What is Scarring Alopecia?

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

Are scarring alopecias the only forms of alopecia that result in permanent damage to the hair follicle? if so is Androgenetic Alopecia scarring or non-scarring? Also, is hair loss due to vitamin/iron deficiencies and/or hypothyroidism a scarring or non-scarring form of alopecia? If so then is it theoretically possible to regrow hair years after losing them to these conditions even if it is not yet known how to do so?

Scarring alopecia (otherwise known as cicatricial alopecia) is a hair loss condition caused by an underlying medical issue that causes “scarring” of the hair follicles and the skin around it, as the name implies. It is is generally not treatable with a hair transplant procedure.

According to WebMD, some examples include “dissecting cellulitis, eosinophilic pustular folliculitis, follicular degeneration syndrome (previously called ‘hot comb’ alopecia), folliculitis decalvans, lichen planopilaris, and pseudopelade of Brocq, to name a few. Scarring alopecia may also be part of a much larger condition such as chronic lupus erythematosus, where many organs of the body can be affected.”

Androgenic alopecia is NOT scarring alopecia. Androgenic alopecia is genetic, where the follicles are genetically programmed to “die” after a certain period of time (no scarring).

Vitamin/iron deficiency or hypothyroidism can cause hair loss as a side effect from the underlying medical issues, but there is no scarring involved. In general, scarring alopecia is permanent; however, for many patients we have found a good cosmetic solution with Scalp MicroPigmentation (SMP).

Tags: scarring alopecia, hairloss, hair loss

Not Hair Loss News – Cancer Death Rates Are Declining in the US

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

Snippet from the article:

Cancer death rates continue to decline in the United States for both men and women. Experts say the four major cancers, lung, colorectal, breast and prostate, account for more than two-thirds of the decline.

In 2001, a routine PSA blood test helped John Nemeth, 77, of Glendora detect prostate cancer at a very early stage. Twelve years later, the cancer is gone after undergoing a minimally invasive treatment.

According to 2013 National Report Card on Cancer, success stories like Nemeth’s are on the rise. Deaths from the top four cancer killers are dropping.

From 2001 to 2010, lung cancer deaths dropped 29 percent, a faster rate than in previous years.

Read the rest — Cancer death rates drop 29 percent over decade

Tags: cancer, death, health, prostate cancer, breast cancer

Not Hair Loss News – Type of Anesthesia Might Influence Prostate Cancer’s Return

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

Snippet from the article:

For men having prostate cancer surgery, the type of anesthesia doctors use might make a difference in the odds of the cancer returning, a new study suggests.

Researchers found that of nearly 3,300 men who underwent prostate cancer surgery, those who were given both general and regional anesthesia had a lower risk of seeing their cancer progress than men who received only general anesthesia.

Over a period of 15 years, about 5 percent of men given only general anesthesia had their cancer recur in their bones or other sites, the researchers said. That compared with 3 percent of men who also received regional anesthesia, which typically meant a spinal injection of the painkiller morphine, plus a numbing agent.

Read the rest — Type of Surgical Anesthesia Might Influence Prostate Cancer’s Return

Correlation does not imply causation, but the research is interesting.

Tags: prostate cancer, cancer, surgery, anesthesia

I Have Rheumatoid Arthritis and Lupis — And They’re Taking Their Toll on My Hair

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

I have always had very thick and long hair. However 15 years ago I was diagnosed with Rheumatoid Arthritis and 4 years ago with Lupus. The medications, rashes and the progression of the diseases has taken their toll on my body and my hair. Each time I comb my hair it sheds heavily. I try to limit the amount of heat I put into my hair, and my beautician deep conditions it every two weeks as well as lengthening the time between relaxers. Last visit, we discussed a small amount of weave to thicken it up because you can now see scalp.

I already see a Dermatologist for Lupus related skin problems. It seems when she corrects a skin problem, my hair benefits. However, when the skin problems reoccur so do the hair problems. Do you have any suggestions to help make my hair stronger?

I really can’t offer much help here. In general, if you treat the cause of hair loss, such as your lupis and RA, the hair will grow back. Treating the underlying condition will treat the hair loss.

Tags: lupus, arthritis, hairloss, hair loss

Is Propecia Causing My Gastritis?

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

Hello Dr.Rassman,
Thanks for your wonderful service. I have a question on one of the side effects (not sure). I am 32 and started taking Propecia a month ago. I started to experience abdominal pain especially around the chest. When I searched for similar symptoms in your blog, I found that in one similar case you had advised that it may be because of ‘Gastritis’. I also compared the symptoms provided in the internet with mine and found it to be exactly the same. Any way I am planning to consult a doctor soon.

My question is that does Propecia cause ‘gastritis’? It is mentioned that gastritis may be caused due to ‘nonsteroidal anti-inflammatory drugs (also known as NSAIDs)’. Does Propecia belong to this category of drug?

I have seen good results with propecia even less than 1 month of using. Now in case the doctor tells me that Propecia caused the ‘gastritis’ do I have to stop taking that? Because i do not want to stop Propecia. Please advise. Thanks once again for your great work!

Propecia is not a NSAID drug and it most likely does not cause gastritis. Aspirin and ibuprofen (Advil, Motrin) are NSAID class drugs. Poor diet, spicy foods, alcohol, and obesity are generally the culprits of gastritis. This site (which polls people on the web, is not scientific, and I do not endorse) indicates that gastritis is seen in 0.1% (one in a thousand) Propecia takers, so I wouldn’t believe the medication is related to gastritis.

Finally, as I have had said numerous times, the Internet is not an ideal place to seek personal medical diagnosis or answers. It will confuse and distort the issue. If you have a medical problem, see a doctor for an examination and receive a diagnosis by a medical professional. You can then look up your diagnosis on the Internet for a better understanding.

Tags: propecia, finasteride, nsaid, gastritis, hairloss, hair loss

Body Temperature and Alopecia Totalis?

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

My daughter has alopecia totalis. We have been told that the body is hot on the inside and that is why the hair fell out. It is a Homeopathic term. Will changing the body chemistry have a positive effect? Have you heard of any homeopathic remedies that work? Do the hairs sometimes just return on their own?

Getting information on this is difficult at best. Thanks for your help

I have never heard about the temperature issue you discussed. Alopecia totalis does go through remissions and often returns.

Tags: chemistry, body heat, alopecia totalis, hairloss, hair loss

Myotonic Dystrophy and Hair Loss?

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

Hello, I am currently a 20 years old male, with extremely fast paced MPB in the front region. There is no extreme history of MPB in my family, although my dad and his brother are both above 50 and both thinning.

Anyways, my question is, my father has miatonic dystrophy, which of course is a genetic disease effecting muscles. I have never been tested for the disease, however I was looking up symptoms and one was listed as possible frontal hair loss at an earlier age due to hormone changes. My dad of course, did not experience this. I had just got a prescription from a dr for proscar, and was wondering IF this was the case, would there even be a point to taking it? I write to you because none of the physicians I’ve seen seem to know what they are talking about.

Hair loss in the great majority of men (especially frontal hair loss that occurs in a specific pattern) is due to genetics. It does not matter if your father or uncle didn’t see male pattern baldness until their later years, as the gene can also come from your mother and can even skip generations.

Though myotonic dystrophy can cause hair loss, I am a bit worried if none of the physicians can explain this to you before you were prescribed a medication to treat genetic hair loss in the first place. Was your doctor not aware of your family history?

Tags: myotonic dystrophy, hairloss, hair loss

In the News – Teen with Alopecia Crowned Beauty Queen

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

Snippet from the article:

A Salt Lake City woman is preparing for the next round of a beauty pageant, after winning a crown in a competition last weekend. The catch, she has no hair.

19-year-old Angelica Galindez was diagnosed with a condition called Alopecia, when she was 12. “The hard part was just looking at myself in the mirror,” says Angelica, who is now completely bald.

Alopecia is a type of hair loss that occurs when the immune system mistakenly attacks hair follicles. Angelica lost nearly all her hair by the time she was in high school. “It was very challenging, I cried a lot, I slept a lot, just to sleep away the pain,” says Angelica.

Read the rest (and see the video) — Bald SLC Woman Crowned Beauty Queen

This young lady proves that beauty shows through even without hair. I applaud her for her courage.

Tags: hairloss, hair loss, alopecia, beauty queen, pageant

My Daughter Had Chemo for T-Cell Leukemia and Her Hair Never Regrew

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

My daughter was diagnosed with t-cell Leukemia 10 years ago. She had 2 years of chemo and 2 weeks or radiation to the brain stem. She is now 14 and has very, very thin hair with much breakage. We were never prepared that her hair loss could be permanent. You can see her scalp through her hair. We have tried many things with no luck. We have no idea where to go for help.

I looked for a Trichologist, thinking they would have answers but cannot find any in Michigan. I don’t know how she would feel about having a hair transplant at this time or should we go to a Dermatologist? Wigs did not work so if you have any suggestions on what we should do, we would greatly appreciate it. (she had T-cell Leukemia)

Thank you for your time!

If the hairs never grew back after almost a decade, unfortunately there is not much you can do. Hair transplantation will likely not work since the donor hair will also be depleted. From a medical or surgical perspective, unfortunately there’s really nothing I can think to offer.

If your daughter has some hair density, there are hair camouflaging products like DermMatch or Toppik — and there is also a permanent camouflage called Scalp MicroPigmentation (SMP).

Tags: leukemia, hairloss, hair loss

Female Hair Loss from Graves’ Disease?

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

(female)
I was diagnosed with Graves Disease (hyperthyroidism) a few years ago and it has caused hair loss. I’ve been taking prenatal vitamins to help prevent the loss but it is still thinning fast. Is there any help out there for me? Desperate for Answers

Other than getting control of the Graves’ disease, I don’t know of any specific treatment for hair loss resulting from it. If you have the disease under control, the hair will likely come back! Give it a full year.

Tags: hyperthyroidism, graves disease, thyroid, hairloss, hair loss, female hair loss

Addison’s Disease and Propecia?

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

Hi I’m 30 and suffer from Addison’s disease. I’ve noticed over the past 3 years my hairs been getting thinner and thinner and I want to do something about it. Propecia seems like a good starting point…. only problem is I have this rare endocrine disease and am worried about serious side effects. Should I be worried? Should I try rogaine instead? Many thanks.

You should first see a doctor for an examination and a diagnosis of your hair loss cause. You shouldn’t just jump at trying different medications/products blindly. You can also ask your endocrinologist about your concern with Propecia (finasteride 1mg). First and foremost, make sure your hair loss is due to genetics if you’re even considering Propecia.

I have seen many patients with hormone disorders (though not Addison’s disease specifically) and there is no reason they cannot be on Propecia that I can think of. But even to my own patients, I always advise them to check with their endocrinologist first.

Tags: propecia, finasteride, addisons disease, hairloss, hair loss, hormones

I’ve Been Picking At My Scalp Flakes and My Hair Is Thinner In Those Areas Now

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

I am an 18 year old male and have seborrheic dermatitis on my scalp. Over the past few months little flakes started to appear attached onto my scalp, after a while i developed a desire to pick and scratch the flakes on my scalp in order to remove them. Doing this resulted in some parts of my hair becoming thinner, not necessarily hair falling off just looking thinner if you understand?

Will the follicles where i picked at my scalp heal naturally within time or is this permanent? Where my hair looks thin is not really noticable for now..
(I do not suffer from any MBP)

Picking at your scalp and/or hair causes traction alopecia. In some people, the picking gets so severe that a name to describe the process is worthy for your review — dermatillomania. I’m not about to diagnose you with this disorder over the web, but the hair could become permanently lost if you continue to pick or pull at your scalp.

Dermatillomania (skin picking) and trichotillomania (hair pulling) are both obsessive compulsive disorders and you should see your doctor if you find yourself continuing to pick at your scalp.

You can learn more about dermatillomania here. You can learn more about trichotillomania here.

Tags: dermatillomania, trichotillomania, hairloss, hair loss, skin picking, ocd

Not Hair Loss News – Coffee Lowers Risk of Prostate Cancer Recurrence?

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

Snippet from the article:

Drinking 4 or more cups of coffee a day is associated with a lower risk for prostate cancer recurrence and progression, according to a prospective study published online August 2 in Cancer Causes and Control.

The study authors found that men who drank that much coffee daily had a 59% reduced risk for prostate cancer recurrence and/or progression, compared with those who drank 1 or fewer cups per week (P for trend = .01).

The coffee consumption was measured before a prostate cancer diagnosis, not afterward, note the authors, led by Milan Geybels, a PhD candidate in the Department of Epidemiology of Maastricht University in the Netherlands. He worked on the research while studying at the Fred Hutchinson Cancer Research Center in Seattle, where one of his coauthors, Janet Stanford, PhD, is codirector of the program in prostate cancer research.

Read the rest — Daily Coffee Tied to Lower Risk for Prostate Cancer Recurring

Tags: prostate cancer, coffee, cancer

Regrowing Hair After Chemotherapy

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

I am trying to find a product that will help grow my hair back a little faster after chemo therapy. Is there any product that you can recomend to use to help?

I meet a lady that used some amino acid and her hair grew really fast

I don’t know of any commercially available product that accelerates the return of hair after chemotherapy. We have written about cold cap therapy before, but that is something that is used during chemotherapy to maintain the hair, not to regrow it faster after the chemo treatments are complete.

I realize this information doesn’t help you if you’ve already lost hair, but it is the only chemotherapy-related hair loss treatment I am familiar with. At this point, just being patient for the hair to regrow is likely going to be the best course of action.

Tags: chemotherapy, hairloss, hair loss

In the News – Finasteride Makes Prostate Cancer Screening More Reliable

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

Snippet from the article:

Men being screened for prostate cancer can dramatically reduce their risk of unnecessary treatment by taking an already-approved drug, a new study shows.

Although doctors still hotly debate the value of prostate screening, most agree that the PSA (prostate specific antigen) test leads some men to be “overdiagnosed” and even “overtreated,” because it detects many tumors that won’t ever turn deadly.

Many men are unaware that some prostate tumors — while technically malignant — are essentially harmless, growing too slowly to ever cause trouble in their lifetimes. Men are actually better off if these tumors are never found, says Otis Brawley, chief medical officer at the American Cancer Society.

Read the rest — Drug makes PSA screening test more reliable

This is a seven year study of 19,000 men that showed taking finasteride makes the PSA test much more accurate.

The article goes on to say that the study found that “men on finasteride were 43% less likely to be diagnosed with a ‘low-grade’ prostate cancer — the kind most likely to lead to unnecessary treatment“, though there was no difference in survival rates between those that took finasteride and those that took the placebo.

Tags: prostate, psa, finasteride, proscar, propecia, hairloss, hair loss, prostate specific antigen