Eyebrows Fell Out After Moving to a New House

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

Hi I moved into this new house and about a week in i began to experience dryness around my eyebrows and my eyebrows began to fall out because these little white and clear things which may have been exposed hair follicle would form at the base of the hair and the hairs would subsequentely fall out. I have patches of missing hair and saw a dermatologist who said it was seborrhiec dermatitis which i dont think it is – would you have any clue what this condition may be?

Without seeing you, any ideas I’d have about your situation would be a complete guess. If your dermatologist diagnosed it, he/she must have given you some treatment for it. Follow the advice and see where you are in a few months. I always believe that if you are fortunate enough to find a good doctor, stick to that doctor so that you can last long enough to see the benefits of the advice/treatments you are given. If you are not satisfied, then find a new doctor, but do not use the Internet as a doctor substitute (even if I enjoy helping people like you).

Tags: eyebrows, hairloss, hair loss, seborrheic dermatitis

Phosphorylase Kinase Inhibitor for Psoriasis

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

Hello Dr. Rassman,

How about the aid of a phosphorylase kinase inhibitor for the treatment of psoriasis? Could this work? A friend of mine, Dr. Madalene Heng has conducted significant research in this area. (https://psoriainfo.org/)

I do not know much about phosphorylase kinase inhibitors for the treatment of Psoriasis other than what I have read about it at both the site you recommended and at PubMed.gov

As a psoriasis victim myself, I might look into it further.

Tags: psioriasis, phosphorylase kinase inhibitor

I Think My Dad Has Alopecia

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

hi dr rassman,
my dad i think has alopecia universalis, he has no hair anywhere visible, though he can grow remnants of a beard but ive never really seen it grown out enough to know how much, i read that this disease usually shows up when people are young & in round completely bald patches where the hair falls out in larger amounts than normal shedding. i asked my dad if this is how he lost his hair or gradually and he said gradually and he started when he was 25. does this make sense, is it possible that this could happen later in life, is there anyway to tell what genetic disposition you may have, your mother or father side, cause my dads hair was always very thin even when he wasnt bald im told, but i clearly have my moms hair its very thick, does that indicate whether or not i will go bald or not?

You are correct that alopecia universalis generally appears in the younger men, but that is just an ‘expression’ of the gene and the tie to age may not be absolutely chronologically determined — so it can appear at any age. The ‘complete’ disappearance of hair may also not occur immediately and at times, some hair may be present on the beard for example. To answer what your future has in store, there are people who can do genetic testing for the gene. Maybe you can find this on the referenced links below. As you may know, there is clearly a relationship between alopecia universalis and alopecia areata, so looking at both diseases has relevance. The genetics of the process is nicely outlined in the first reference below:

Tags: alopecia, hairloss, hair loss

Chicken Pox and Female Hair Loss

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

I am a 23 year old girl and have patches of severely thinning hair on my crown. I started losing my hair at the age of 20. Prior to that I had very thick and long hair but it has thinned very rapidly for reasons I am not sure of. My grandmother on my dad’s side is bald and I am afraid that I might have inherited that from her. However, I also had chicken pox when I was 21 years old and lost a lot of hair then. It never completely grew back after that. Also, I have applied aurvedic hair oil all my life, so does having an oily scalp cause thinning? I also have acne, so is it hormonal? How will I know what exactly is wrong with me? Please help. Thank you very much.

First, you need to have a complete medical work-up, because hair loss in women is often a side symptom resulting from some other problem. Female hair loss is inherited and some women report relatives with similar histories at similar ages, but first assume that the problem is one that has a cause which might be fixed. It is a difficult problem to address, because there are very few medical treatments available for female genetic hair loss, but if (for example) you had a thyroid problem causing the hair loss, then it needs to be addressed before expecting changes in the hair situation. If your hair loss condition is affecting your life, you should want to consult a good doctor who understands hair loss, but first any doctor can do the test defined elsewhere in this blog.

Chicken pox may have been a medical stress that may have caused you to lose hair or to accelerate a genetic pattern inherited as discussed above. Oily skin and special shampoos and hair products, however, are not generally associated with hair loss.

Tags: hairloss, female hair loss, hair loss in women, chicken pox

Scarring Alopecia

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

Hi Dr. Rassman,

I am a twenty year old female who have been diagonised with scarring alopecia after going to a dermatologist in regards to my hair breaking off in the center of my head. About a year and a half ago, after I took out the braids I had in my hair, about two of my braids that was located in the center of my head came out. I figured this happened because my hair might have been braided to tight so I didn’t worry to much about it. Well a few months later I got my hair braided again and when I took my braids out this happened again. After a months of waiting for my hair to grow back which it didn’t it just spreaded and became so noticeable that I had to get my hair cut to length of the bald spot, at this point I decided it was time to see a dermatologist.

At my first visit he couldn’t see if any thing was wrong with my hair because I don’t have total baldness, just in the area where my hair came out at it is thinner and dryer than the rest of my hair. So, he suggested to do a biopsy and the results of biopsy was that I have scarring alopecia. The PA gave me my results and told me that there is nothing I can do,but I plan on seeing another dermatologist. My questions to you is what you think I can to do to help my hair grow back or what can I do to stop it from thinning and is there any treatments for scarring alopecia.

Thank you very much for taking the time out to read my question!

Stop braiding your hair.

The classic scarring alopecia diagnosis reflects an autoimmune process and it may occur from a wide variety of medical conditions, but what you are describing sounds like traction alopecia from the braids and scarring reaction to it. You need to get some insights into the biopsy that was done. Go back to your dermatologist and have that conversation with him/her. For more information click here.

Tags: alopecia, hairloss, female hair loss, hair

Hypothyroidism in Women

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

I am a 43 year old women who has always had long, fine hair. About the age of 30, I noticed that my hair was starting to thin in the top of my head. I had enough hair to cover it, but it was still thin.

I found out shortly after that I had hypo-thyrodism. So, now I am on synthroid — and my hair is even thinner. I don’t know what to do about it (is there anything that can be done). I am really scared that within the next four-five years, I will hardly have no hair. It’s thinning around the edges. I do get perms, but I get them every 4-6 months. I hardly put heat on my hair because I know that heat can ruin hair as well. What can I do?

Many women have the same problem as you and I sympathize with your concerns. Unfortunately, there has not been a medical breakthrough in hair restoration options for women and their unpatterned hair loss as there have been for men with male pattern hair loss. The first thing is to have your hypothyroid condition well managed. The next step may be to see a doctor who can assess the pattern of hair loss and the degree of miniaturization to understand what is going on, and to check if these measurements change over time. Beware of doctors who are eager to sell you a hair transplant surgery. Women are generally poor hair transplant candidates.

Tags: female hair loss, hair loss in women, hypothyroidism, hairloss

Hydroxyzine, Chemo, and Female Hair Loss

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

I have a good quarter size balding spot on the top back of head. I am a 44 year old woman, along with this ,I have been experiencing itching on skin as well as head. I am 5 years out of remission from Lymphoma, in which I had chemo and radiation……is this linked? Doctors purscribed HYDROXYZINE…every 6 hours..25mg…it makes me drowsy, but, if I don’t take regurally, i found after 3days..i stopped, the itch comes back…more and more hairs fall from my head…seems only these from the top spot…help

It is not clear from your question if the bald spot came on after the chemotherapy and radiation. If it did not and the cancer has not returned, then I would doubt that these are connected. If you scratch over and over again, you can break off hair and produce a bald spot. You need a good doctor to put the story together and examine you, then you will know what is happening.

How Fast Can DUPA Take Effect?

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

I have a question about this condition which you call DUPA. Is its onset so sudden that you could go from having an overly thick head of hair to diffuse thinning including the sides and back in only 1 month. Also can chemical overprocessing make some of the individual hair strands thinner, because if so than I experienced it. I am torn between whether this is a chemical issue or I am suffering from sudden DUPA.

DUPA (diffuse unpatterned alopecia) will not appear in a month. If and when it hits, I suspect that it will develop over a long period of time (months to years). Chemical damage, on the other hand, will have a short cycle.

We do not understand a great deal about DUPA, but we are aware that the zone of hair around the sides and back of the head may not be permanent in everyone throughout their lifetime. If you go to an old age home and look at many of the men there, about 1/3rd to a half of the men over 80 have a see-through look on the sides and back of the head. When this is evaluated by mapping out the scalp for miniaturization, one sees many thin hairs in this ‘donor rim’ that should not be there. This diffuse alopecia may extend throughout the head, even in men who have no balding. I would venture to make the diagnosis of DUPA in these men. I believe that this condition, which the dermatologists have labeled ‘senile alopecia’, is something that hits men in all decades of life and a few men develop this condition when they are in their 20s or 30s. The use of Propecia has benefits to about half of these men, so I generally put people on Propecia who show signs of DUPA. Many of the poor transplant results that are seen occurs when the patient has DUPA and the surgeon does not check for it. The transplants become thin and the donor area, which was see through prior to the procedure, gets more see through after. I strongly warn every one of those patients I see with DUPA against having hair transplants and consider this condition a contra-indication for hair transplant surgery.

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I’ve Tried Propecia for 6 Months and Have No Results

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

Dr Rassman, I am a 39 year old male with very thin hair. i went to Dr bernstein about two years ago because i saw a change in the texture of my hair. It was getting thinner all over, especially in the front.Dr Bernstein said I was losing my hair and was on my way to becoming bald. He took a sample of my hair also. he said i was not a candidate for a transplant since the quality of the donor area was not good. He gave me a year prescription for propecia and told me to visit him in a year.I have been on propecia for six months now , but have not seen any results. it seems my hair is getting even thinner, especially at the hairline. does this mean that if the propecia does not work, i am out of options,since i am not a candidate for a transplant ? If the propecia does work, will that make me a candidate ? I didn,t want to visit dr bernstein again until i have been on the propecia for a full year and since it has not grown hair for me, would he be able to do anything for me?

In most patients over 30 years old, Propecia will help stop further hair loss instead of growing thicker hair. However, there are some fortunate patients who will have thicker or fuller hair after about a year on Propecia. If you experience further thinning after being on Propecia for a year or so, you may be continuing on the natural course of rapid hair loss.

If Dr. Bernstein said you were not a candidate for hair transplantation and he confirmed that you are balding, AND are not helped by Propecia after a year, then I might think (I am guessing here, since I have not examined you) that you have a condition called Diffuse Unpatterned Alopecia (DUPA), which is an extensive analysis of the diagnosis process for hair loss and planning for the future. It is important to revisit Dr. Bernstein after you have been on Propecia for a year.

Pigmented Knuckles, Autoimmune Disease?

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

18 month ago I noticed my hairline was receding and took propecia accordingly.

6 month later I began to notice that the hair on my arms, legs, eyebrowns, and in the public region were thinning. At 12 months, I began to notice pigmentation on my knuckles and small bumps on my nails – even sore joints – all signs of an autoimmune disorder.

I’ve noticed anecdotal evidence on the web that this can happen.
Is there further evidence to support this?

Autoimmune diseases can attack any organ in your body, including your hair. If you think that you have an autoimmune disease and there are many skin pigmentation changes, see a good dermatologist first. What you are describing is outside of my area of expertise.

Polycystic Ovarian Syndrome (PCOS) and Hair Loss

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

hi im 23, female and for 3 years now my hair has gradually become noticly thin all over my head i have been told by a dermatologist my scalp is ok and that my hair has only thinned out due to stress but i feel its through dht, as my hair falls out from the root and regrows finner especailly the sides where it was effected first. my hair around the sides of my head to the back of my ears look near enough bald now even though theres hair there. please HELP i feel like i cant cope with my hair loss its effecting my life so much im highly thinking about taking propecia cause my hair is so important to me i dont wont to where a wig the thought of it makes me sick. please note i have polycistic overies and have been told that can cause thinning of the hair, i have also had alot of blood tests except dht which have all come back normal once again pease help me. regards kelly. x

ps, the loss of my hair has caused me to look so unatractive, and was applying to be a model but i now feel it can only be a dream. i wish and wish for a mirical every day.

Polycystic Ovarian Syndrome (PCOS) can produce some masculine hormonal changes, including hair loss on the scalp and hair growth in areas like the face (i.e. upper lip) and some body hair growth. You need to get your hair mapped out for miniaturization to outline just what is happening to your scalp hair, where on the head it is happening, and to what degree. Drugs like finasteride (Propecia) may work, but if you should become pregnant on this drug, there is a likelihood that your child will develop abnormal sexual characteristics like hermaphroditic changes. There is a report in the literature that women with PCOS and hair loss have been helped by finasteride, but be warned not to get pregnant if you go that route. The metrics obtained with mapping of your scalp hair will show the value of any treatment modality, therefore it is critical to get the measurements in hand before any treatment is started. With that positive note, you probably have genetic female hair loss which can impact the course of treatments as well, and just like men with hair loss and finasteride treatments, there are no guarantees that it can work. Any approach to this requires a really good doctor to manage your hormonal problems.

For more info on PCOS, see:

Lyme Disease, Female Hair Loss

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

I am female, 46 years old. I do have many lyme disease symptoms from neurological to joint and cartilage problems to nervousness…too many to list. I was previously on intravenous twice for months at a time. I was diagnosed at least 6 years too late. I have alot of raciness inside of me and I am always thinking of too many things ata time. I am so miserable about my hair. All my hormones are great and my blood tests are fine. Now what? My hair falls out all over, short and long. How do I know if it is Lyme? Can stress cause a diffuse hair loss all the timne for years? What can I do? Is there a world famous hair Dr.? I am so frustrated and unhappy. Please help, thanks!

It is not clear if Lyme Disease is associated with your hair loss, but it may have triggered a stress response that may have set off a cascade that may not be reversible. Stress in itself can be a cause of hair loss. It seems to be a vicious cycle, and unfortunately there is no “cure” for hair loss in women about 80% of the time. If you are this concerned you may want to see a good dermatologist or possibly even a hair transplant surgeon who will map your scalp for miniaturization to make a diagnosis. Be wary of eager doctors who want to sell you a hair transplant surgery.

Is Triangular Alopecia Genetic?

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

Dr. RASSMAN

I am 24 years old, female, and I have triangular alopecia, two questions that I have for you are will transplant stay in or continue to fall out and will I pass this on to my children. My hair loss began when I was 15. Thank you for being concerned about a disease which may not be terminal and to some people not that big of a deal. To me sir it has destroyed my self esteem,and in so many ways left feeling all alone.

Triangular alopecia is an inherited genetic defect in the area near where the temple prominences are located. Sometimes it is on just one side and sometimes it is on both sides. It tends to run in families, but not always and it does not often ‘express’ itself in the first generation of those who have it. It may skip many generations so those that have it can not find the family link to it. It might be spontaneous, but there is no way to be sure that it is not somewhere in the family line. This condition is easy to diagnose because of its characteristic appearance and can be transplanted quite effectively. There is no need to have your self esteem destroyed, just get a hair transplant by a good physician who knows how to work with the temple prominences.

About to Undergo Chemo — Anything To Minimize Effects on Hair Loss?

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

Good Afternoon Doc,

This question is not for me, but rather my brother, who was recently diagnosed with testicular cancer and will undergo a fairly strenuous (and stressful) 9 week session of chemo, followed by a major surgery to take out some of his lymph nodes.

He’s 23, has a perfect hairline, and no signs of male pattern baldness or thinning (unlike myself) so far. His good looks are definitely an asset and he’s concerned that his hair may go for good because of the stress and trauma he will soon experience. He’s already buzzed his head in preparation.

Now granted his hair is minor relative to the rest of his health, but is there anything he can do to minimize negative effects to his hair from cancer and stress? Would propecia help at all or would it simply get killed off by the chemo (or maybe the two drugs don’t interact at all and propecia would help)? Any other advice?

Thanks for the help!

There are no offerings that are approved for people on chemotherapy to prevent the hair loss that is associated with the treatment. The reason that the hair falls out is because most chemotherapeutic agents try to ‘knock out’ cells that are growing fast (cancers are essentially cells that grow out of control and that is almost the only thing they do). The cells in the body that normally grow very fast are also impacted by these drugs and these normal cells include: certain blood cells, platelets, intestinal lining (causes nausea and vomiting), and hair cells (causing hair loss). The cancer cells could die (that is the hope) while the other cells that get impacted by such drugs also die, but as these normal cells have a source for new cells (like stem cells) the populations usually recover after they go through their natural recovery cycle. Blood cells are relatively short cycled (they grow from a kind of stem cell), but a person may need blood transfusions while the recovery cycle kicks in. Intestinal cells usually re-grow in a matter of days to a week or so (nausea and vomiting stops at about that time) and hair re-grows when it passes through its normal telogen cycle (3-6 months when it re-grows hair probably from some type of stem cells as well).

I have recently been made aware of two new drugs in clinical trials that will target the protection of hair during chemotherapy. That means we might see some new breakthroughs in the next few years, far too long for those on chemotherapy today, but maybe in time for others who go this path.

Seborrheic Dermatitis Recovery?

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

Hi, Dr. Rassman,

I would like to say that it is extremely generous of you to be extending help to thousands people out there who are troubled with hair problems.

I just have one short question for you and hope you may help me with it: do people generally recover from seborrheic dermatitis? It has been plaguing me for nine years, and I sometimes wonder if I will ever recover from it.

Thank you for your kind attention!

Yes, people do recover from seborrheic dermatitis if they are compliant with the treatment plan devised by their dermatologists. Some people heal slower than others and some of them do get better. Maybe the question you are asking is if there a cure for it? To that question, I would say “no”, but there are treatments that make it better and more manageable.