Lupus Nephritis and Hair Loss

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

Hi Dr. William,

I have been on steroids (Wysolone) for 6 months as I was diagnosed for Lupus Nephritis. I have lost hair significantly. Now the steriods have stopped, i need to know will the hair come back or is there something that I can try to stimulate hair growth.

Thanks

Lupus is one of the medical cause of hair loss. Corticosteroid (Wynsolone) is another potential cause of hair loss or hair thinning (as well as other side effects). The only medical option you may have at this time is topical minoxidil (Rogaine). As your hair loss was not a cause of male pattern baldness (I am assuming you are not male), drugs such as Propecia will not help.

Unfortunately there really is no drug or other treatments to grow back hair completely. There are many products out there that claim to grow hair, but I would take caution as there are no such products.

Tags: lupus, hairloss, hair loss, wysolone, steroid, corticosteroid

I Have DUPA — Can I Transplant My Beard Hair to the Scalp?

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

i was wondering if a person like myself with DUPA had a strong beard would if be possible to transplant it to the scalp and if so how much coverage would i get?

Such a transplant (beard to scalp) would technically work, but to what master design is the question! The character of beard hair is different than scalp hair.

You’d need to come in for a consultation and let me look at the many variables. With your goals clearly defined, we can discuss not only using beard hair, but perhaps even leg, chest, arm, and pubic hair as well. I generally do not recommend body hair transplants, but in a case of DUPA (diffuse unpatterned alopecia), things are different. Generally though, the hair of DUPA patients is so thin that you may not get what you need from other body parts.

Tags: dupa, diffuse unpatterned alopecia, hairloss, hair loss, bht

Minoxidil and DUPA

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

Does a guy with diffuse unpatterned alopecia have the same chance of responding to minoxidil than a guy with male pattern baldness? thank you for your time sir

Since topical minoxidil is not specifically for treating male pattern baldness (it can potentially grow hair anywhere on your body), there is a chance it could work for diffuse unpatterned alopecia (DUPA). There are no firm studies to prove or disprove this theory, though. It is worth a try, but you need to stay on it for a full year of two applications a day to know if it is working.

Tags: dupa, alopecia, minoxidil, hair loss, hairloss. mpb

Hair Cloning and DUPA

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

Both you and Dr. Bernstein mention in various places that it will be ten years before hair cloning will be available as a successful treatment for hair loss. If and when this process becomes available to the public, would it be effective for DUPA patients as well? Or would the process still require a stable donor area?

I am a 19 year old male experiencing DUPA. Assuming propecia does not work, I think all of us with DUPA are wondering whether there is any effective solution we can look forward to, or if we should just shave our heads and get on with our lives.

My heart goes out to you. If the medications do not work, there is little to offer other than the use of concealers. Hair cloning can not be predicted for a time line. If/when cloning becomes a reality, these types of questions can probably be answered, but it is way too early to guess as to what future technologies could do.

Tags: hair cloning, cloning, dupa, hairloss, hair loss, propecia

Dermatitis and Minoxidil

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

Hello Dr. Rassman,
First of all I’d like to congratulate you and your partners for your wonderful work on hair restoration. Also, I really felt relieved when I came across your website, because I always kind of felt alone since I first started experiencing hair loss (which was about two years ago).

I am 22 years old and although my hair loss story is not a very long one, I think it is a little bizarre, and here’s why. About two – two and a half years ago, in about March 2006, I first started having a lot of dandruff, which was of the dry type though; my scalp skin was dry and felt normal. So, I did not really pay any attention to it, I would just shampoo twice or three times a week and I thought I was alright. Then in the summer, I suddenly started losing hair. I was terrified because I was always proud of my hair – I would even buzz it and still my scalp would show through very little. The dandruff became flakes, the skin dried off completely, and everytime I shampooed (with a zinc pyrithione shampoo) my scalp would get red and irritated. It was a case of “bad seborrehic dermatitis”, my dermatologist told me. So, I had to shampoo with a coal tar and salicilic acid shampoo. So far so good, I thought I would keep it under control like this. But the hair loss continued and I was left with little hair, compared to my previous strong thick hair. Even today, the scalp balance is totally screwed up and if I don’t shampoo one day, my scalp gets oily in a weird way, it kinda looks like something between oil and sweat. My hair has become fine too. Now about hair loss: I had some diffuse thinning, most of it came back although finer and oilier, but lately I see some temple thinning which is quite alarming. I shampoo with Nizoral 2% but I see very little difference, I am trying to dry my scalp to a normal level and it always oils up again. My questions are:

  1. Is the dermatitis killing my hair , causing MPB?
  2. I recently started using Minoxidil, is it any good if the scalp is possibly still infected by dermatitis?
  3. Will propecia, considering I start using it, have any effect on my hair/sebum/hormones on my scalp?

Thanks a lot, I would really appreciate if my mail is posted, I am sure it would help many guys in the same situation as me.

  1. Seborrheic dermatitis should not be a cause of hair loss and it is not caused by an overt infection. I wonder if you have psoriasis.
  2. Minoxidil should not hurt you, but it can make the seborrheic dermatitis worse.
  3. Before trying Propecia, it needs to be determined by your doctor if you really have male pattern baldness. If you do, then Propecia (finasteride 1mg) is the right way to go. Get your hair mapped out for miniaturization and know for sure what you are treating.
Tags: minoxidil, rogaine, dermatitis, dandruff, nizoral, propecia, finasteride, hairloss, hair loss

Tinea Capitis / Ringworm Scars (with Photos)

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


I had Tinea Capitis as a child and i would pick them off of my scalp leaving these scar spots. I was wondering how much it would cost to fill in most of the “bald spots” also if i get them filled in would it be possible for me to cut my hair and the hair that was transplanted will regrow?

Iam 19years old Male, You have permission to use my pictures if needed.

Ringworm

First, thank you for allowing me to publish your photos. This is an extraordinary case, and one that is ideal for follicular unit extraction (FUE), where we can re-arrange the hairs from one place to another.

What I’m wondering, though, is whether you’re going to experience male pattern baldness. There is a genetic test that will tell you if you carry the balding gene, and it would be worth getting tested. If you do not have genetic MPB, then I would perform FUE all over your head, redistributing the hair from one place next to the balding areas, one at a time. If you are carrying the balding gene, then we would have to rethink the strategy. Cost might become an issue, as there is a great deal of cumulative balding, and although the fees are generally charged per graft (group of hairs), I could work with you on pricing due to the unique nature of the case.

Tags: ringworm, tinea capitis, scarring, scar, hairloss, hair loss, fue

Is DUPA Progressive or Stable?

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

You’ve mentioned the condition Diffuse Unpatterned Alopecia (DUPA) as being the miniturizing and loss of hair on the sides and donor zone, and that your pretty much screwed if you got it.

What I want to know is if (DUPA) is a stable condition or is it a progressive condition, meaning will a person with (DUPA) eventually lose all his donor hair or will it just become thin and stay thin?

DUPA can be stable once it appears… or it can be progressive. The other day I met with a young man who clearly had DUPA a year ago with 50% miniaturization in the donor area. When he came in this time after being on Propecia (finasteride) for a year, the miniaturization rate was down to 10% (a figure I’d call normal). Successful treatment for DUPA with finasteride is in the minority of patients I see, but his hair loss needs reflected a Norwood Class 3 pattern, so he might become a candidate for FUE if the process remains stable.

Tags: diffuse unpatterned alopecia, dupa, hairloss, hair loss, finasteride, propecia

DUPA vs Senile Alopecia

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

Hi dr Rassmann, What is the differance between dupa and senile alopecia if any. Also my nape of the neck hairline has always been very high, my son has the same. Never been able to cut my hair really short at the back hair line, looks abit funny if i do. question is my father had senile alopecia, is the high nape of the neck hairline a symptom, or problem, when you look for dupa in a patient. Currently im a norwood 3 to 4 with good donor dominence, on meds,at 39 years old. Thanks great blog.

Both diffuse unpatterned alopecia (DUPA) and senile alopecia take on the same appearance. The former is a diagnosis made in younger men while the latter is in older men. The hair loss on the nape of the neck reflects a genetic factor present in some family lines. You can try to see if minoxidil helps with the loss of hair in the nape of the neck.

Tags: senile alopecia, dupa, hairloss, hair loss, minoxidil

Yeast and Seborrheic Dermatitis

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

Hi Doc,

I have been suffering from seborrheic dermatitis for the last 1.5 years. I read somewhere that yeast containing food aggravate the problem. Is it true? Are there any specific food items that I should avoid?

Thanks!

There appears to be an association between yeast and seborrheic dermatitis. There’s a great article on the American Academy of Family Physicians website that says:

“Pityrosporum ovale, a lipophilic yeast of the Malassezia genus, has been implicated in the development of this condition. It has been suggested that seborrheic dermatitis is an inflammatory response to this organism, but this remains to be proved. P. ovale is present on all persons. Why some persons develop seborrheic dermatitis and others do not is unclear. The colonization rate of involved skin by this organism may be lower than that of uninvolved skin. Nonetheless, the fact that seborrheic dermatitis responds to antifungal medications is strongly suggestive of the role of yeast in this disorder.”

Read the rest of the text at American Academy of Family Physicians

Tags: yeast, seborrheic, dermatitis, food, skin

DUPA and Propecia

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

In earlier posts you mention that half of men with DUPA receive benefits from propecia, but in more recent posts you seem less certain. In the past few years have you seen DUPA patients receive worse results with propecia, causing your optimism to diminish?

Also, you mention that propecia MAY have a better chance if the underlying cause of DUPA is genetic–what does this mean? In your experience, does the presentation of DUPA differ when “the underlying cause is genetic”?

(My brother, only two years older than me, is losing his hair in a traditional MPB fashion, while I am experiencing DUPA in a presentation similar to FPB). Any insight, at all, would be helpful. Thank you.

With more and more exposure to diffuse unpatterned alopecia (DUPA) patients, I am less convinced that Propecia works for them. If there are no side effects seen though, maybe there is value in taking it. Other industry experts tend to have adopted that view as well.

Tags: propecia, finasteride, dupa, hairloss, hair loss, diffuse

Macular Degeneration from Propecia?

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

Dear Doctor,
I have a question about possible serious side effect of using Propecia. I am 23 years old male and I have started using Propecia one month ago. After already two pills I noticed some small defect in my vision which becomming worse in time (I was seeing crookedly by one eye). The diagnosis is macular degeneration. My ocularist thought it was caused by Propecia though there were no information about this side effect in the label. I was said that if macular degeneration appears by youth it is in most cases caused by using steroids and its interference to hormones. I have never taken steroids and so doctor thinks it is a result of Propecia’s hormones changes. I would like to ask you have you ever seen similar case of Propecia side effect? Could Propecia theoretically caused it (already after two pills)? And do you recommend me to continue with finasteride in the future? (I stopped after 15 pills and now I am much more worried about my vision than my hair).

Thank you very much.

EyeThis is a question you need to ask of your ophthalmologist. A short course of Propecia should not cause any problem and macular degeneration from Propecia is not defined as a known complication of the disease that I could find. I’ve certainly not had any patient mention anything like this to me over the years.

For more about macular degeneration, see Wikipedia.

Tags: macular degeneration, retina, eye, blindness, hairloss, hair loss, finasteride, propecia

Multiple Sclerosis and Hair Loss?

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

(female)
I have noticed that my hair is breaking off. There are several pieces of hair that are only two inches long on the top of my head. I color my hair to cover the gray, but I am also on several medications. I was diagnosed with MS in 2003. Do you have any thoughts on what could be causing this?
Thank you.

Look at the medications that you are using for the cause of your hair loss. Some medications used in treatment of multiple sclerosis (like mitoxantrone) can cause mild hair loss. Speak with your doctor about them.

Tags: multiple sclerosis, ms, hairloss, hair loss, mitoxantrone

Seborrheic Dermatitis After a Hair Transplant

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

Hello Doc. can you please answer this question please. Can a flare up of seborrheic dermatitis during the growth period (3-9 months)following a hair transplant procedure,in the recipeint area(itching,redness,swelling, etc..) lead to poor results of the transplant?? Also if the scar from a strip harvest is still pink and tender 6 months after procedure, will it always be like that or will it eventually toughen and turn all the way white? thx

Seborrheic dermatitis should not impact hair growth from a hair transplant. Scars can be judged by their width, and scars that are greater than 3mm may cause a problem. The pink color is usually gone in less than 6 months, but it can be delayed. The pink color has really more to do with the way your body heals the scar (appearance) than on the actual strength of the healed wound at six months.

Tags: hairtransplant, hair transplant, seborrheic dermatitis, hairloss, hair loss, scars, scarring

Clarify About Folliculitis Decalvans and Hair Transplantation

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

In your post here you say: “This is your worst case scenario. I have had 3 such cases over my years in practice.”

Can you clarify what you mean here? Are you recommending not getting cosmetic surgery if the disease is under control? Or, are you just saying that as a general warning of what could happen if one did get cosmetic surgery? Have you only had 3 cases of this disease to treat with a hair transplant?

My areas are I guess you could say small, but they feel like they are the size of a baseball on my head. Right now, only one area is really noticeable. How long should one wait, to consider the disease under control to have any type of cosmetic surgery? I have not had any activity in a few months now. Three doctors have recommended that because my areas are “small” a doctor may be able to just remove the scared area and fuse my scalp together. Is this a viable option?

If the areas are smaller, what are the typical prices for hair transplant?

The medical field is not clear about the cause of folliculitis decalvans. It is thought to be an autoimmune disease that presents like an infection of the hair follicles, but it does not respond to traditional treatment. The disease can be aggressive and destroy many hair follicles and badly scar the scalp. Hair transplants into this area may likely fail and may reactivate the disease (bad news when this happens). I always want to know if the benefits will significantly outweigh the risks.

The decision to have another surgery within less than a year from a previous episode may not be a good decision, but you and your doctor are in the best place to make that determination. I haven’t treated you, and I couldn’t make any recommendation without examining you at the very least. Our fees are listed here.

Tags: folliculitis, folliculitus, decalvans, hairloss, hair loss, scarring

Man with Female Pattern Hair Loss or DUPA?

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

Hi,

What could cause a male to have slightly thinner donor zone hair than on the top of his head. Most people can’t tell I have thinning hair, but the top is a little thicker than the sides. Even my barber has said so. The only strange thing is I have been buzzing my side and back to a number three every 2 weeks for 15 years.

Also, there was a post a few days ago about questioning if dupa was real. I’m confused: what exactly is the difference between a male with a female pattern and someone with dupa? I mean they are discribed exactly alike. Diffuse thinning throughout the whole scalp, but you said fpb is NOT dupa?

If you have thicker hair on the top than on the sides and back, well, I would assume that you were born that way. We could record the differences in densities and confirm that observation if you like, but measurements are the key to the validity of that observation.

Diffuse unpatterned alopecia (DUPA) is generalized thinning of the entire scalp hair and presents that way in men. Women also may have diffuse unpatterned thinning as a presentation of their genetic balding and it may look similar to DUPA in men. Female pattern hair loss may not be uniformly diffuse, while DUPA is more uniformly diffuse (though still unpatterned). Both men with DUPA and women with classic diffuse genetic unpatterned hair loss may have similar mechanisms behind it, but the science is unclear to me as an expert. It is easy to get confused, and I’ve rewritten this response twice trying to make myself more clear. Medicine is a descriptive science and therein lies the problem.

Tags: dupa, diffuse, alopecia, hairloss, hair loss