Would Ringworm or Alopecia Be Obvious to a Dermatologist?

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

Hi, I have a 9 year old daughter who has a small bald spot on the top of her head. The spot is a little smaller than a dime and is a spreading a little in into an oval. There are a few hairs growing out of it and the skin is a little pink. She also has a dry itchy scalp. My daughter used to have a thick full head of hair, and I also noticed that it is thinner. I did take her to the doctor who told me it was from stress and it should grow back. He said to wait six weeks, but it has been there a couple months already! Would it be obvious to him if is ringworm or alopecia? I am currently waiting to see a dermatlogist because they are booked for a month. Should I be worried? Does it sound like she should see someone sooner?

Thank you for any advise you can give.

Your pediatrician can diagnose and treat ringworm and certainly your dermatologist will have no difficulty making the diagnosis and treating it. See Head Fungus Won’t Go Away.

Tags: ringworm, dermatology, alopecia, hairloss, hair loss

Hair Loss Over and Over Again in Cycles

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


dear doctor,
i am 22 years old. for these 4 years, my hair has lost several times. in fact the first time happened when i was 9. i got some treatment and it grew back. when i was 19, i noticed that my hair fell out some parts. there were just small parts, round size. then i went to the west china hospital which is the best one in the west of china.the treatment went though half a year and i went to see the doctor once a month.they gave me some chinese medicine and something that i can wipe on the non-hair parts. besides that, every month i was taken an injection on non-hair parts. the name of the medicine for the injection is Diprospan Compound Betamethasone Injection after several months, i was recovered.

but, just after half a year. the problem happened again. and i got the same treatment. then after several months it happened again. so, june, 2006 i went back to hospital again. this time, i didnt take those chinese medicines but only got the injection (i made this decision), but the difference is that the doctor didnt inject on my head but my muscle. then after two injections my hair grew back. but i still got injection once a month and it lasted 3 more month. but last month the trouble came back again.that means i only had half a year happy time. this month i got one injection. i wonder what kind of problem it is? why it happens again and again?

thank you very much, sir!

From your description, it sounds like you have a condition called alopecia areata. Your doctors seem to put it into remission with steroid use. Of course, this is only a guess. For more information on alopecia area, please see the National Alopecia Areata Foundation.

Tags: alopecia, hairloss, hair loss, steroid, naaf

Prostatitis and Propecia

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

My clinic in the UK has recommended the duel treatment of Propecia and Minoxidil for my MPB. I’m 40 with a receding hairline and a small bald spot on the crown. The slight complication appears to be that I had an acute prostatitis 2 years ago and the symptoms has not gone away completely. My question therefore: is it appropriate for me to take Propecia with symptoms of prostatitis?

You should be asking this question to your doctor who prescribed you the Propecia. Prostatitis is a general term that describes an inflammation of your prostate gland. You need to see a doctor for this problem and you should not be having symptoms for 2 years. Propecia, which is a brand name for finasteride in a 1mg tablet, may have an effect on your prostate, as the medication finasteride is also used to treat prostate conditions. This does NOT necessarily mean it will be good or bad for your prostate. You need to get your prostate checked. At such a young age you should not be having prostatitis unless you are doing something to irritate it or have an underlying prostate condition. There are many causes of prostatitis.

Tags: prostate, prostatitis, propecia, finasteride, hair loss, hairloss

Cirrhosis and Propecia

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

diagnosed with alcohol cirrhosis august 2005. haven’t drank since (life is great thank GOD). liver enzymes normal, checked in january 2007. ast was 32 (30 high). would like to take propecia. what type of medicine or class of of drug is this or what can i compare this as to taking say glyburide for diabetes? what scale of toxicity from say 1-10 is it?

Propecia is metabolized by the liver, so doses of the drug should be lower. The actual dose needs to be controlled by your doctor. To my knowledge, Propecia is not toxic to the body, but if you have poor liver breakdown of the drug, blood levels will rise with more incidence of side effects possible.

Tags: cirrhosis, propecia, finasteride, liver, hairloss, hair loss, alcohol

Psoriasis, Picking, and Maybe Even Traction Alopecia?

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

First, I have to say what an amazingly informative site this is! I am a female in my mid-twenties. On and off for the past 10 years I have suffered psoriasis on my scalp. It gets scaly and itchy. Usually I am able to avoid picking it; however over the past 8 months I went through a very difficult period and was under tremendous stress. Unconsciously, I began to pick at my scalp and it has now turned into a persistent bad habit. I have noticed that as a result my hair is thinning. I have always had thinner hair at this point the hair loss is not blaringly obvious but it is getting to the point that I have to avoid certain hair styles all together and harder and harder to hide. I had assumed that this was a result simply from pulling at the scalp and playing with my hair. Now after reading more on your site I am concerned that I am suffering traction alopecia in addition to the psoriasis. I know that controlling the picking is the first step and I am assuming this is a psychological issure but I have not found anyone to help with this. I saw a Dr. who prescribed me Fluocinonide, which helps moderately with the irritation. Is there another course of action you recomend? A way to help the scalp heal and perhaps prevent traction alopecia?
Thanks!!!!

You are right. You must first treat your obsessive disorder and stop picking at your hair (trichotillomania). Without that, nothing is going to work, because even if you help your hair grow by other treatments, you will most likely continue to pull the hair out. If you could stop picking at your hair, your hair will grow in 4 to 6 months provided that you did not do so much picking that you have developed true traction alopecia.

Also see: I Am Pulling My Hair Out and Need Advice

Tags: trichotillomania, psoriasis, hairloss, hair loss, alopecia

Mixed Connective Tissue Disease and Hair Loss

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

My husband was diagnosed with mixed connective tissue disease. He is 55 and is currently on prednisone (20mg) and celcept. He is seeing a rheumatologist who is trying to get him off prednisone with very little success. All other medications he has tried are causing severe side effects. He has been in the hospital 3 times since being diagnosed 5 months ago. His hair is thinning and we told his doctor but he has not said much about what to do about it. His disease is still not managed. We would like to get a second opinion. Anyone in San Francisco area or bay area?????

Unfortunately, I do not have any suggestion for you on treatment. Autoimmune diseases can have hair loss as a side effect and the use of steroids can also be a cause. Ask your doctor for a second opinion. For the readers that wish to learn more about this rare disease, please see MayoClinic.com.

Tags: mixed connective tissue disease, mctd, hairloss, hair loss, autoimmune, disease

Anything I Can Do for Alopecia Universalis?

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

hello, I have Alopecia universalis & pitting nails. The treatment of last year: cortisone (painful), prednisone, minoxidil (2%), revalid, zinc, vitamins. Now I do… nothing. What`s your advice for me?

Sorry, do not have any solutions for your condition. I would recommend visiting the National Alopecia Areata Foundation site for more information on research and support.

Tags: alopecia, universalis, naaf, hairloss, hair loss

Does Eczema Cause Hair Loss?

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

You said in a previous post that skin inflammation causes hair loss. If Eczema is a disease caused by skin inflammation, does Eczema cause hairloss?

Inflammation of scalp (and eczema) may cause hair loss from scratching when you comb and/or brush your hair, as it may pull out if you are not careful with it. Using a good conditioner will help soften the scales and separate them from any crusts.

Tags: eczema, hairloss, hair loss

Hair Loss from Asacol or Prednisone?

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

I’m taking prednisone and asacol, my hair is falling out quite a bit and the dr. doesn’t agree that it’s from Asacol. He thinks it may be from the prednisone. Will this subside? I’ve been taking asacol for about 3 months and about a month ago is when my hair started falling out drastically. Its getting very thin, and I’m afraid of going bald and as a female that’s very scary.

Based on the medications you are taking, I assume you have IBD (inflammatory bowel disease). Prednisone is one of the many medications that may cause you to lose hair or have thinning of the hair. It causes many other negative side effects. However, if you need to be on these medications for a medical condition, it is a catch 22 situation. You need to speak to your doctor about your side effects and your concern for hair loss. You should never stop taking any medication on your own without speaking with your doctor.

Tags: prednisone, asacol, ibd, hairloss, hair loss

Hair Loss On Scalp and Body

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

I was wondering if alopecia areata is the only type of hair loss you can lose your body hair along with your scalp hair? I have hair loss on my head and eyebrows and eyelashes and pubic region. However, the hair on my head is not the patchy loss that is consistent with alopecia areata, it is a diffuse thinning that gets worse at the temples and the back of my head. I was also wondering if you could recommend a good hair loss doctor in the Atlanta,Georgia region.

If you are considering that diagnosis, you need to see a dermatologist who can prove such a diagnosis with biopsies. Keep in mind that the decision to biopsy or not biopsy would be the call of the doctor. Alopecia areata is amongst a series of diseases that have a common thread of attacking hair follicles at some level. The different conditions have many things in common, but they present in very different ways. This makes the diagnosis more complex. The most extreme of these conditions is called alopecia totalis and alopecia universalis. You had better see a dermatologist for further evaluation. For further reading, please see:

Tags: alopecia, areata, totalis, universalis, naaf, aad, dermatology, hairloss, hair loss

Are Thinning Eyelashes and Eyebrows Related to Thyroid Problems?

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

I keep noticing that people with thinning eyelashes and eyebrows keep mentioning thyroid problems. I take synthroid. Can this cause my problem? The lashes are also curling the opposite way that they should. Hoping for an answer. Thank you.

Thyroid disorders can affect hair growth. In particular, low function of thyroid can cause loss of hair in the eyebrows. Patients who suffer from hypothyroidism (decreased function of thyroid gland) may lose their eyebrow hair, especially the hair in the lateral one third of it. I am not aware that thyroid diseases or its medications can change the curling of the eyelashes. See a doctor to further evaluate this.

Tags: eyebrow, eyelash, thyroid, hairloss, hair loss

I Didn’t Know Weaves and Wigs Would Make My Traction Alopecia Worse!

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

I’m a 38 yr old black female. My hair started thinning in the crown about 10 yrs ago. I started braiding it to keep out the chemicals. About 3 1/2 years ago I was diagnosed with traction alopecia. Had never heard of it before. I started wearing weaves and wigs to cover up the ugliness. I never realized that this would make my situation worse. Now the balding has spread to the top and front of my head. Is it too late for a hair transplant that would work. The hair on the sides and back is relatively thick, but it seems so unhealthy. At the rate I’m going I feel like I should just shave my head bald and call it a day. I feel so ugly. I did see a dermatogolist for the diagnosis, but I never got any advise on what I should do to help the situation. Can you recommend anyone to see on this side of the country??

If you are diagnosed with traction alopecia, you need to keep your hair short with no weaves and wigs. After stopping the insult, you should wait for at least six months and see if your hair regrows. In many cases, traction alopecia may cause permanent damage to the hair follicle and may not reversible. Repeating the evaluation of your hair after this period of time will show the areas of permanent hair loss. At that point, a hair transplant specialist can evaluate you for further treatment options if the hair failed to grow back. Then, if you are using a wig, be sure that it is converted to clips to prevent the transplants from developing traction alopecia.

Tags: traction, alopecia, hairloss, hair loss, weave, wig

Spina Bifida and Hair Loss

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

My 24 year old son, with spina bifida (mylomeningocele) has suddenly, started aggressively going bald. I’m stunned, there is no hair loss like this on either side. My father had a full head of hair, his bio father and grandfather had crown loss after the age of 50.

Could this be related to his spina bifida? I’m very upset. It’s not enough to be a young man paralyzed, but he also has to be bald??

Balding impacts almost 50% of men in their lifetimes. Even when there is no obvious family history, the genetics can skip generations. He should be treated like any young balding man. Get his hair mapped out for miniaturization to find out if he has the genetic pattern balding process going on. A diagnosis is critical. The best treatment for genetic hair loss is Propecia (finasteride 1mg) daily. He needs a Master Plan for his hair loss. The Spina Bifida in conjunction with balding may make for more stress, and stress is clearly something that accelerates the rate of hair loss in young men.

Tags: spinabifida, spina bifida, hairloss, hair loss, stress, propecia, finasteride

Dr Strick’s Alopecia Treatment

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

Hi Dr Rassman, I was diagnosed with alopecia areata and I would like to see the Dr Richard Strick that you wrote about on this blog but I am coming from FL and am wondering is that a specialty that he does or can any dermatologist do that treatment?
Thanks

If you are coming from Florida and want to see him, I would call his office and get the appointment first. His information can be found on the American Society for Dermatologic Surgery site. Maybe he can recommend a local doctor for you at the time of your visit.

Tags: strick, hairloss, hair loss, alopecia, treatment, dncb

Considering BioMatrix at Hair Club

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

I visited doctor Rassman for a consultation on two occasions: the first time was about 6 years ago, the second time about three years later. On both visits Dr. Rassman advised against transplant surgery because of limited donor hair. I appreciated his honesty and have adhered to his advice.

I recently visited the Hair Club in LA. I am considering their biomatrix procedure. I would appreciate any advice you could give me. Thank you

I did write about the Bio Matrix before, but I am still not too familiar with it, so it would be unfair for me to give you solid advice. You were kind enough to come into my Open House on February 3rd to ask me this question after you already submitted it to the BaldingBlog. It was a pleasure meeting you. Your examination showed you have Diffuse Unpatterned Alopecia (DUPA), and based on the Hair Club’s website, the Bio Matrix product appears to be interwoven with your own hair or placed on a bald head (the actual picture they used was man with frontal balding). If they actually weave it into the existing hair, I feel it may actually make you balder from traction. Be very careful with any product that could pull on your hair and deplete your current good hair supply.

Tags: hairloss, hair loss, dupa, biomatrix, bio-matrix, hairclub, hair club