I Took an SSRI for 18 Months and Saw Hair Loss for the Past Year

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

I was on an ssri for the last 18 months and have had telogen effluvium for the past 12. Hair loss is from all over the scalp as is minaturization. It has not thinned out too noticably except on the courners of the hairline where it is very noticable. Can i expect regrowth, what time periods would i expect?

I do not know what to expect. I would follow up with your doctor for a good examination. Telogen effluvium generally takes up to a year for the hairs to grow back. It may take longer and it may not grow back to its original density.

Tags: hairloss, hair loss, ssri

Rogaine Caused Shedding Almost Immediately and It’s Not Stopping

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

Hi, I have 2 questions I am hoping you can answer.

Is hair loss on benzodiazepine, specifically xanax or ativan rare or common side effect? IF so, would taking it several times a month really impact hair loss?

Also, I am using Rogaine 5% (i am a female) for 10 weeks and I have been shedding from it almost immediately. I am still shedding and it is not letting up. I lose about 150-200 hairs a day. Based on what I read, the shed should not last this long. I am mostly concerned because I am losing most of my long thick hairs. Could I possibly be having an adverse reaction to the Rogaine?

Thanks

Hair loss from benzodiazepines are usually uncommon, though it is known to occur.

You need a specialist on female hair loss to assess what is happening to you. Minoxidil can cause a short term shed (1-3 months) usually reversing with the benefits progress from that point forward.

Tags: benzodiazepine, hairloss, hair loss, female hair loss

My Doctor Prescribed Nandrolone Decanoate to Treat My Hair Loss

/by William Rassman, M.D./4 /,

Hi Doc,

I am 27 years old and I am suffering from MPB.My doctor prescribed me nandrolone decanoate and minoxidil 5% 2x application which worked well for 2-3 years but seems like its not working anymore for me. I am planning for making a switch on dutasteride 0.5 MG/day.

I would like to know if nandrolone decanoate really helps in treating hair loss. Nandrolone decanoate and dutasteride can be used at a same time?

Please provide some information on this.

Thank you.

Nandrolone decanoate is an anabolic steroid and is not used or approved by the FDA for treating male pattern baldness (MPB). Anabolic steroids would likely accelerate your hair loss.

Dutasteride is not FDA approved for treating MPB, and I’ve written about the medication before many times. Some people are prescribed dutasteride (Avodart) off-label, but the proper dosage for treating hair loss isn’t clear. The only FDA approved oral medication for treating this is Propecia (1mg finasteride).

What you are doing and your treatment seem unorthodox. Please follow up with your doctor, address these issues, and get a clear explanation.

Tags: steroids, hairloss, hair loss, nandrolone, deca-durabolin

In the News – Some Medication Can Change Your Hair Color and Characteristics?

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

Snippet from the article:

Going thin on top? Or is your hair losing its colour? Your medication could be to blame.

Drugs for blood pressure, acne, depression — even common painkillers — can lead to hair loss, according to a report by scientists at the University of Melbourne. And other drugs can turn a brunette into a redhead, or make straight hair curly.

Doctors say it is important that patients see their GP if they notice any unusual hair loss (do not stop taking any medication without seeing your doctor). They can be switched to other drugs, if appropriate, or the dose can be reduced. In other cases, patients can be reassured the effects are unlikely to be permanent.

Read the rest — Bad hair day? Blame it on your medicine

The article mentions that some epilepsy drugs are linked to hair loss and hair curling, antidepressants are linked to hair loss, and some psoriasis treatments are linked to hair color and characteristic changes.

Tags: medication, drugs, hairloss, hair loss, hair color

Permanent Female Hair Loss from High Doses of Chemo?

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

(female)
I am currently receiving chemotherapy for my synovial sarcoma. I have 2 more rounds of Ifosfamide to go (Cisplatin/Adriamycin in my previous rounds). I will have 6 total rounds of chemo. I’ve read everywhere that permanent hair loss can occur if there has been very high doses of chemo given. What counts as “high dosage?” Do you think 6 cycles of my chemo will cause permanent hair loss? I just want my hair back!! Thank you.

The reason for hair loss with chemotherapy is because these drugs kill cells that are fast growing, and hair cells fall into that category. We may not know immediately if the hair loss is permanent or temporary, because some of the women who have had such treatments may also have genetic hair loss that is triggered by the drugs. Only time will tell.

Within a year, there is enough time to survey the hair loss. Doing bulk measurements on the newly grown out hair and then repeating such measurements over time will tell much about how the hair may or may not be recovering.

I suggest that you finish your course of chemotherapy and after 6-12 months, you might consider being evaluated by someone like me if you are in the Los Angeles area. At one year out, call me and send me photos so we can start a dialogue.

Tags: chemotherapy, chemo, hairloss, hair loss

I Take Excessive Retinoids and Have Hair Loss

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

I’ve been taking excessive retinoids for quite some time now. I started coincidentally thinning (just a little bit to the point of being 100% unnoticeable) around the end of last summer. I stopped taking the acne medications towards the end of the first semester of college (which was right around October/November). Then I went back on the retinoids in February, but developed a full, thick head of hair. I eventually upped my dosage and went on a more intense medication.

Side note: I also went vegan right before college. Second semester I ended the veganism. I was also taking a medication called doryx, which had reported side effects of hair loss, on and off. My slight hair thinning continued throughout the rest of the semester. I went to a dermatologist who didn’t really look at my hair, but prescribed propecia and rogaine. It completely ruined my hair and made it 70% thinner, more brittle, and with bald spots within 2 months. I took propecia and rogaine together for a total of 29 days.

My hair is still falling out rapidly. I also was taking acne medication throughout that period, but stopped in the middle of my propecia dose. I am no longer a vegan and no longer take retinoids or doryx, but my hair is still falling out severely. My dad started having thin hair in his 40s–same with my grandpa. I am only 19 years old. What exactly is going on?

Oral retinoids have been linked to hair loss if you take excessive doses (source), but there’s really no way for me to pinpoint what the exact cause of your loss is considering the medication you took, the change in diet, and your age. I don’t know your complete family history, and just because your dad lost hair in his 40s, it doesn’t necessarily mean that you would too.

You may have the genes for balding and the diet change or medication caused the loss to begin sooner. Or your genetics alone could be responsible for the hair loss starting at 19. Or you don’t have genetic male pattern balding, but the medication or supplements are causing it.

There’s just too many variables that make it impossible to come to any definitive cause.

Tags: hairloss, hair loss, retinoids

I’m Shedding Hair Months After Taking an Oral Corticosteroid for Breathing Problems

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

Hello Dr,

I was prescribed an 8 day cycle of an oral corticosteroid containing 20mg of prednisolone to treat a mild breathing problem. 2 or 3 days after the treatment ended, a massive hair shed started along with acne and seborrheic dermatitis all over face and back. I used to loose around 10 strands of hair when showering and this number raised to more than 80 after the treatment.

3 months have passed and my hair hair is still shedding. My hairline receded more in these 3 months than the whole last year (I have been diagnosed with MPB 1 and a half years ago and been taking finasteride for a couple of months now).

What happened after I took the corticosteroid, will this shed ever stop? I’ve been to several doctors and no one believes me or gives me a reasonable explanation, I am kind of lost. What can I do to regulate my body back to normal and stop the shedding? The hair I lost is gone for good?

I have a hard time believing that you can’t get straight answers from doctors, particularly the doctor that prescribed you the corticosteroid. There is a well known connection between exogenous steroids and hair loss where the drug triggers genetic predispositions to balding. I can not tell you how long this might go on, as this is an individual genetic issue in each case.

Tags: hairloss, hair loss, corticosteroid

Using Minoxidil After My Eyebrow Transplant

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

Dear Dr Rassman,

I had an eyebrow transplant 10 months ago. There was a fair bit of shock-loss and I was recommended by a really kind doctor (not actually my operating surgeon) to try latisse and minoxidil. The latisse has I think helped. I have for the last two weeks been trying topical minoxidil 5%. I have noticed shedding of hairs and also increased flaking (I already have moderate dermatitis).

In such an instance, what would you typically recommend?- continue with the minxodil but at a lower dosage, switch to a different formulation, or altogether stop using it. At what point do you know if the minoxidil is doing more harm than good? Is a little bit of flaking ok? Is it best for someone with dermatitis not to use minoxidil? I would be grateful for any thoughts.

Many thanks

We do not typically recommend minoxidil or Latisse (bimatoprost) following an eyebrow transplant. There is no good clinical evidence behind this, but I do realize many doctors recommend this approach.

If there is eyebrow loss and flaking I would definitely discuss these issues with your doctor or a dermatologist.

Tags: bimatoprost, latisse, minoxidil, rogaine, eyebrow transplant, hairloss, hair loss

Rogaine Made My Hairline Much Thinner Within Weeks

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

Doctor,

Mid 40’s diffuse thinning. Not bad. Gave Rogaine a try and within weeks was much thinner. It says doesn’t work at the hairline, but the hairline went from fairly full to very thin. If it doesn’t work at the hairline why would it shed hairs there? If it shed hairs at the hairline does that mean it will grow them back? Otherwise why continue to use it?

Thanks

Your experience is unusual. Shedding reports with Rogaine do not explain your findings. I don’t have all the answers, and this is certainly such a case. There is a suggestion that for some users, Rogaine accelerates the anagen stage in the hair loss cycle, which means that it first has to go through telogen (hair loss phase). I would think it would regrow there, but I can’t confirm with any sort of guarantee.

Remember, hair grows at a rate of 1/2 inch per month, so in a month all the benefit you can get will impact only the lowest 1/2 inch of hair. This usually gets better in a couple of months, so do not get discouraged. Speak with your doctor and ask him/her to measure your hair bulk to get a baseline measurement to compare to after 3 months.

Tags: rogaine, minoxidil, hairloss, hair loss, hairline

68 Year Old Woman Lost Her Eyebrows — Is It Medication Related?

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

I have been taking Pradaxa for over a year-I also take metoporol & digoxin. I always had plenty of hair & my eyebrows were almost perfect naturally.about 6 months ago my eyebrows have disappeared almost completely & my hairline is receeding–could these meds be causing this??? Thank you! I am a 68 year old female & would like my eyebrows & hair!

metoprololWomen lose hair just like men, but in different patterns and stages. Women don’t go bald like men, but they thin out later in life. This can also be genetic as well. For women, there may be other medical issues such as thyroid conditions. There’s a list of possible causes here.

In general, medications can be the cause of hair loss. Pradaxa (dabigatran) and Lanoxin (digoxin) aren’t known to cause hair loss as far as I can find, but metoprolol (marketed as Toprol or Lopressor) does have hair loss listed as a rare side effect. More importantly, these medications are taken for serious health issues, so they should not be stopped or changed without a serious discussion with the doctor.

Many women lose their eyebrows and this can be genetic as well (as do men). A hair transplant procedure is a good option for those who want eyebrow restoration.

Tags: pradaxa, digoxin, metoprolol, hairloss, hair loss, female hair loss, eyebrows

I’m Worried About This Shedding I’m Seeing After Starting Minoxidil

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

Dear Doctor,

I am 28 yr old male. I have been losing a few strands of hair here and there for the past couple of years. However, it aggrevated in the past six months or so, with visible thinning of hair on the crown and receding of temples. I consulted a physician and a dermatologist. My reports about anaemia, thyroid function and blood sugar levels are normal. I was informed that I am suffering from genetic male pattern baldness.

I have been prescribed Minoxidil 5%, twice daily, Propecia once daily with Nizoral 1% twice a week. I have been on the above regime for a month. However, I have observed dramatic hair loss in the past month. I am loosing about 300 hair everyday. The most worrying part is that there are times when I loose a bunch of two to three hairs with a single white bulb at the bottom.

I am told that the use of Minoxidil can cause such increased hair loss. From your vast experience, can you confirm if such increased hair loss is common in the first month of treatment?

Also, assuming that this increased hair loss is pursuant to initial reaction to Minoxidil – will the hair lost in the past month grow back to their original length and thickness or is the best case scenario that only small thin miniature hair will replace them?

Thanks

I’ve had some emails over the years of reporting on this site from people asking about minoxidil shedding. I’ve written about it here.

I can’t say for sure how long it’ll persist or if those shed hairs will regrow, but it seems to be a temporary thing that lasts about a month in those that see this initial shedding and the hairs usually do return.

Tags: minoxidil, rogaine, shedding, hairloss, hair loss

Topical Steroids and Male Pattern Baldness?

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

Hi Dr. Rassman,

It’s well known that steroids injected into the human system can exacerbate MPB. But what about topical steroids (prescribed by a dermatologist) applied to the skin? In my case, to an area just above the eyebrows (so not even close to the scalp area)?

(I wish I could tell you the name of the steroid but my dermatologist appointment won’t be till Tuesday – I’m just ANTICIPATING what the derm will prescribe).

Thanks!

To answer this, I would have to know why you are using topical steroids and for what period of time you expect to use them. For example, when topical steroids are used for psoriasis and applied in short bursts over a three time application, the treatment works well and will not cause acceleration of your MPB.

Tags: steroids, hairloss, hair loss

Will Finasteride Prevent Hair Loss from Accutane?

/by William Rassman, M.D./11 /,

Two years ago I took accutane to deal with bad acne. During such time I ended up receding a lot around the temples – to the point of NW1.5ish – which certainly wouldn’t have normally happened – considering I was only 17 then.

To deal with the hair loss I’ve recently gone on Finasteride. However, my acne has also returned in a moderate form that like before, doesn’t respond to any creams. I know this second round will fix my skin once and for all, but I don’t want to lose any more hair.

Do you know if my taking Finasteride will somehow prevent hair loss from Accutane? The hair loss I suffered whilst on Accutane appeared to be TE as I was losing a lot more eyebrow, eyelash, and normal hair than normal – all with a white bulb at the end. I just want clear skin, and to maintain my hair. But my skin is so sensitive to acne creams thanks to Accutane, that I’m unable to treat it. It’s a real catch-22 and I’m afraid to go on Accutane again in case I go bald or something.

Propecia (finasteride) is used for the treatment of genetic hair loss, not for loss caused by other medications. I doubt that it will protect against possible hair loss caused by Accutane (isotretinoin).

Tags: accutane, propecia, finasteride, hairloss, hair loss

Scalp Burning and Hair Loss After Taking Xanax

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

(female)
I’m having hair loss and a burning scalp, I think the hair loss is due to zanx a drug I use for depression, I’ve found after taking this tablet my scalp start to burn. I also use baby shampoo which helps the scalp.I have dry eyes and the baby shampoo also helps the eyes, normal shampoo burns my eyes

I assume you mean Xanax (alprazolam) when you wrote Zanx. If I’m wrong, please let me know. I haven’t heard of “Zanx” otherwise. With all that being said, Xanax does not cause hair loss as far as I’m aware… unless it is an extremely rare side effect (see this past post).

If taking a medication causes a burning sensation to the scalp, discuss these things with your doctor and consider stopping the treatment. If using normal shampoo burns your eyes, don’t use it. Perhaps you have an allergy to an ingredient in the shampoo or you’re just getting it in your eyes.

Tags: xanax, hairloss, hair loss, burning scalp

Permanent Hair Destroyed By Accutane

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

Hi doc
I want to know if there is medication that can cause hair transplants to fall out. I know you’ve said that transplanted hair is permenent but is there any cases where medication can result in that not being the case?

I recently performed a hair transplant procedure on a patient that I had initially transplanted 17 years ago. He had good results at that time, but slowly over the years, the 2500 grafts he had transplanted in 1995 had died off. When hair transplant surgeons say that transplanted hair never falls out, one is reminded of the old saying, “Never say never”.

The permanent hair I transplanted for him 17 years ago was slowly destroyed by the drug Accutane (isotretinoin), which he has been using for years. Of interest, his donor area is also damaged with much less density than I measured 17 years ago and the Accutane clearly impacted those hairs as well. I suspect that the transplant will be possibly more successful this time around, as the hairs that he had in the donor area survived against the Accutane attack.

So while it is true that in most cases the grafts taken from the donor area for transplantation aren’t susceptible to hair loss, it’s possible that some medications could cause continued loss. It’s not very common though, and in the majority of cases the transplanted hair is permanent.

Tags: hair transplant, accutane, hairloss, hair loss