My Teenage Son Has Alopecia and Wants Laser Hair Removal

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

My son, has had alopecia since age 13, when he turned 19 this year he started having laser treatments on his scalp to permantly remove the rest of his hair in order to look more uniformed and without patchiness. After 6 treatments already, the patchiness still exist, but permant damage was done in some areas. Is he now scarred for life @ age 20. Please help!!! He would like all of his hair removed nice and smooth skin, I wish he never would have had laser to begin with and had hoped for hair to regrow. Is regrowth ever possible now?

Regrowth of hair in the presence of active alopecia areata is likely not possible. I would need to evaluate him to understand the complex process and findings you are telling us about. Am I correct to assume that the lasers produced skin damage? Was it skin discoloration or is it real scarring? Is your son also balding from genetic causes? What was the last time he had a diagnosis for determing if the alopecia areata is active now? There are a number of doctors who specialize in the treatment of alopecia areata — has he seen any? It seems your son wants to be bald. There is nothing wrong with being bald (or shaving the head), but being scarred is a problem. Please send me photographs and if they are good quality, I can review the problem with you.

As an aside, bald has been coming into style in recent years and has been more accepted by the “hip” young men of today. It should be clear to most people that the option to shave the head may be lost if you have a hair transplant procedure performed. Anyone with a good hair transplant that uses strip harvesting would have a noticable scar if the head was shaved, even if the scar was only 1mm width in size. This is also true even with the minimally invasive follicular unit extraction (FUE) technique where punctate scars (1mm in size) may be present. The presence of a Master Plan is critical in whatever you do.

Tags: hairloss, hair loss, hairtransplant, hair transplant, laser, removal, alopecia

Treatment for Dermatitis in Eyebrows?

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

Hi,
Not only I have dermatitis on my eyebrows but my eyebrows are getting thinner. A dermatologist gave me a treatment for my dermatitis (carefully rubbing the treatment on my eyebrows) but I am too afraid to touch my eyebrows now. I rather to have an oral treatment for my dermatitis, and an oral treatment to regrow my eyebrow hairs (if there is any). Also I am planning on getting my eyebrows transplanted, though would that help against my dermatitis, and a hair transplant cost A LOT OF MONEY!!!

Topical medications work best for dermatitis. Regrowing eyebrows that are lost from manipulation can be difficult or impossible (if the hair has been lost from traction). Transplants will be exposed to the same dermatitis condition as the original eyebrow. Sounds like you need to get the primary problem under control first. Transplant only after the dermatitis is controlled.

Tags: hairtransplant, hair transplant, hairloss, hair loss, dermititis, eyebrow, treatment

Hashimoto’s Disease

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

I was just recently diagnosed with Hasimoto’s Disease. I just turned 21 and my hair is falling out on my head, I have bald spots on my scalp, mustache, and also my chin. Also my eyelid is missing hair in the middle and my left eyebrow hair has also fallen out. I’v been taking Synthroid now for 8 months and just last month the doctor told me that my thyroid hormone levels are back to normal, I’m at 125 mcgs as my daily dosage. I would like to know will my hair ever grow back to the way it use to be and how long would it take before i notice any differences?

You are experiencing balding spots in several areas of your body. Although hair loss could be seen in the conditions that thyroid function is diminished, your patchy hair loss could be due to alopecia areata. Alopecia areata (AA) is an autoimmune disease and it could be associated with other autoimmune diseases like Hashimoto’s. Thyroid disease is reported in about 8 to 11% of patients with alopecia areata. You need to see a dermatologist for confirmation of your diagnosis with a biopsy if it is thought to be appropriate. As we discussed in previous posts, recovery from alopecia areata is spontaneous in many cases, but could be facilitated by injection of local steroids or other medications in the hands of an expert on AA.

Tags: alopecia areata, alopecia, hashimoto, thyroid, hairloss, hair loss

Alopecia Areata Gene?

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

Dr you responded to one of my questions suggesting that I get tested for the alopecia areata gene…i contacted the naaf & the person i spoke with said she is not aware if testing for the gene is possible, can you tell me if you know otherwise and where i can get this testing done?

Angela Christiano, a researcher at Columbia University, studied alopecia areata and alopecia totalis in populations of families. She found genetic evidence that made people prone to this disease. I found this article in the Journal of The American Academy of Dermatology, Alopecia areata: current state of knowledge, which could be another starting point for your research. Here is an abstract of the article:

Blaumeiser B РJ Am Acad Dermatol Р01-APR-2006; 54(4): 627-32, From NIH/NLM MEDLINE, NLM Citation ID: 16546583 (PubMed) Full Source Title: Journal of the American Academy of Dermatology Department of Medical Genetics, University Hospital of Antwerp, Antwerp, Belgium. bettina.blaumeiser@ua.ac.be Authors: Blaumeiser B; van der Goot I; Fimmers R; Hanneken S; Ritzmann S; Seymons K; Betz RC; Ruzicka T; Wienker TF; De Weert J; Lambert J; Kruse R; N̦then MM

Abstract: BACKGROUND: Familial aggregation of alopecia areata (AA) has been previously described, but systematic studies with information obtained directly from family members have yet to be undertaken. OBJECTIVE: We sought to study the pattern of familial aggregation of AA by assessing the affection status of patients’ relatives. The study included 206 index patients with a total of 1029 first-degree and 2625 second-degree relatives. METHODS: First-degree relatives were directly interviewed, whereas information on second-degree relatives was obtained by interviewing the index patients and their first-degree relatives. RESULTS: Estimated lifetime risks were 7.1% in siblings, 7.8% in parents, and 5.7% in offspring. The risk in second-degree relatives was slightly higher than the reported population risk. Age at onset in index patients and first-degree relatives was significantly correlated. LIMITATIONS: Using patients drawn from specialized hair clinics may have produced results showing a higher proportion of early onset and severe cases. CONCLUSION: The familial aggregation of AA supports the role of genetic factors in the development of the disease. In addition, our data indicate genetic factors might contribute to the age at onset of AA.

For a Complete Review, you might locate the following article: Alopecia areata: current state of knowledge. Norris D – J Am Acad Dermatol – 01-JUL-2004; 51(1 Suppl): S16-7 From NIH/NLM MEDLINE Journal of the American Academy of Dermatology University of Colorado Health Sciences Center, Denver, CO 80262, USA.

Tags: alopecia, areata, totalis, hairloss, hair loss, gene, genetic

Iron Deficiency, Birth Control, Hair Loss

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

Is it true that iron deficiency in women can cause hair loss that may appear to be AGA? If so, does supplementation actually help?

Also, do you know if oral birth control pills (Ortho-tricycline lo) can cause progressive hair loss while on them. I am not refering to hair loss after discontinuing but progressive loss over time.

Iron deficiency with or without anemia has been reported as a cause of hair loss. Hair loss seen in iron deficient patients is typically more diffuse. In patients who are prone to male pattern baldness, iron deficiency can speed up the hair loss process.

Birth control pills or medications that manipulate the estrogen balance can cause hair loss as well. Although any medication containing estrogen may cause hair loss, the opposite also occurs and in some situations estrogen may be protective. Excessive hair loss (telogen effluvium) could be often seen in withdrawal from estrogen, or in postpartum phase and can last about a year after the baby is born.

Tags: birth control, iron, anemia, hairloss, hair loss, estrogen

Seborrheic Dermatitis and Minoxidil

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

I have had patches of sebhorrheic dermatitis on my scalp since I was little but since I started using Monoxidil for my hair loss it has spread over my entire scalp. My doctor perscribed the strongest medication that she could prescribe (clobetasol propionate) and it isn’t working at all. I just started using the monoxidil 3 months ago and was wondering if my scalp will eventually adjust and stop itching and flaking as bad?

It sounds like you are reacting to the minoxidil, which can increase the flaking of the scalp. You are probably not a candidate for minoxidil, so try stopping it for a week or two and see if the problem goes away. When people react to this medication, it usually does not get better and may actually get worse. Long term use of topical steroids are risky, so be careful.

Tags: dermatitis, minoxidil, steroid, hairloss, hair loss, clobetasol

What is Diffuse Unpatterned Alopecia (DUPA)?

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

Hello!
I have seen many dicussions related to Diffuse Alopecia or DUPA, but I have never understood the causes. Is it genetic hair loss expressed in a diffuse pattern, or is it a kind of disease caused from something else?

Thanks a lot for your time!

Diffuse Unpatterned Alopecia (DUPA) is a condition where the hair has miniaturization throughout the scalp without a particular pattern to it. Women who have genetic hair loss have something that acts and looks like the male patient with DUPA. It is generally believed that in men, DUPA is genetic and hormonal. At times, it will respond to Propecia (finasteride 1mg) in slowing down its advancement and in about half of male patients it does get better (slightly) with Propecia.

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

Hairless Spots on My Leg — Alopecia Areata?

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

Hi Dr Rassman, I have 2 round, completely hairless bald spots on my leg, very slightly pitted & ridged fingernails, and some hair loss on the sides of my head. I have read a lot about alopecia areata and was relieved to find out that al. areata hair loss is usually in clumps, but then I came across a website that said that there is a type of alopecia areata that is a general thinning of the hair (not talking about dupa), I have also read on this site that there can be several reasons for round hairless patches other than alopecia areata, and lastly I have read that there can be many reasons for pitted fingernails, my question to you is can you tell me the list of tests I should have done to evaluate what I am experiencing? I plan to see a Dr. regarding this as well, but I also wanted to ask your thoughts. Thank you.

You have 2 round and hairless spots on your leg along with pitted and ridged fingernails. Although alopecia areata is frequently seen in clusters, it is not unusual to see just one area involved. Accompanying signs like pitting and ridging fingernails are found in alopecia areata (AA), but it can also be found in fungal infections as well. It is a good idea to see a dermatologist and if presenting typical signs, you may not need any other tests. If AA has an unusual presentation, your doctor may choose to take a skin biopsy to confirm the diagnosis.

Tags: hairloss, hair loss, bald, spot, alopecia, areata, leg

Teen Girl Losing Hair, Wonders If It Is Cancer

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

Im a 14 year old girl and about 2 weeks ago I cut my hair myself. I always do so I didnt think anything wrong was going to happen. But now any time I run my hand though my hair I have like a hair ball and it’s starting to scare me because I used to have really thick hair. My mom has thin hair. Could i have cancer? My grandmother has a history of it.

Based on what you’re telling me, I doubt that you have cancer. If there is a family history of cancer (ovaries, breast, uterus) then you should find out if your family has the gene for such cancers. If that is the case, you can get checked out for the cancer gene as well. If it is not in the family, I doubt that you need to get the genetic test. I remember when I was in medical school, each and every time I found out the details of a disease, I seem to have developed the symptoms of that disease. Eventually, I learned to disassociate my learning from my life and I stopped getting the weird diseases. At 14 years old, cancer is unusual, but that is a matter you should discuss with your parents and your doctor.

Tags: teen, female, woman, women, girl, hairloss, hair loss, cancer

5 Year Old Daughter’s Hair Won’t Grow — What Can We Do?

/by William Rassman, M.D./19 /, ,

My 5 year old daughter’s hair will not grow. The sides (around her ears) grow longer than the very back and top of her head. We have tried trimming it, (she does not have enough to trim any more than an 1/8 of an inch at a time), we have tried shampoos to strengthen it etc. When I run my hands through her hair, it comes out. We have taken her to a local doctor who had no answers for us. She is almost six and we are scared that this is going to become an issue with her soon. We do not know where to go at this point? Any suggestions?

There are a number of genetic diseases that could be responsible. A good dermatologist should evaluate her. An example of a genetic disease can be read about here — Gene Glitch May Up Inherited Hair Loss.

Tags: dermatologist, hairloss, hair loss

I Was Diagnosed Chronic Kidney Disease and Stopped Propecia

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

I am 35 years old I was diagnosed with Chronic Kidney Disease earlier this year (stage 3). Up until this point I had taken Propecia with good results. My Doctor has told me to stop all medication, vitamins etc but since stopping Propecia my hair is falling out quick. Is this normal? I want to go back on Propecia but my Doctor said no. Do you know if Propecia has any adverse affects on the kidneys?

Many thanks

There is no documented adverse effect of Propecia on the kidneys. Propecia use is safe in patients with renal failure. Propecia is being eliminated from your body by two different ways:

  1. Excretion in the urine (39%)
  2. Excretion in the feces (57%)

This means, even if you have severe kidney failure, your body can get rid of Propecia through the liver and it will be excreted into the feces; so in theory no real adjustment is needed for Propecia in patients with kidney failure. Having said that, you still need to talk it over with your physician and make sure about the other reasons that he/she may have wanted it discontinued. Share this blog posting with your doctor. You might want to try the regular dose and then check for blood levels at the lab.

Tags: propecia, finasteride, hairloss, hair loss, kidney, disease

Hemorrhoids and Hair Loss

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

Excessive bleeding from hemorrhoids for a period of four days triggered hair loss which has persisted and has fallen out over a period of four months. I have an iron deficiency although I am not anaemic. Worringly, my hair loss has not occurred on the back and sides (a characteristic of AGA). Do you think my hair will regrow?

Iron loss from acute and chronic bleeding can cause hair loss. It is a controversial issue. A link between iron deficiency and hair loss is not fully shown in every study and that is why iron-deficiency screening is not routine for people with hair loss. However, studies show that whatever the cause of hair loss, having too little iron in the blood makes it worse.

Treatment of iron deficiency is easy and patients with accelerated hair loss due to iron deficiency will respond beautifully to correction of their iron deficiency. You may also be predisposed to AGA and iron deficiency has just triggered the ‘genetic switch’. The good news is, even if this is the case, your hair loss should improve considerably with treatment of iron deficiency.

Tags: hairloss, hair loss, iron, hemorrhoid

Our Entire Family is Experiencing Hair Loss — Even the Children!

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

We moved in to a 25 year old house 11 years ago and over this time we have all (7 kids and parents) experienced thinning hair. We are all at the same level of hair loss, typically thinning on top. It is getting noticeable (this has been a very slow process) I have been to doctor many times but no answers. I have had a blood test that shows higher than normal levels of copper? Any help would be very much appreciated.

Ages and sex are as follows:
girl-6
girl-9
boy-12
boy-15
girl-16
girl-22
girl-23
Mom-43
Dad-45

Thank you

Hair loss can be a sign or a clue that something is going on with your health. If your entire family is truly experiencing hair loss and it has started around the same time, one would think that there is an environmental influence.

A genetic cause of higher than normal levels of copper in your blood is a condition known as Wilson’s Disease, which causes copper to accumulate in the tissues and cause extensive damage. You can also get higher than normal copper in your body from environmental factors such as drinking sources. Your brief history seems to fit with an environmental cause, since the hair loss cases all occured around the same time frame. There may be other causes beside copper, such as lead, or other elements in your environment and you may want to get some public health professional involved if it is impacting the entire family as you say. An evaluation of the hair shafts themselves can be made by a good toxicology lab under the proper direction of a qualified doctor in the field.

Tags: hairloss, hair loss, environment, copper, lead, poison, family

Any Solutions for Severe Dandruff?

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

Dr. Rassman,

For the past 3 to 4 years, i am suffering from severe dandruff. I have also been diagnosed with PCOS last year which is now under control. Mine is long hair and this dandruff is also cyclic. Some times it is perfectly clean and sometimes at its worse. I have used topical products like diprovate with minimal improvement and the shampoos are also not giving the desired result. The dandruff is primarily flaky which is very embarrassing to me. Please suggest me if there is any solution to it. My hair is thinning day by day.

Dandruff may be the sign of a skin disorder like seborrhea, psoriasis, etc. You need to see a good dermatologist and find out if you have some scalp disorder causing what you are seeing and calling dandruff.

Tags: dandruff, dermatologist, psoriasis

Adrenal Problems and Hair Loss?

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

Is there a correlation between adrenal fatigue/insufficiency and hair loss (in the form of total head miniaturization, but yet have no balding, no recession.) I have very low DHEA levels and high cortisol levels…. would chronic/high physiologic stress levels induce hair thinning/miniatuzization?

Yes, it is a possibility, as low adrenal function in such conditions as Addison’s disease affects about 1 in 100000 people. Hair loss throughout the body is a reported finding in this condition. I do not have experience with following people with this disease, as they are treated with appropriate hormone supplements. I have never seen a patient with Addison’s disease and studied the existence of miniaturization or a follow-up of this in a treated patient. Sorry that I can not shed more light on your question.

Tags: addisons, disease, hairloss, hair loss, adrenal, cortisol