Hair Loss in Child?

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

My new doctor recently told us that my 3 year old step-son has alopecia. She didn’t get into specifics with it but said that his condition seemed to be improving on it’s own. He has a bald spot on his right side and it was really bad in January when he first moved in from living with his mother. Is it possible malnutrition caused his hair to bald? He was also extremely underwieght according to another doctor?

There are many causes of hair loss including fungal and bacterial infections. In children, fungal infections are not uncommon. Malnutrition would be unusual, particularly without dieting. Included are other conditions of genetic origin such as Alopecia Areata. If it is going away on its own and your doctor already has seen it, is involved, and is comfortable with your step-son’s situation, then just wait it out.

Itchy Scalp Where Hair Is Thinning

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

Hello Dr. Rassman
Am 25 year old male whose fighting the deadliest enemy of all men, that is hair loss, which has attacked my frontal hair causing a diffused loss, yet my temples and crown seems fine. My point is that i have noticed alongside my falling hair, there is a persistent itching in my scalp especially within the regions where hair loss is occuring most, slight scalp redness can be seen upon close inspection. Is there any possiblity that the two are related?

The first thing that comes to mind is ‘what came first, the itch or the hair loss’? It is possible that you have a skin problem and that the skin ‘itch’ is actually making your scalp flaky and red. If you scratch the itch, you can produce traction alopecia (in your case, it would be hair loss from pulling hairs with scratching), or you can have other skin disorders like Psoriasis (visit National Psoriasis Foundation). It is also highly possible that you have male patterned balding and you need a good doctor to determine if there is miniaturization corresponding to the genetic process in the frontal area.

Female Bald Spot — Alopecia Areata?

/by William Rassman, M.D./8 /,

Hey Dr. Rassman, I just found out this bald patch in my head and wondering if there’s anything i can do to prevent it from getting worst? I’m 27f and there’s no bald history in my family that I know of. My hair is thinning as well, and have not tried any products at all… what kind of re-grow hair products would you recommend?

Thanks.

If you have a bald patch that appeared on your head, I would be concerned that you might have Alopecia Areata (search this site). First, get to see a good dermatologist. This can be a serious problem and it should not be washed away with topical solutions and hair care products.

Patchy Hair Loss Pattern

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

Dr. Rassman,
I’m a 21 year old male and I’m quite physical fit and eat properly without excessive drinking or smoking. For the past four months now I have been noticing some patchy hairloss on different parts of my head. One being on the left side and the other largest being on the right rear near my crown. At first it looked like perhaps alopecia but the patches were not round and also not smooth. Now the balding on the right side has turned into what looks like a circle, almost like a crop circle at least 3 to 4 inches in diameter and the left side it also a random pattern that is not fully smooth. I have also noticed a small circle on the back of my head down by my neck. I saw a dermatologist and apperantly she has never seen this before and now has me taking a bunch of blood test for HIV, syphilis, and lupus. I am most certain I dont have HIV or syphilis and I do not have any other symptons of lupus. Do you have any ideas what this unusual hair loss pattern could be? Thanks for the help.

If you have a series of bald patches that appeared on your head, I would be concerned that you might have Alopecia Areata (search this site for “Alopecia Areata”). I am surprised that your dermatologist said that she’d never seen this before, as it is a common problem in the study of dermatology. This can be a serious matter and you may want to see another doctor if what you said is true. Read the website material and learn about this condition. Then when you meet with either your present doctor or the next dermatologist, bring this up as a diagnosis possibilities. You also must realize that I am taking what you say as what you reported here.

Chronic Thyroiditis and Hair Loss

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

Dear Dr William Rassman,

I’m a woman and I’m 30 years old. I’ve been losing my hair for 13 months, 150 hairs per day and a lot of them when I wash my hair. They have informed me that I have the telogen effluvium and a miniaturization of my hair. I have no problem with my health and hormones. Only a problem (Hashimoto thyroid), but the TSH is normal. What can I do for that? Can I expect that with the time, the hair loss will be stopped? Have I a risk to become bald? I have a lot of hairs, and 10 years ago I have had the same problem and the hair loss had been stopped 2 years later.

Thanks for your help.

The connection between Chronic thyroiditis (Hashimoto’s disease) and hair loss has been known for some time. Clearly, your thyroid needs to be under good management, then pulling back and looking at the hair loss under the guidance of a good dermatologist would probably be the best way to command what is going on with your hair. I doubt that you will go bald, and you probably will find that control of the hair loss will be like your last episode years earlier. Women almost never go bald, but they can push thinning at times. If it had reversed before, then you might safely assume that it will reverse to some degree again. The focus, as you so rightly concluded, is to stop/contain the hair loss. Like a chicken and an egg scenario, what came first? Chronic thyroiditis may have layered on top of the female balding genetics in your family line.

Propecia with Hyperthyroid

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

Good day Sir, I would like to ask if you can recommend propecia to me, despite of having hyperthyroid and heart problem.thanks and god bless

I would doubt that there is a problem with Propecia use, providing that you have dealt successfully with the treatment of your thyroid problem. You need to see a doctor and have a full examination of your scalp. Confirmation of the diagnosis is critical before I would write a prescription.

As thyroid problems are a common cause of hair loss, I think this is an informative page for those intertested in learning more about thyroid disease: Hyperthyroidism.

Psoriasis and Hair Loss

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

Hi,

I have male pattern baldness. it started at age 18 from my temples and has been receding terribly over the years, and more esp over the last 5 years. I am now 43. I used to have severe psoraisis on the face and scalp and was told the hair loss was because of that. Now the psoraisis has gone down considerably, alomost completely but the receding continues. i also have thick scabs on my scalp on and off that do not look like psoraisis scabs, i think it could be symptomatic of systemic yeast/eczema?

I used to have a very thick full head of hair, more than the average person so the hair loss over the years was more apparent to me than to others. Now, it is apparent to everyone. i just have a strand or two to cover my unnaturally high forehead, the hair on top is very thin, weak and sparse, there is more at the back but that too has recently thinned a lot.

In the last 3-4 months, my hair has been falling out in clumps, and is extremely coarse, dry and brittle. Please dont tell me it is age because this has been happening throughtout my adult life , but has has gotten much worse recently and esp since my first ever perm a year ago. But the frontal hair has been receding steadily since age 18. It has been very distressing and depressing for me, and nowadays, i dont even like to look in the mirror and see my unkempt hair. No matter what i do – hair oils, etc, it is as dry n weak as ever and receding all the time. help would be very welcome and appreciated.

This is an area where I have first hand knowledge, with the worst form of scalp psoriasis one can have. Mine, like yours, burned out in the scalp and I have almost none of if at this time. But I never lost hair because I was careful about not pulling off the plaques which would have almost certainly produced traction alopecia. Psoriasis does not cause hair loss unless the plaques are pulled off and the hair comes out with the plaques regularly.

With regard to hair transplants, I am frequently asked by people with psoriasis, if the psoriasis can be moved from one part of the scalp to another. In my experience, psoriasis can not be transplanted from the affected area to an unaffeced area, but any surgery done on active psoriasis, can make it worse, unless it is treated topically prior to the surgery.

You may have a skin condition and this must be defined by a good dermatologist. The rest of your needs are easily dealt with through traditional hair transplantation, which is extensively discussed in my book, The Patient’s Guide to Hair Restoration.

Lyme Disease and Hair Loss

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

I have had Lyme disease and taken massive quantities of antibiotics. I am also 57 and taking a small amount of estradiol. I also recently (over a six month period) lost 12 pounds on a diet prescribed by my endocrinologist which eliminated foods I was allergic to (wheat and dairy). my hair has been falling out for about four months now. I thought it was due to the antibiotics, but I quit them three weeks ago and the hair loss is as bad as ever, particularly when I wash my hair–a handful! I am down to half my normal head of hair (and have also lost it on other parts of my body). Do you know of a good Alopecia doctor in Los Angeles who could help me. And, of course, what are your thoughts?

I am in Los Angeles, so I’d like you to please pay me a visit. I can add other doctors to the mix that have the specialties to deal with some of the problems we identify. It sounds like many of the elements you discussed can contribute to your hair loss. Medications, hormones, weight loss, and some types of allergies all are known factors that by themselves can produce hair loss, but first, you need to have a good, caring doctor who will look at you as a person first, and with a desired head of hair second. I might not be the right one for the entire management, but certainly I am good to have on the team.

Call my office at 800-NEW-HAIR to set up an appointment with me. The consultation is free.

Patchy Hair Loss and Alopecia Areata

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

I have patches of hair coming out on my head. It looks like someone hit me with a shot gun and every place the buckshot went, I lost a patch of hair around it. It started a couple of years ago and then stopped, but did not get better. What should I do? Will a hair transplant fix this?

It sounds like you have Alopecia Areata. This is an autoimmune disease that has genetic origins. You need to see a dermatologist. Hair transplants usually fail to grow in the patches of hair loss if the disease is active. Visit the National Alopecia Areata Foundation website for more information.

Birth Control Pills Causing Hair Loss?

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

Hi! I’m 21 years old and female. In feb 2004 I started taking birth control pills, and 3 months after starting them, i started losing hair. Then after 7 months of using them i stopped, because my hair was falling out in clumps. No I have been off more than a year and i still dont see any improvement. Doctors have made bloodtests, and they were OK! Hair loss is diffuse all over and they have a little white tip at the end. In my family no one has hair problems, not even my two grandfathers or my father! Is it normal to lose hair for such a long time ? i truly believe i am going to bald soon :(
Thank you for your time!

Please see my previous post about Depo-Provera which answers the question about birth control pills and hair loss. Unfortunately, some women with hormone changes can precipitate female genetic hair loss and once it has started, it may not be reversed ‘if it was to be in her cards’. About 30% of women over 50 are affected by this genetic process. Although we can reasonably accept hair loss as normal in men, women have a unique type of suffering because it is another ‘attack’ on their feminity in a society that is heavily hair conscious and weighted to beauty and youth. When a young women get genetic hair loss prematurely (I fully realize that it is always premature for a woman of any age), then it is the worst type of insult that flaunts aging very painfully. What the male and female genetic hair loss is, is the ‘miniaturization’ of the hair (the thin hair that becomes even thinner as the process advances), but the location of this miniaturization is different in women than in men. Men have it develop in patterns (front to back) while women generally have it all over the head: front, top, back and sides. Some women will retain the frontal 1/2 inch of hair as healthy, even with the process of miniaturization everywhere else.

When you discussed that your tests are completely normal, I would raise the issues of Thyroid and pituitary function, as well as the absence of circulating angrogens, amongst other causes. Some doctors talk about chronic effluviums or the presence of diffuse alopecia areata (you need to have a dermatologist evaluate this).

Minoxidil does work on some women, often better than men. Some men have a diffuse patterned hair loss like women (about 1-2% of men) but some of these men are helped by Propecia (about half) while that drug has not been determined to be safe for women and even when experimentally given to women by a handful of doctors, few if any benefits were observed.

Triangular Alopecia

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

Dear Doctor Rassman,
I am 20 years old. I want to know something more about triangular alopecia. My temples are receded about 1.5 inch. I have also genetic hair loss in bitemporal area and also in vertex (or at least it is what the doctors said). My father has lost also all of his temple hair including the hairline and the top, but nobody else in my family lost his temples hair, even though everybody has genetic hair loss. In addition I want to say that my temple hair is changed. Above the ear it is thicker than before but with less hair count, curly (it was not) and with a slower growth. Can it be part of genetic hair loss or it is genetic and something else in the same time? I have tried many doctors in Vienna, but I was not satisfied. When I ask about Propecia thay said: “It is not for you, it is for old men”. There is a clinic, Moser Medical, with some doctor of ISHRS but from the emails that I sent to them, they seemed more commercial than helpful. Can you tell me something about my condition? Thank you for your time and for this website.

Triangular alopecia is a condition of hair loss which impacts the anterior temple area on either or on both sides. It may not be a complete loss of the temple hair, at times showing an atypica or asymetrical pattern, even to the point where a little residual tuft may be present on one side and no problem on the other side. It can affect either men or women and it is not necessarily part of the genetic balding process we commonly see, which produces balding in other parts of the scalp. It is probably another inherited process and hair transplantation is the best approach to treating it.

Avodart for Androgenic Alopecia?

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

Dr Rassman

Do you know for certain if GSK has dropped the idea of continuing Avodart studies for androgenic alopecia?

I can not speak for Glaxo Smith Kline, a pharmacuetical company, as to their official or unofficial plans for the drug Avodart. They manufacture Avodart for prostate disease as the most powerful and most effective DHT blocker. In theory, it should work better than Propecia, but without a committment by this drug company to bring it to market as a hair loss drug, the FDA will not allow it to be sold for hair loss.

Hair Loss 1 Year After Pregnancy

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

I am 32 years old & had my 3rd child 1 year ago, in August. Approximately 4 years ago I was treated for multiple symptoms of malnutrition from losing too much weight too fast. Ridges in my fingernails, major hairloss, hardened areas under the skin on my face & finally an MRI was ordered for an orange sized induration on my hip- it was negative. I got the issue under control & resolved all of these problems. I gained nearly 100lbs with my last child & now a year later my hair has begun to fall out at an alarming rate. I am not dieting & have slowly lost some weight from the pregnancy but in a healthy way. I take no hormones or birth control & I am not on any other meds. I am also in nursing school clinicals which I started 5 days after the baby came. Would I be more likely to suffer hair loss, having a history of it, than I would normally be, related to stress or diet? With it being a little over a year since the birth, I didn’t attribute it to post-baby hairloss, could it be? Thanks for any advice you may have.

You have many variables here which are hard to put together. You clearly recognize that hair loss can occur with pregnancy along with malnutrition. You also recognize that pregnancy hair loss often reverses after a year or sometimes two. I would ask for many tests to rule in or out a series of medical conditions such as thyroid disease, which does start post-pregnancy in some women. The relationship with these hormonal diseases can also cause hair loss, particularly when combined with the genetic predisposition for female genetic hair loss.

Be sure that you are evaluated by a good generalist doctor first, then get your hair graded for miniaturization and patterned hair loss. These may fit together to point or narrow down the possible diagnosis. Start with a good, well-trusted doctor who cares about your overall well being.

Medications for Diffuse Unpatterned Alopecia

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

Hello. I am 24 year old male, who believes I am suffering from diffuse unpatterned alopecia. My hair is thinning evenly over the top and the side of my head to from the classic horseshoe pattern of a Norwood class VII. I have been taking Propecia since January and i do not believe its working as the thinning has progressed. My dermatologist did not seem to concerned and told me to continue taking it for the full year before asking for any other options. Are there any other effective options available? I have read about Avodart and minoxidil, or the possibily of a chemical imbalance, but I do not know if they are effective for this condition.

I believe that DUPA can be reversed with Propecia. I see this in about half of the patients who are taking it. For those like you, it may be worthwhile, after trying Propecia for a year, to consider Avodart, but I have said many things about this drug which you should review.