Dandruff and Hair Loss in 16 Year Old

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

My son is 16yrs old. I noticed when cutting his hair he had a thick piece of what seemed like caked dandruff it was there for the longest time. Then one day when cutting his hair the thick piece of dandruff was gone and ther was a bald spot. As I looked at his head I noticed there was a thin straight line of baldness then off to the right was another little spot. I took him to the dr. who did a blood test for his throid and that came back good. His spot is getting bigger and it doesn’t look like any hair is growing back from where I orig. saw the spot. There is not balding in either of the families. I checked his head tonight it looks like there is flakey dandruff all over his scalp and even some broken skin like he had been scratching. I have made an appointment with a dermotoligst but what should I expect. Do you have any idea what this is?

What you are describing may be a localized area of psoriasis or seborrheic dermatitis which crusted and then with the crust ‘ripped’ off, the hair came out with it. The loss of local hair from an acute traction episode, could be responsible for what you are observing, and if this is the case, the hair will return if your son leaves it alone. What appears like dandruff may turn out to be seborrheic dermatitis, eczema, psoriasis, alopecia areata, or some other dermatological inflammatory disease of the skin. Your planned visit to a dermatologist for further evaluation is a good next step.

On a separate, interesting note, doctors have recently pinpointed the Psoriasis gene: Forbes.com

Who Do I Take After in My Family?

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

Hello,
I guess like most other guys, I’m a bit paranoid about hair loss. I (age 25) got a haircut recently and my dresser said it was ‘thin’ in the front and that thickening shampoo will make it look better. After CAREFUL examination, I’m quite sure it’s NOT thin, it just looks that way because it’s right where I part the hair and after spiking it with gel, the distribution of hair is completely even. Not that I should even put stock in a hairdresser.

Anyway, I have a question about the ‘genetics’ of hair loss. I realize that it’s not a cut’n’dry thing where you get it from your grandfather. However, in your judgment, whom am I taking after – I have my dad’s color (light brown dirty blonde although he was balding by 20) but my maternal granddad’s hairline and texture (his was black but wispy/baby fine) and he kept it until he died at 84. PS: My mom was graying at 21 and and that is exactly when my graying started. Although my dad’s hair has thinned out majorly he has no gray. So I THINK I’m fairly safe.

Also, this isn’t a question but more of an observation – many people think that treating hair loss is failure to accept the aging process, just like skin creams and facelifts for wrinkles. HOWEVER, I’m pretty sure that anyone with baldness would take a few wrinkles and a full head of white/gray hair ANY DAY!!! So in essence it seems more like not a fear of getting older but the lack of power over an incessant degradation process. Thanks for your input. :)

It is normal to be worried about hair loss. We live in a ‘hair society’ and the history of every civilization has focused upon linking hair and health and virility. We are a product of those prejudices and each culture has its own twist on the balding process. Male pattern baldness (MPB) has a major genetic component, but it does not follow one to one from generation to generation. It can skip generations and what is inherited may not ‘express’ itself the same way as it moves down to the next generation. That is what makes the process so confusing to those that try to sort out some clear, predictive model like the Mendelian genetic predictable pattern.

If you are concerned about hair loss and want a scientific or medical approach, you need to map your scalp for miniaturization to see if the hair loss follows a pattern for MPB. You can setup a free consultation in my Los Angeles office by calling 800-NEW-HAIR or visiting the Request Additional Info page. Your options do not necessarily include a hair transplant. It may be just that you are noticing a mature hair line.

2 Year Old Daughter Has Bald Spot on Crown

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

My 2 year old daughter started with a bald spot on the crown of her head and now it is really thin on top. She pulls out her hair when she gets mad but not often enough to cause this. She wont eat well and vitamins dont seem to healp the situation. Can you please tell me what is wrong?

First of all, your pediatrician should be central to your daughter’s management of her ‘hair loss’. Young children go through varying quality of hairs at different ages. Have you noticed that many children are almost bald under the age of 1? This is not really balding, but rather a migration from a baby’s fine hair to a child’s thicker hair that occurs in the first few years of life. Could you daughter be in such a transitional phase, assuming that the bald spot is not really a spot but rather an area that appears bald? Although there are many causes of hair loss in children (infections, genetic and autoimmune diseases, etc.) you have to be sure not to overreact. See your pediatrician.

Hair Loss After Using a Hair Relaxer

/by William Rassman, M.D./5 /, ,

Hi. I have read a lot of your articles but still confused. I am asian american female age 18, and about 2 years ago I used a relaxer kit I bought from Walgreens for my hair becuase I had thick Frizzy hair. I asked the lady at the store to see if I can use it beucase I thought it was only for African Americans. She said yes so I bought it. After I used it my hair, it has been falling out really bad after showers especially. I let it fall all it wants knowing that I had thick hair for about a year and a half. About 4 months ago I noticed that my hair are growing thin. I have hair that is at least 16 inches long but my hairs that are newly grown comes out very easily. And the my short hairs come out very easily. When i get out of the shower, about 1/4 of hair that falls out are thin and decreased in size. And they look very thin and you can barely see them. the diameter of my hair has decreased to half the size it used to be but I don’t have any bald spots. Some of my friends I talked to say that it cant be the relaxers becuase chemicals can’t have an effect that last 2 years. And 2 years ago was the first and last time i have ever done that to my hair. I havent dyed my hair since… and my hair should be fairly healthy beucase there arent any chemicals i have put in these for 2 years.. All the relaxed hair has been cut off already… but the hair is growing thin. they said it could have been becuase i switched off and on Birth control. But i dont believe that is the problem. I have gone on and off birth controls before and never encountered this problem. And i only realized it right after that relaxer i used. My father is going bald at the crown but none of my aunts or uncles or grandmothers or father has this issue… even if I am a girl, could I have inherited it from my father… and if so why would it hit me so young. But I did notice that after I used the relaxer, i started getting dandruff and i have never had dandruff in my life before that.. Not the dandruff is still around… But it seems to run in the family from my mother. But the thing I dont understand is that why would i start getting dandruff right after I used that too.. Ugh it is ruining my life and I feel like I have nothing to live for..

Your problem does seem a bit serious and if the hair that is falling out is really much thinner that the hair that remains, this complaint is very characteristic of a genetic female hair loss problem. This is best determined by visiting a good hair doctor and having your scalp mapped out for miniaturization. If what you are experiencing is female genetic balding, it will show up in the mapping.

Since it has been over two years since you used the hair relaxer, it is very unlikely that it may have an affect on your hair now. Birth control pills can affect hair loss and hair composition, however, this is generally on an individual basis, so it is not absolutely clear whether it is the birth control that is affecting your hair. The dandruff problem you mentioned does not affect hair loss unless you are scratching your scalp vigorously, but you might want to check into some products such as Selsun Blue or Head and Shoulders. Dandruff seems more detrimental to your self esteem moreso than thinning hair. Getting back to the thinning hair and hair loss, it is normal to lose about 100 hairs a day, but these hairs should not be much thinner than those that remain.

I’m Taking Proscar On My Own At Age 18

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

Hi, I started taking proscar on my own, I have noticed significant thinning in my temples, and I decided I had to take it, it was obvious that my hair was receding. I’ve only been on it for about 3 weeks now. I am only 18, and my beard is far from being grown in, and I have little body hair. Will being on proscar stop my body and facial hair??

I know you probably suggest not to be on proscar/internals when at my age, but I’m willing to risk some side affects if I can help my chances of not being bald at 20. I’ve heard all about its in effectiveness on the temples as well, but I figure since i’m so young it might help. I just really want to know about what will happen to my body/facial hair, as well as perhaps stunted growth if I am still growing/broadening (which is possible)

Thanks a lot.

You seem to think that you know the answer, but you should not be taking Proscar without the supervision of a doctor. Proscar is 5 times the dose needed to address hair loss. In addition, especially without a diagnosis of male pattern baldness or a map of the hair on your scalp for miniaturization, you will have no clue what you are treating, where you are going, or if there is anything really wrong. I often discuss the benefits of finasteride (Propecia), but taking medications without a doctor’s supervision is wrong, risky, and may be unnecessary.

Dandruff and Hair Loss

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

I grew my hair for a good 10 months before cutting it much shorter because it was too messy, it has been 3 months since. I have noticed my hair is much thinner at the front of my head, i’m 18 years old and this is quite distressing…How do i know if this is baldness or just because i grew my hair for so long? I also get a lot of dandruff, could this be the cause?

Neither dandruff or leaving your hair long will cause hair loss. Otherwise, most of the rock stars with long hair will be bald by now. You need your hair mapped out for miniaturization to determine if you really have early male patterned balding. Visit a dermatologist or a hair doc to get this evaluation.

My Son Became Vegan And Started Losing His Hair

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

My 17 year old son became a vegan (6 months ago) and now his hair is falling out in an alarming manner. He eats fruit,nuts,beans and soy products. He has lost 15 lbs and was only 120 to begin with. Tired all the time and now depressed. I took him to a dermatologist and he said nothing was wrong. Can you help us?

From your description of your son’s condition (weight loss, lack of energy, depression, hair loss), there may be an underlying health issue. He should be seen by his primary care doctor who can evaluate his health (not just his hair loss). Of note, a vegetarian diet lacks certain vitamins such as vitamin B12. Anyone starting a new diet should be evaluated by a medical doctor and receive proper nutritional eduacation. Mal-nutrition is a known cause of hair loss.

Norwood Class 4 at Age 20

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

Hello,
Well i am a 20 yr old guy. I started losing my hair since i was 16. By now i am a Class 4 patient with receded hairline from the front and at the top of the head. Many people have told me that hair transplant is not safe for a 20 yr old male. Is it true? ANd does it have any side effects. Kindly let me know on that.
Regards

At the young age of 20, you are experiencing accelerated hair loss. Your final pattern may be reflected in your family, so probe the entire history of hair loss amongst the men from both your mother’s and father’s sides. Having a hair transplant at this early age may lead to further hair loss, called shock loss, from the trauma of surgery itself. Thus, the net benefit of hair transplantion may outweight the hair loss experienced from shock loss and most (not all) 20 year olds are asked to wait for more time to pass. We can not determine the true pattern of your hair loss until you’re later in age. Hopefully, you have been using Propecia since the beginning of the balding process and this finding reflects a failure of the drug. If not, it is prudent to go on Propecia for now and wait for a response (in about a year). The drug can stabilize or reverse the hair loss in someone of your age. If you bond with a doctor and have been on the Propecia for a year or so, then you can discuss a hair transplant. Going forward along the surgery route requires that you develop a Master Plan for your future hair loss management taking your worst case scenario and balancing it with the worst case ‘donor’ hair availability (that is what is meant as a Master Plan for your hair loss).

My Hair Started to Regrow at Age 80

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

i just turn 80 years old and started to grow new hair. please let me know why? thank you

Either God or medications, I suspect. Count your blessings! Most people at 80 lose their hair just by getting to that age. My grandfather had a full head of hair at age 102. How much hair did you grow, how obvious is it, and where is it growing?

High Forehead in Teenager

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

Hey,
I’m 15 years old and my forehead is huge, my hair is about 1-1.5 inchs further back then it should be. I have long hair to cover it,but I hate having it, I would prefer having short hair. Is there anything I can do? Is this permanent?

I’m not certain if you are male or female, so I am assuming your are male. If I am incorrect, please send me another email and reference this response.

There are a series of reasons that can produce a high hairline:

  1. if this is new for you and is an evolving process then it could be a maturing hairline
  2. you could have a genetic high hairline, something that is not uncommon
  3. you may be experiencing hair loss

Youthful or female hairlines: Wrinkle your brow while you look into the mirror. The highest wrinkle reflects the top of the frontalis muscle and both youthful and female hairlines start at this level in all children (male or female). If your hairline is touching this line, then you may have a genetically high hairline.

Mature male hairline: Repeat the above procedure, and if the center of your hairline is about 1/2 to 3/4 inch above that top wrinkle, then the hairline is a normal mature male hairline. For you, at 15, that would be unusual as this hairline usually starts to appear between the ages of 18-29 in most men.

Genetic hair loss: This would be higher than any of the two above hairlines, certainly higher than 3/4 inch above the highest wrinkle. One way to rule out hair loss is by mapping out your head using densitometer or a magnifying video-camera. A good doctor should be able to tell you this.

Too Young for 3 Year Old to Have Hair Treatments?

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

My 3 years old son begin lose 3 spot of hair 6 months ago. Local specialist doctor determined he had alopecia areata and suggested to wait and observe becase he is too young. Hair loss problem did not stop. Up till 3 months ago, he had lost more 70% of his hair. Doctor still suggested to wait and observe because his young age even though explaining to me the few possible treatments. My son condition did not improve nor getting worse since then. Should my 3 years old son take possible treatment or is it too risky for such young children to take treatment?

Alopecia areata is an autoimmune condition where your body’s immune system mistakenly thinks it’s own hair follicle is a foreign invader, like a bacteria or a virus. It is diagnosed under a microscope by a biopsy of the scalp. Although it is natural to be concerned about unnatural hair loss in a 3 year old, alopecia areata is not a sign of a serious disease. It is more of a social and emotional disturbance. While some treatment may be available, it is not a cure or a guarantee that it will work. There is no permanent cure for alopecia areata. In addition, the treatment in itself may be more harmful to your child than it does good. For instance, steroids are sometimes used to treat alopecia areata by decreasing your body’s immune system. It is not hard to realize that this may not be the best choice when the main purpose of your body’s immune system is to fight infections and diseases. In short, it is a balancing game of choosing the lesser evil. Thus, for your son, taking the conservative approach of waiting and observing may be in your son’s best interest. Hoping that your son’s hair may grow back on its own (and not be permanent) is the best you can do with this disease.

Hair Loss in Young Teen Girl

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

I’m female and 14 with fine shoulder-length hair and recently i’ve noticed abnormal amounts of hair falling out all the time. i haven’t told anyone yet, but i’m scared it’s something serious. I’m thinking maybe it is the drugs i’ve been taking to clear up a bad ear infection, sinusitus, and conjunctivitous, which has just cleared up and i’ve finished the treatment. Maybe it is because i have a very irregular menstural cycle, having my first and second period over a year. What is wrong with me???

You need to be evaluated by a good doctor. This type of question would be too difficult for me to provide an answer to over the internet, especially without knowing your medical history or even being able to see you in person. There are many causes for women’s hair loss, including hypothyroidism, eczema, alopecia, dieting, malnutrition, autoimmune, drugs, infection, genetics, etc.

Help, I Lost 35-40% Of My Hair In 1 Month!

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

i have a serious problem. i am 20 yrs old and about a month ago i noticed my hair falling out.i believe in this past month i have lost 35-40% of my hair. yet it is not coming from the usual places for a pattern baldness condition. i have no receding hair line at all and my vertex is fine. i notice it mostly on the top and upper sides. from my research i found in most cases pattern baldness elapses over a long period of time i.e years or more. is it possible to have such an accelerated case. About 6 months ago i underwent lasik surgery and about the time this started i had gotten a huge tattoo done that took 2 seatings of 5 hours each which were very painful. i also feel huge anxiety and very stressed even before this and worse because of it. currently i am on propecia for 4 days and rogaine for 4 days. i am awaiting blood test results but my doctor informs me the chances of this not being perminant are very small. i have no bald or balding family members on either side. this makes absolutley no sense, out of no where and so fast. if it really is pattern baldness and my symptoms continue at this rate all my hair will be gone before the medicine even starts to work. i eagerly await your comments on this letter.

It is normal to lose hair after a stressful event in one’s life – a process called “Telogen Effluvium,” but it is less common (although not unheard of) to have an accelerated case such as you describe. Since your hair is falling out generally all over, I doubt this is male pattern hair loss, especially given your age and prior history. So your doctor is right to do blood tests – fast hair loss like you have can be the sign of a more serious underlying medical condition. I can’t reassure you completely without seeing you and examining you myself, but you should definitely wait and see what the tests show, and calm yourself if you can (stress will set up one of those vicious cycles).

As for treatment, that will depend on the cause but you should be reassured that you are on the only two medications that we can prove work for male pattern hair loss. Propecia and Rogaine will take months to work, about as long as the hair would normally take to grow back, so don’t give up on those medications in the meantime. Take heart, hair can grow back! – It often does miraculously even after seemingly huge losses, and you don’t have any answers yet that should make you despair!

Am I Too Old for Propecia or Rogaine?

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

I had many transplant procedures several years ago. In fact, the last one was about 6 years ago. I have very little donor area left so am considering Rogaine and or Propecia. At 43, is this too late? Also, can I combine the two aforementioned medicines?

Thanks!

The best way to answer that question is to determine just what of your original hair population is still left. If there is some original hair, then Propecia (for men only) may help. Rogaine (minoxidil) may get some of the hair growing when Propecia does not. At age 43, that is still having enough hair or hair ‘buds’ to see regowth from either (or both) of these medications. If you do not try it, you will never know. For a man, I might try Propecia first (for 8 months or so), then add on minoxidil. If you separate the timing for starting each medication, you will know better what is working. Get a good doctor, have him/her analyze your situation and do not treat this blindly. My heart goes out for you, but you need a Master Plan even at this late stage in your process.

Alopecia Areata in 4 Year Old

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

My daughter who is 4 years old has been diagnosed by doctor has having “alopecia areata (AA)” . I am really worried about her treatment.

She is being given
a)Minoxodil Topical Solution USP 2%
b)Prednisolone Sodium Phosphate Suspension- Omnacortil suspension- 5m/5ml
c)Tretinoin Cream USP- Retino -A 0.025%

is this a good medicine or any new development has been done in this year 2005? please do let me know if any thing else can be done to get my daughter treated permanently

Doctors who treat Alopecia Areata have a particular interest in this disease. This appears to be a standard treatment for this disease, but this is a highly specialized field and I would assume that your doctor is fully in command of the treatment.