me in any way or have I permantly damaged my hair? If there is anything I can do and what products do you suggest? Because i’m so afraid of being bald or keeping my hair this thin.

Thank you for reading
God Bless

Although chemical relaxers can cause damage to hair, you need to be examined by a properly trained physician to make sure you do not have another reason for your hair loss. With your long term use of chemicals and heat, there is a high probability that you have damaged your hair. A miniaturization study would definitely help to understand the role of MPB in your hair. Without knowing the true cause of your hair loss it is hard for me to recommend a treatment.

Tags: hairloss, hair loss, chemical relaxer, damage

Fluocinonide Topical Prescribed for Female Hair Loss?

/by William Rassman, M.D./15 /, ,

Hello Dr.(40 year old African American female) I was told on the 8th of Jan 08 by a Dermatologist in a county hospital that I have scaring in the crown of my head and very few follicles left because of the way African-American women process their hair, and then as he exits the room he says, there’s nothing we can do. A more sympathetic intern stayed behind and offered to prescribe Fluocinonide Topical Solution USP,0.05% 60ml,will this have any benefit at all? and am I a candidate for anything else transplant or otherwise. P.S., know any good specialist in Houston, TX.?

Fluocinonide is a potent steroid medication and I do not like to second guess another doctor’s recommendation. You should probe your doctor’s opinion on just what benefit he expects to see and over what period of time. My personal feeling is that it is sometimes more difficult for a doctor to do nothing — and sometimes when a doctor feels compelled to do something, medications prescribed may have little or no value. I do not have recommendations in TX at this time.

Tags: fluocinonide, steroid, hairloss, hair loss, doctor, female, women, woman

My Hair Sheds in the Winter

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

I have very healthy hair and whenever I consistently go to a hair dresser it grows to a considerable length. Instead of me paying the money to a hair dresser, I decided to do my hair myself at home and save money this way, however I notice that during the winter months my hair sheds a lot. Is this normal among African Americans? My hair will not grow to a considerable length because it sheds so much during the winter. Is there anything I can do to prevent this?

Humans have asynchronous hair growth, which means that we do not shed in seasons, but do so relatively uniformly over the year. I can not explain your situation, but an examination is a good start, because your time frame view may not go back to every winter.

Tags: hairloss, hair loss, winter, season, asynchronous

Relaxing African Hair After Hairline Lowering Procedure

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

Hello, I am a 30 year old African American female, I have a very high forehead. I am interested in bringing my hairline down surgically, but I perm/relax my hair. What I want to know is, with that type of surgery would I still be able to relax my hair. If so how long after I relax should I wait before I have the procedure done and how long should I wait after the procedure to relax again? Thank You for your time!

Hair can be relaxed prior to a hair transplant procedure. A hair transplant is your own naturally growing hair, just moved from one place to another. You can perm, color, or relax transplanted hair just as you would your normal hair. You should wait about two to four weeks to relax your existing hair after a transplant procedure, but transplanted hairs will most likely not grow in for 6 to 8 months. Hairline lowering procedures for women gives an immediate result; a hair transplant also has a waiting period for the hair to go through its normal cycle before it starts to grow.

Tags: hairloss, hair loss, hairline, lowering, women, female, woman

I’m Looking for an African American Doctor

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

i am a 31 year old black women. i was dianosed with alopecia a year ago (10-1-06). i was getting injection in the top of my head and around the temples with this medicine called (clearmgsin and depomedrol a steroid) but i am still bald in the top of my head. some of the side hair started to grow but not fully. the doctor told me that i should consider a hair transplant. i dont know if i am a candidate for transplant. i’m looking for a african american doctor


Alopecia means hair loss in Latin. Hair transplantation in an African American patient is difficult due to the curly hair that extends beneath the skin down to the roots. It is much more difficult to transplant than someone with straight hair. As such, you need to find a very qualified hair transplant surgeon with extensive experience transplanting African American patients. Having an African American doctor as your surgeon does not necessarily mean he/she would have the aforementioned experience. Moreover, most patients are not aware of the technical expertise required by the hair transplant staff. In other words, hair transplantation is a team effort and being an African American doctor will not be a solution for you without extensive experience with similar patients.

Tags: african, black, hairloss, hair loss, hair transplant

My 7 Year Old Son Has a Very Scaly, Flaky Scalp

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

my son is a 7 years old african american. he is having the worst problem ever with his scalp. i have tried every kind od dandruff shampoo there is and still no relief. i wash his hair 2xs a week now because the flaking and the scabs are so embarrassing. after i wash his hair its looks clean and free of scales and flakes but his scalp is red. usually after 2 days of washing this whole process reoccurs with the itchy, scaly flakyness. what should i do?

If I had a 7 year old son, I would want an expert to examine and diagnose him. You need to take him to a pediatric doctor, one with an interest or experience in dermatologic conditions. There are many causes of flaky scalps and you need to consult with a good doctor.

Tags: scalp, flake, scaly, flaky, child, dandruff

Hair Loss from Braids?

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

I washed my hair one day after pulling out braids. I went to my personal hairdresser to get my hair redone only to be told “Honey you know you have a bald patch” then she proceeded to rub it with her finger. It was as smooth as could be. It now has a few strains of hair and i have bought things specifically described for hair loss near to the neck. It itches a the bottom of the spot. Just tell me what exactly to do please cause it really bugs me out.

You describe a condition known as traction alopecia, where hair follicles are permanently damaged with constant traction (in your case braids). That area may never grow hair back. You need to see a hair specialist (a good hair transplant surgeon may help), but you should wait for 6 months to see if it does grows back.

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

Woman Taking Propecia Is Experiencing Accelerated Hair Loss

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

I am a 42-yr old African American woman. I had hair restoration surgery in March 2006 for androgenic alopecia in the crown. For the last year and a half, I’ve been taking Propecia in pill form 2.5mg/day as well as topically. I’ve noticed since taking the meds, I’m experiencing diffuse thinning all over my head now. Have you heard of Propecia causing accelerated hair loss? Is this a temporary side effect? If I stop now, will my density return?

Propecia (finasteride 1mg) is an oral medication for the treatment of androgenic hair loss approved only for use in men. It blocks a hormone known as dihydrotestosterone (DHT) which is responsible for hair loss in men. Propecia is not approved for women, because female hair loss is not necessarily caused by DHT and it may cause birth defects when women take the medication. Finally, only 1mg of finasteride is recommended for the treatment of androgenic hair loss. Taking 2 mg or 2.5 mg is not necessarily twice as better or effective. It will however increase the potential for more unwanted side effects. I would recommend that you see your doctor and address these concerns to him/her and or see another physician for a second opinion. This website is NOT a second opinion.

The question should be: Will taking Propecia harm me if I am not going to get pregnant? We really don’t know the answer to that, as the appropriate clinical studies were not done on women so safety and effectiveness are still up in the air. I couldn’t possible know the cause of your hair loss without an examination and a detailed medical history.

Also worth noting, Propecia is not available in a topical form or available in 2.5 mg strength.

Tags: finasteride, women, woman, female, propecia, hairloss, hair loss

Central Centrifugal Cicatricial Alopecia

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

I am a 54 year old Africia American Female that has Central Centrifugal Cicatrical Alopecia, is there hope? and if so what can I do.

Also called “hot comb alopecia” in the past, central centrifugal cicatricial alopecia (CCCA) is a rare condition that presents with cicatricial alopecia in the central scalp. This lesion grows larger around its center and tends to destroy the hair follicles and causes permanent balding.

It was thought that this condition has to do with combing or use of oil for hair styling in African-American women. The cause of this type of hair loss is still not known and its treatment is difficult, as seen with this and other similar scarring alopecias. This condition that is usually seen in African women presents as an unusual sensation (pins and needles) on the top of the scalp followed by tenderness in those areas. There is no visible sign of inflammation in the area. Skin color may change to become fleshy and eventually hyper-pigmented (darker). Hair loss in this condition is usually permanent.

Tags: central centrifugal cicatricial alopecia, ccca, alopecia, african, women, woman, female, hot comb, hairloss, hair loss

I Want a Hair Transplant, But I Am Concerned About Keloids

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

i am seriously considering a hair transplant on the sides of my hairline. i am a african american women who have had traction alopecia for quite some time now. i have a small keloid on my ear, and my dermatologist has been giving me injections to clear this up. he also told me that if i get any plastic surgery, there is a chance that i will develop keloid scarring. i do want my hair transplant, are there things that they can do to remove the keloid from the donor site?

Keloids are very rare on the scalp. Many people have stretched (flat) or hypertrophic (raised) scars, but actual keloids (they look like tumors growing out of a wound) are so rare that they are worth reporting in medical literature. You can test the donor and recipient areas with a punch wound and/or a needle and then wait it out to see if it forms keloids. That may be the best way to know for sure.

Tags: keloid, hairtransplant, hair transplant, african, alopecia, hypertrophic

Gel, Bleach, Hair Dye — Could These Have Caused My Hair Loss?

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

Hi, i am an African American teen whose hair is shedding and i do not know why. Could gel possibly cause your hair to fall out? Like the edge of the top part of my hair is constantly getting thinner and i dont understand why this is occurring. My hair is really thick and shoulder length. Or maybe the bleach i used in october is taking my hair out, then then it could possibly be the dye i used a two weeks ago. I do not know what is going on. Yet, dr. if you know whats wrong or have any hair loss prevention tips, please let me know. Thanks for your time. God bless

ALL are possible, but there are many other reasons for hair loss. I just can’t diagnose your condition via the internet. The more junk you put on your hair, the higher the risk of hair damage, particularly bleaching or straightening compounds. It is unlikely that commercial grade hair gels will cause hair loss. If you are concerned you should see a doctor for a more complete evaluation.

Tags: hairloss, hair loss, bleach, gel, dye, female, women, woman