Traction Alopecia from Dreadlocks?

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

I’m an african-american and I’ve had my hair in dread locks for the last 6 years. Because of work I have to wear my hair in a bun at the back of my head and I have noticed for the last couple of years my hair has stopped growing not along the hairline inside the bun. Is it responsible for what is happening and what can I do about it?

Yes, dreadlocks do cause hair loss. When it stops growing, this may be the first sign for the hair loss that will follow. Change your styling and hope that it is reversible.

Tags: dreadlocks, hairloss, hair loss, alopecia

African Hair and Noses

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

I am an African American man and I want my frontal hair loss fixed and a nose job. I do notice that more white people get these types of surgery than black people. Why is that?

The kinky hair of African individuals makes it slightly more difficult for hair transplants if the surgical team is not able to manage the hair grafts that are not straight below the skin. Hair transplantation is a peg in a hole skill (like fine needle work), but when the grafts are not straight, it is more difficult to put them into a straight hole. With the right skills, the team can coax the hair into the needle holes created in the recipient area.

I’ve asked Beverly Hills based plastic surgeon and UCLA Medical Center’s Clinical Assistant Professor of Plastic Surgery, Jon Perlman, MD, to answer the nose question. Here’s his response:

Black people’s noses are more difficult due to a general lack of cartilage available from the septum to build up the height of the missing bridge. Some doctors (not myself) prefer to use silicone grafts however though not unreasonable, it is associated with a much higher risk of future extrusion from within the nose. The advantage is that it comes in a package and can be relatively easily placed on the bridge of the nose to build it up.

Fuller Hair Volume

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

I am aged 23 years old and i am a African American. My hair is long to some sort. It falls to my mid upperback. But i have one problem, its thin. I do not have full thickness and on each side is thin as well. I have never dyed it but have used perms. I may perm 3 times a year about every 4 months. I tried hair thickness oils and all the hair volume supplies u will find in a beauty supply store. What can I do to receive full volume and to cease the thinning on the sides.

The things you are doing may be damaging your hair and causing hairs to break off, making the bulk appear less full and giving the appearance of a finer, thinner hair shaft. The more you treat it and abuse it, the worse it will get. There are hair thickeners that will cause the hair shaft to absorb water, making it appear thicker. Check with your hair stylist for recommendations. This is not a doctor problem.

Folliculitis Decalvans Specialist in Atlanta?

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

Hi Dr.:
I found the previous blog on Folliculitis decalvans very helpful as I am a 23 year old of African descent also suffereing from the same problem. I am searching for a dermatologist with specific training in this area as you suggested but I haven’t had any luck. The listing of Doctors on the American Academy of Dermatology’s website is pretty basic. Do you have any specific pointers or referrals on this. I live in the Metro Atlanta Area. Thanks for your help.

Try to go to a major university clinic. They are bound to have those that focus in this disease. You have a number of good university medical centers in Atlanta.

For the readers of this blog, note the following references for clarification. This is a bad problem which in essence reflects an aggressive infection of the scalp hair follicles, amongst other causes.

Hair Loss After Stitches in My Scalp

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

Hey,
I’m 18 years and of african descent. My problem is that I’ve noticed that whenever I get my hair cut (down to the skin) the hair on the right-forward side of my head grows slower than the left. I have noticed signs of possible hair loss in future but nothing like this, hardly even a horseshoe pattern.

Also quite recently I was involved in an accident and got stitches on the boarder of my scalp (this was after I noticed thinning). I want to ask if this affects possible hairgrowth in the area. Thanks.

It is not unusual to have hair loss around the scar for a distance of a mm or two. Most of the hair around the scar should grow back within a year but there may be a small area around the scar that will not grow hair. Sometimes, people who are genetically prone to hair loss may find that a bad cut or accident on the head could start the process off and without any balding present, the sutures can produce some hair loss. It may just appear as thinning or it could advance to general hair loss. If the scar is too big and unacceptable to you, hair transplants into the scar can help, but the diagnostic mapping of your head is critical for you to define just what is going on.

I Took Out My Hair Braids, And Now It Is Thinning

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

Hi doctor,
I am a 24 year old black man with no real history of baldness in my family, For the past year I have watched my hair shed every since I took the braids I had in my hair for 2 years, I have been going to see a doctor about this for the past year and in doing so they’ve checked my blood and have not found anything abonormal but I am really worried. I work fulltime, I also go to collage fulltime, getting ready to have a baby and get married, I also eat lots of fast foods. my hair never did anything like this pior to me growing braids, can you help me by giving me so advice on how to prevent my hair from continuing to shed and give me an Idea as to what may be causeing this. Thnks and hope to here from you soon

There may be two different things going on here:

  1. Putting your hair in braids for 2 years may have caused traction alopecia if they were tight.
  2. You may have a component of male pattern hair loss (even without a family history).

    3. Or you may have a combination of both 1 and 2.

My Hair Is My Beauty and I’m Running Out Of It

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

I am a 21 year old African American female who has been dealing with Seborrheic Dermatitis and eczema since the age of fourteen. I have used everything from Mycolog, Desonide lotion to Selenium sulfide based shampoos. Now don’t get me wrong the do relieve me from the itching and greasy scaling of the skin. However in 2004 I noticed that the back region of my hair was thinning out. Also the right side had become infected due to constant scratching and became inflammed. About 2 weeks later the hair in that surrounding area started to fall out. I decided to do a biopsy so they could see exactly what was going on and hopefully remove the extra skin. I was later told that it was growing so I could either leave it in the state it was right now or try again. I chose to wait because it has really been frustrating for me and I didn’t want to make it worse than it already was. The only thing that bothers me is that I’m a young adult and I hide because of my appearance. It’s just a well known fact that a woman’s hair is her beauty and I’m running out of it. I just need some help and guidance and was wondering if you would point me the right direction. I was wondering will my hair ever grow back and how will I restore so it doesn’t happen again.

It seems you are being followed by medical doctors for the cause of your hair loss. If there is an infection on your scalp complicated by your dermatitis and eczema, most medical doctors are well trained to address your problems. I realize hair loss can be a devastating experience for both men and women, but it is my opinion to treat the underlying medical condition and your hair should return once you get your medical problem solved.

Hair Too Thin For Transplant?

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

my son who is 24, and african american went for a consultation this morning for possible hair transplantation, and he was told his hair was too thin. does that make any sense to you? too thin to transpant?

Being turned down for a hair transplant because of thin hair does not make sense to me, but I do not have the benefit of examining your son’s scalp to map his hair for miniaturization. Sometimes hair transplant doctors who are not experienced in the field are reluctant to perform hair transplant on African Americans because of their unique hair characteristics. African American hair can be very fine and thin naturally and it can also be very coarse as well. That does not mean he cannot have a hair transplant and someone like your son is just as much a candidate as anyone else, provided that he meets reasonable criteria standard for ALL men. The race card is not in play here. You or your son should research hair transplant doctors who are willing to show pictures of their patients. At NHI, anyone has the opportunity to come to one of our monthy Open House events to meet many of our hair transplant patients and see an actual surgery in progress. Everyone coming in can have their scalp mapped out for miniaturization as part of the basic diagnostic process we carry out for everyone.

Using Grafts from Other People

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

I am a 49 year-old African-American female. My mother and her two sisters suffer from female pattern balding. They are all in their 60’s. None of them have balding to the degree that I have. My two sisters still have the very thick hair we all had as children. I have general thinning all over. The top of my scalp and the sides have very thin, and in some cases bald spots. I never permed my hair. I am now wearing my hair in dread locks. Short of shaving my head, I don’t know what else to do. I would like to see if I am a candidate for transplant. Not the strip kind. Maybe the very small graft units. Do you have any experience in using hair grafts from other people. Or is this science fiction. I do not know if I have enough hair to transplant.

I do have experience transplanting hair from different people but they were identical twins. Otherwise, the difference in our individual genetic makeup will reject the ‘foreign’ hair.

Female Temple Hair Loss

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

Approaching high school my hair started to thin in the temple area. I am female, African American and No one in my family has genetic hair disorders or anything but, I believe very strongly that ever since I started to relax/perm my hair, is when my temples started to fade.

With relaxers, you have to keep putting them in every couple of months otherwise your hair will fall out. I do put my hair in a pony tail a lot, but instead of brushing and pulling backwards, I brush down to cover my temples and then put it in a ponytail.

Without the option of Hair transplant surgery or wigs for right now, how can I get my temples to grow back? Will they always be this way or get worse?

Sometimes people describe the corners of the forehead as their temples (which is incorrect). If you are losing hair from the corners of your forehead, you may have male pattern balding. If you are losing hair above your ears, up to the corner of your frontal hair line (your temples), you may have hair loss from the use of topical chemicals to ‘relax’ your hair. You may also have a condition known as diffuse alopecia areata or a known genetic condition where the temples themselves will fall out (Triangular Alopecia) without other areas of the scalp being impacted, but we need to review your pictures to help make this diagnosis as it has a characteristic appearance. You should be evaluated by a qualified doctor for a definitive diagnosis if this problem continues to be an issue for you. If you send us pictures, we may be able to help further.

Hair Grows to Half Inch, Then Falls Out

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

Well I have a question. I’m trying to grow my hair, this is my third time trying, but when ever I get to a certain length it just stops’ growing and it starts falling out. I’m a 23year old African-American male. I don’t have a receding hair-line and its just weird that when my hair gets to be about half an inch it just start falling out. I have used and still use all of the “DO GROWN” products, and still I can not figure out why my hair falls off. I wash my hair once a week, I always put SULFER8 twice a day, once in the morning and once in the afternoon. I don’t know what to do. Can you help me??

Generally, hair has a cycle that lasts from 2-6 years in my experience. I have always believed that if you let your hair grow out to its full length, take that length and divide it by 1/2 (in inches) and you will get the hair cycle. In your case, if your maximal growth is 1/2 inch, then that would tell me that your hair growth cycle is 1-2 months. If you hair grew slower, then the cycle could be longer.

I have questions for you:

  1. Does it grow to 1/2 inch everywhere, or just in one area?
  2. What about the hair around the sides and back?
  3. With African hair, the length must reflect the straight hair for the calculations above. If you hair is wiry, then you may not be measuring length, but perhaps height. How are you measuring that it is 1/2 inch length?

Practing medicine over the internet is not an easy eask when I can not examine you directly. Miniaturization metrics through mapping your scalp would be a helpful thing for me to do, to help you understand what is happening on your head.

Scarring Alopecias in Women

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

Hi,
I’m a 30 year old African-American female with hair loss on the entire top of my head. I was diagnosed 9 years ago with scarring hair folliclelitis and since that time my hair loss has escalated. I’ve worn weaves, wigs and the hair piece that you have to use a special tape to wear it. I feel that by using these methods to cover up my hair loss, i’ve made it worse. I was interested in hair transplant but do not know if I would be a candidate. Can you please tell me?

Weaves, wigs and the hair pieces cause hair loss. This is common in the African-American female community where balding (hidden by wigs) may be the norm in some communities. As you have already seen a dermatologist, I would suggest that you go back to that doctor. Scarring alopecias are a special case diagnosis which your doctor can put into perspective for you. Hair transplantation in a patient with active scarring alopecia do not go together. An alternative to a biopsy may be a test transplant of 10 grafts into the bald area. If they grow in 6-8 months, then the disease may be inactive and you may be a candidate for a hair transplant. Hair transplants for African hair tend to do very well provided that the skin in healthy.

Top of My Scalp Is Sore

/by William Rassman, M.D./20 /, ,

I am 34 year old African American female. The top of my scalp is sore, thinning and I can not get rid of the dandruff. Is this part of Alopecia? Also, Why do I have soreness at the the top of my scalp and I believe thinning? What can I do for the soreness and thinning? I relax my hair approx every 4 Months. Please help. Thanks.

Chemicals that relax your hair for a long period of time, may cause skin irritation and/or hair loss. Drandruff treatment are found in every pharmacy and you need to experiment with each until you find one that works well for you.

Products for Covering African American Hair Loss

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

Hello doctor. I am a 27 year old african american male, with only a small degree of hair loss on the sides (by the temple) that basically are about the size of a quarter on each side that messes up my hairline. I have been looking at a couple products to get that look ok, and was wondering what your recommendations would be. I heard that Dermatch was the best and easiest to apply to areas on the hairline. Will this look good in our hair? Would toppik or coueve be better than this? My hair is very short and looks great when it is first cut, but when my the rest of my hair grows out and outpaces the small receding areas it doesn’t look so good. Let me know your recommendations, and thanks.

Best to try these products on your own, as they are not expensive and can be washed off in the shower. The problem may be that these products work well behind hair, but not in frontal bald spots. Nevertheless, I’d try it first. If it does not work for you, then hair transplants may be the only other option. If you are gentically balding, I suggest that you get a working diagnosis and consider Propecia (if indicated) at least to stop the hair loss.