Using a Hair Relaxer While Alopecia Areata is in Remission

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

Since last year I have been experiencing hair loss. I am a 49 year old african american female who in December 2009 had a noticeable bald spot that began appearing at the left side of my crown. From December until January 2010 the spot began to move from one side to another and then became quite bad. I finally went to see a physician who diagnosed me with autoimmune disease and alopecia. He prescribe a topical steroid (betamethasone dipropiontate lotion) and encouraged to take biotin. The back of the hair has grown back and now between a nickle and a quarter spot still remains at the crown. I am experiencing hair growth and to the roots it is quite coarse.

Would you recommend that I put a kiddie relaxer in it to get some of the thickness straighten out?

Kiddie relaxerIf you are asking whether a hair relaxer will help or make your condition worse, I would guess “no” to both. If you are asking if a hair relaxer will help with your look, that’s a styling question and I would rather leave that up to you.

As far as I know, hair relaxer for kids contains the same chemicals as hair relaxer for adults, but it is just marketed differently. In other words, you still run the risk of causing chemical damage.

Tags: alopecia areata, hairloss, hair loss, hair relaxer, chemical

Female Hair Loss from Depo Shot, Stress, or Breastfeeding?

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

I took the depo shot twice. The first one in oct. and the last in jan. in march I noticed a bald spot on the top of my head and it is now that bald spot is as big as my fist compeletly bald, I also have over 12 bald spot all over my head and they just seem to be getting worse.

Is this the cause of birthcontrol or is it due to stress and breastfeeding? Will my hair ever grow back. Please help i’m going bald, i can’t hide it anymore. I going to have to buy a wig, please,please help me!

thank you

If I had to guess, it sure sounds like alopecia areata, due to the many bald spots you’re describing. It might just be stress or hormone related, but it can be a serious problem and you should see a doctor to get the proper diagnosis.

While breastfeeding does not cause hair loss, thinning hair can occur months after giving birth, but it is usually a diffuse loss across the scalp (not strictly in spots).

Hair loss from the Depo-Provera contraceptive shots is another possibility, and I’ve written about that here.

Tags: alopecia areata, hairloss, hair loss, hormone, stress, female hair loss, breastfeeding, depo

I’m a Woman and Was Prescribed 5mg Finasteride Daily

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

I am a female, aged 68 years. My doctor just put me on finasteride 5mg daily. Is it now safe for women? And is the dosage too high? If I cut the pill into fourths, would that still be too much?

I would ask this question and your concerns with your doctor. If you need a second opinion, you need then see another doctor.

Please understand this from a medical perspective and I’m not just trying to brush you off. You provided your gender and your age, but I cannot advise you with just that information. For example, is there a breast, ovarian, or cervical cancer history in your family or have you had one of these cancers in the past? There are many variables, so that is the role your doctor plays in these decisions.

Finasteride is not FDA approved for treating female hair loss (I assume that is why you were prescribed it), which means that your doctor prescribed it to you off-label and you need to ask him/her about this. For men, 1mg is recommended for treating hair loss and 5mg is for treating the prostate… so it is unusual for a doctor to prescribe 5mg finasteride for treating female hair loss.

Tags: finasteride, hairloss, hair loss, proscar, propecia, female hair loss

Breast Cancer, Hair Loss, and Dismissive Doctors

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

I am among the many young victims of breast cancer (37 y.o. with estrogen+ progesterone+ Stage III breast cancer) who has undergone 16 rounds of chemo, 6 surgeries (including oophorectomy), and 35+ radiation tx, plus am currently on aromatase inhibitors. I am treated at one of the top 10 facilities for cancer in the US, yet trying to get help for my slow growing Ludwig Type II hair while on aromatase inhibitors, esp. 2 years after chemo is proving more daunting. First, my oncologist revers me to dermatology, then dermatology refers me to endrocrinology, then endocrinology suggests I see a hair specialist doctor….but now I read in your archives to defer to the oncologist. It frustrates me that I am being punted around between medical specialties who don’t want to have any liability or necessarily want to work together to come up with a treatment plan for this pervasive side effect which many women in my position are experiencing. No one wants to touch this hair loss issue with breast cancer survivors.

I researched all the medical literature, and although there is plenty of information on observations of hair loss, there is nothing about the treatment of hair loss for those of us who are on either tamoxifen or aromatase inhibitors after breast cancer. I already started 12.5% Rogaine with Retin-A along with 5% minoxidil foam, Aminexil with Madecassoside, and washing with alternating 1-2% Nizoral. Propecia isn’t even an option. Also, I feel I’m relegated to wigs which you deem may accelerate hair loss (although if it not bonded or clipped to hair, I don’t know how that would be the case). Is there anyone in the San Francisco Bay Area that even has the breadth to tackle this problem?

Please tell me there at least some proprietary research out there that is addressing this issue on the horizon, because then I won’t be such a cynic about medicine. Clearly quality of life after cancer involves helping to alleviate hair loss as a result of aromatase inhibitors.

Pink ribbonI am truly sorry to learn of your frustration (we’ve all been in situations where we’re referred back and forth and feel like we’re getting nowhere), but the hair loss issue really isn’t specific to breast cancer survivors. Hair loss in all women is a very difficult issue to treat. There are many potential causes, and especially with your medical history, it can be hard to pinpoint the cause. The only FDA-approved medication available to women to treat hair loss is minoxidil (Rogaine), but you should be careful with taking 12.5% and 5% minoxidil foam at the same time so that you do not overdose yourself. Some women have had minor success with Propecia, but that would be taking the medication off-label and there are potential serious risks for women that use this medication (so just to be clear, I do not recommend that approach).

Unfortunately, there are very few options available to women that are losing their hair. For men, Propecia slows the process down, could reverse it, or even completely stabilizes it for years; hair transplantation just rearranges permanent hair from the back to the front. For women, the hair loss may be so diffuse that there is not much to rearrange and there is no specific area of permanent hair like is the case with men. Approximately 20% of women may be helped with hair transplantation, so each patient must be individually evaluated. With regard to your specific situation, I would be willing to see you since you are somewhat local (I do have an office in San Jose) and maybe I can add something to help you, such as the possible use of concealers like DermMatch or Toppik. Wigs might work in your case, but one must be careful that there isn’t traction on the existing weak hair or that’s when you might run into problems with further loss.

I don’t know of any proprietary research, and I wish I had a specialist in mind that I could point you to… but I’m posting your message in hopes that it reaches a wider audience that might be able to provide more insight or assistance. As much as I might want to have all the answers, I fully admit that’s not the case.

Tags: female hair loss, breast cancer, cancer, hairloss, hair loss

I’ve Lost Half of My Hair in 8 Months!

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

Hello,
I was wondering if i could get some advice on my hair loss. Over the past 8 months I have lost over half of my hair. I originally thought it was from dying it, so i stopped doing that all together. I’m 21 years old, and have always had a thick head of hair. We went to the doctors and we found out that i have an underactive thyroid, not by much, but for a 21 year old he said it should be higher, so now I have officially been on the medication for over a month now. My scalp is itchy, and I’m not sure if its from regrowth or loss of hair.

What is the deal with an itchy scalp? How long does it actually take for new hair to regrow? If it does, when will I see signs of it? Are there any other things that it could be?

thanks in advance! your site is very helpful!

If the cause of your hair loss and skin changes are from a thyroid condition, the hair loss may regrow in a year or so, but it may never recover to the point before the disease appeared. Unfortunately, all you can do is really just wait it out and keep following up with your doctors.

The skin condition needs to be looked at by a dermatologist. I couldn’t say if its due to your hair falling out (some people report that their scalp itches before losing hair, though that hasn’t been officially linked), but you wouldn’t see regrowth this quickly after starting treatment. Common causes of an itchy scalp can be found here.

Tags: thyroid, hairloss, hair loss, female hair loss, scalp itch

Vitamin D Deficiency Caused Female Hair Loss for 10 Years

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

(female) I have experienced significant hair loss over the past 10 years. I have recently been diagnosed with Vitamin D deficiency. My dr advised me to take two vitamin D pills twice/week for the first month, and then one/week thereafter.

I have read on this site that regrowth is possible. Is regrowth possible after such a long time, or does the scalp become damaged. At what point is it ‘too late’ to regrow hair?

I do not know the answer other than to offer you hope that when the vitamin deficiency is solved, the hair will regrow. I don’t recall any firsthand experience with a female patient that had a full decade of hair loss due to a vitamin deficiency to base a conclusion on.

Tags: vitamin d, vitamin deficiency, female hair loss, hairloss, hair loss

My Hair Was Pulled and Now My Hair Falls Out and My Scalp Burns!

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

I am a 30 year old female and I had an incident over a month ago when all my hair was violently yanked by my boyfriends 3 year old. I woke up the next morning and started losing hair. Since then my scalp has been burning so bad that I have thought about suicide. The hair fall out is very noticable and is all over the head. It hurts to go outside and I have also developed a white substance on my scalp, almost like a coating that I can scrape off with my nails. It’s gross and waxy. My head has a wierd, painful sensation and I literally can feel the hair detaching from my head. Sometimes I will just feel it fall and at other times I will have a sharp needle-like pain and the hair will fall out. I am so scared about what I have read on other sites.

What is this sensation/pain/burning and how do I stop the hair from falling out? Will my hair regrow or is this burning a sign that the follicles were damaged and I am doomed. I have always had a healthy, thick, beautiful head of hair that goes to the middle of my back. Now it’s falling out in handfuls. I have been to several doctors/derms and they said I’m fine or more accurately crazy for obsessing about it. No one is listening to me! Please help! Any advice? Thanks….

Okay, let’s stop and think about what you just wrote. You are thinking of suicide! Please seek the help of a professional who can help you with this issue. Either go see your psychiatrist/therapist or a physician than can assess your hair loss issue. If no doctors are listening to you, go find another doctor that will! This is obviously a very huge issue in your life right now, so don’t give up on solving it. Without an examination, there’s really not much more help I can provide over the internet, but I wish you good luck.

I can’t explain the intense burning you now feel, but the traumatic hair loss like you describe usually grows back in about one year. What is it that you read on various sites that has you so scared?

Tags: hairloss, hair loss, female hair loss, burning

Daughter Losing Hair After Chemical Straightening

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

My daughter had a small piece of hair staightened at the beginning of March. By Easter we noticed a small patch of balding. Thinking it was due to the straightening and possibly getting into the pool ( she is a swimmer) without washing her hair we just watched the area. It is now May and the balding has spread to the front 1/4 of her head and continues to grow. Could this still be a reaction from the chemicals? If so why has it spread so much from the orignal chemically treated spot? What should I do to prevent more hair loss? Thank you.

It sounds strange that she is losing hair on the front 1/4 of her head. Maybe your description is off and pictures may help, but nevertheless, I would take her to see a doctor to make sure there are no other medial issues associated with her hair loss.

Chemicals can cause skin irritation and reaction, and may cause temporary hair loss. It usually takes up to one year for hairs to regrow if this is the case.

Tags: chemical burn, hair loss, hairloss

Hair Loss from Allergic Reaction to Hair Product?

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

My daughter use a mousse hair product that she used for several years and had an allergic reaction. Her forehead, neck, scalp and eyelids peeled. A few weeks later she notices her hair falling out. She went to the derm and he prescribed topical treatments. They said it would take a few weeks to see results and less hair falling out because of the severe seborrea? Anything you tell her from your experience.

It’s possible to have an allergic reaction to hair products, but she used that particular product for years and then suddenly developed a severe allergy? If your daughter is under the care of a dermatologist already, he/she will have more experience with allergic reactions than I would. Besides, I don’t know what topical treatment/dosage was prescribed, nor do I even know what the allergy was.

Tags: allergy, allergic reaction, hairloss, hair loss, female hair loss

Can I Stop Using Rogaine Now That My Hair Isn’t Thinning?

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

Hi,
I’m a 21 year old girl and 3 years ago my hair started to get a lot thinner. i was under a lot of stress and my dermatologist told me this was the cause. He advised me to try rogain.

I have been using it for 3 years now and I have a lot of new hairs. it doesnt seem like its thinning anymore… although its still nowhere near its past thickness. Im curious as to when I can stop using rogain? Do i have to continue using it forever now that i have started it?

Help!

I would consult with your doctor first… but if the hair grew directly from Rogaine, those hairs could fall out after stopping the medication. You’re really taking a gamble that the Rogaine wasn’t beneficial and the loss was purely stress induced. I really do not know of your personal situation so I can just give you generalizations.

Tags: female hair loss, stress, hairloss, hair loss, rogaine, minoxidil

Switched from Rogaine Foam to 2% Liquid and Seeing Massive Hair Loss!

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

(female)
I was on the men’s extra strength 5% rogaine foam for about a year, with spironolactone too. It has been beneficial for both my eyebrows and hair to some degree, but it has also caused a distressing amount of facial hair in almost every part of my face you could imagine, particularly my temples and jawline. I have never had facial hair before, and constantly trying to remove it just to look normal is both stressful and has had a negative effect on my once nearly perfectly smooth, flawless skin. So now I have decided to switch to the 2% liquid, in hopes that the facial hair will cease, and also because I’ve read that in females there’s no significant advantage recorded in using the 5% vs the 2%. However, in the last 2 weeks I’ve switched, my hair has been falling out like crazy. Is the 2% therefore really that much less effective?

Based on what you are saying, it would seem that the 2% is less effective for you. I don’t think I can add any more input. If everything you are doing is exactly the same and nothing has changed except changing the medication, it would be the next logical assumption.

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

My Doctor Wants to Give Me Steroid Injections for My Female Hair Loss!

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


Hello, im hoping you could kindly help me please? Ive been suffering hair thinning and balding patches for the last two to three years, gradually becoming worse, i have naturally long dark curly hair. I have had been given all sorts of treatments to try and im under the care of a Trichologist and a Dermatologist, ive finished my Minoxodil 4% as the 2% wasnt strong enough, but unfortunately it has not worked, so i went back today to see the consultant dermatologist and he told me he would like to try the steroid injections into the scalp, but i would like to have hair transplant as it is affecting my confidence and feel ugly and constantly compare myself to other women.

Im 28 years old, female, and studying to become a doctor, so i just put the hairloss down to stress but its been over to years now and its worse, please help! Is my doctor correct in trying the injections? he said the transplant would not work. my hairloss and thinning is on my temple area and around the size of the bottom of a mug (cup) and hair thinning on my roots. Thank you for your help.

You need a real diagnosis, and I really can’t help you without that. There is no definitive medical solution for genetic hair loss in women in most instances. You are wasting money by seeing all these specialists and you may end up worse off after these invasive procedures that may not work. Steroids have never been proven to work for genetic female hair loss, but do work for particular diseases like alopecia areata. Plus, steroid injections to the scalp often cause hair loss.

As you say you are studying to be a physician, empower yourself by educating yourself on women’s hair loss issues and treatment. Hair loss in women can be from a variety of reasons, some of which are listed here. As for hair transplants, many women just are not candidates, but I couldn’t specifically say whether you are or not as I’ve never examined your loss.

Tags: hair loss, female hair loss, scalp injections, steroids

Will Hair Regrow After Cyst Removal?

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

I had 2 cysts on my scalp removed at Easter and one has healed quite well but the other has left a bald spot about the size of a 50 cent peice. The skin is more pink and shinny. Will the hair grow back? There doesn’t appear to be any re-growth? Should I be seeking some form of treatment? What can I do to look normal again? This is not a good look for a female. Thanks.

You’ll have to allow more time to see if there will be regrowth. Being patient is all you can do at this point. If after a year the bald area is still the size of a half dollar, then you might have lost hair permanently… and a very limited hair transplant would likely solve the problem.

Tags: cyst, hairloss, hair loss, hair transplant

Skin Atrophy from Oral Spironolactone?

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

I am a 33 year old woman with a diagnosis of AGA. I have found out that skin atrophy is a very rare side effect of oral spironolactone, one which I am experiencing on my facial skin. This is frustrating as spiro is definately working for me. Do you think topical spiro would have the same effect? Also, it seems Cyproterone Acetate can have the same effect so that isn’t an option for me. What do you think of trying Bicalutamide, as it is a non-steroidal antiandrogen? Many thanks.

I wish I could offer some real help, but I don’t know much about the side effect risks of spironolactone beyond what I have read, as I do not prescribe it (or the other medications you mentioned). Spironolactone is a prescription medication, and as such if you’re seeing skin irritation you should immediately notify your prescribing doctor about this.

Cyproterone acetate lists hair loss as a rare side effect (as possible with many medications), but bicalutamide has hair loss listed as a common side effect, so I don’t know why you’d take that as a hair loss treatment.

Tags: spironolactone, hairloss, hair loss, female hair loss

DHEA and Female Hair Loss?

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

Hi,
I’ve recently had a blood test by my dermatologist which indicated a high level of DHEA (about 1343 ng/dL) Can this be the cause of my hair loss for the past 3 years? I have always had thick, thick hair that was very strong up until a few years ago. Now I have a patch of hair near the left center of my crown that refuses to grow back (There is no scarring) The dermatologist thinks he has found the cause but I’m not so sure. He prescribed Spironolactone (100mg) and Rogaine 5% (for men) How can I be sure it’s DHEA? Should I have further testing? I’ve just set an appointment with an Endocrinologist. The hair on my head is thick except the one section and I see some “female pattern baldness” as well near the top part of the crown (hair is very thin) Any suggestions? Other than the high levels of DHEA my blood screening was normal.

P.S. – I am about 90 pounds overweight. Can you help me?

Without seeing you it is almost impossible for me to determine the diagnosis. You report a limited bald area which should not be the case with a hormone problem, as this often produces a more generalized hair loss process. DHEA (an androgen like testosterone) can bring on balding in those individuals genetically prone to losing hair, so the use of spironolactone can reduce the impact of such an androgen if this is a cause of the hair loss.

I would want to know what is going on elsewhere on your scalp (perform mapping of the scalp for miniaturization to show the genetic signs I would expect to find) before I jump in to validate your working diagnosis. Internet opinions without a direct examination for someone like you has marginal value.

Tags: female hair loss, hairloss, hair loss, dhea