I Was Diagnosed with PCOS Six Years Ago and I’m Losing My Hair!

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

I am 23 years old. I was diagnosed with PCOS when I was 17 and was placed on birth control pills. I started to take them regularly, but they started making me sick, so I quit taking them and didnt take them for several years. Just recently I went back the the practitioner who diagnosed me with this and she placed me on a slow-release iron tablet daily along with a new birth control that has iron in it.

I have started losing hair around the middle-back of my head mainly around the crown area. It looks like my part is getting a lot wider, and the part is spreading down to the back of my head. I used to have really thick curly hair but now it is getting thin around the top, and in some patchy areas.

At first, since I am a Registered Nurse, I thought stress was causing it. The last time I went to the doc, she said I was anemic with low iron levels, hence putting me in daily iron, so I thought my anemia was causing it. I’ve been on and off birth control, so I thought that could be another cause.

Am I too young to use a topical treatment such as Rogaine? or Sephren? Sephren is an oral and topical treatment for hair loss in women. What do you recommend? I feel like I am losing more and more hair by the day and it really stabs a knife into my self image and self confidence. I’m desperate for some answers. I wish someone would lead me in the right direction so I can start growing hair in those thinning spots. I don’t want to be bald by the time I’m 30. PLEASE HELP!!

Polycystic ovary syndrome (PCOS) causes hair loss in women who can also inherit the genes for balding/thinning. It is a very difficult condition to treat, as the treatment is often unsuccessful. Since you’re already under the care of a doctor, I’m not sure what I can offer. You need a good doctor/patient relationship.

Hormone therapy might help with the PCOS-related hair loss, though since you mentioned stress and anemia, those are other potential reasons for your thinning hair. I just have no way to know what is causing your loss, or whether it is a combination of things. You aren’t too young for minoxidil (also known as Rogaine, which is FDA approved to treat female hair loss), but the oral Sephren is just a vitamin supplement with no peer-reviewed published clinical evidence that it works.

There is a new cosmetic treatment that we’ve mentioned here called Scalp MicroPigmentation (SMP) which we offer to address the thinning problem in many women. One such patient can be found here.

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

I Chemically Treat My Hair, Wear a Ponytail, and I Saw Female Hair Loss

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

I am a 40 year old african american woman and I process my own hair. I also typically wear my hair in a ponytail. Couple of months ago I notice that I had experienced some hair loss at temple and back of head. It has slightly grown back. Is there anything I can do to prevent this from happening again and can I continue to chemically process my hair…

What you are describing may be traction alopecia caused by pulling from a tight ponytail or possibly triangular alopecia, which can be genetic. The loss could even be from the chemicals if the process you used caused damage. I won’t know what type of hair loss you have without a physical exam.

If you feel your hair loss is from chemical damage (which may be the case, but again, I don’t know) then stop the chemical treatments. If you are wearing your ponytail too tight, then stop wearing a ponytail. If the loss is due to genetics, hormonal imbalance, or a vitamin deficiency, your doctor should be able to give you a better idea of what you can do.

I apologize for such a basic answer, but there isn’t much I can say without an exam and further history.

Tags: hairloss, hair loss, traction alopecia, chemical processing

14 Year Old Girl Finding a Pillow Full of Hair Every Morning

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

(female)
Every morning I wake up to see my pillow full of hair.. more hair than usual. Before I shower, I run my fingers through my hair and get some hair out. When I take out my hair band, strands of hair are stuck to it. It seems that lately more hair has been coming out, but I am only 14 years old and none of my parents or family members are bald. Is this normal? Why is it so sudden? Will it stop? What can I do to help it? Please help because I am worried.

We typically lose 100-150 hairs a day, but if you’re seeing excessive loss, there could be a variety of possible reasons. I don’t know what you consider excessive, though.

At 14 years old, you should get your parents involved and see a doctor to try to determine a cause for your thinning. Until we know why you’re losing hair, we can’t determine whether the loss is temporary or even what the treatment plan might be.

It’s quite possible that you are just seeing the effect of hair cycling, which is common in everybody. If you lose 100-150 hairs per day, you almost certainly are regrowing 100-150 new hairs per day.

Tags: hairloss, hair loss, female hair loss

Is My Female Hair Loss from Ulcerative Colitis?

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

(female)
i have been losing hair for about 7 years now. i think it has to do with my ulcerative colitis. i started to take biotin and a multi vitamin. my hair is white flakes, itchy but im thinking my hair might be growing back. could this happen? when i was pregnant my hair grew back then after nursing my baby it fell out again. i have seen several doctors and they all say it’s hereditary.

Hair loss in women can be difficult to manage, because there are often many factors involved that could cause the loss (including hereditary factors). Have you had any blood tests done to see if there is any other underlying medical conditions? There is a partial list of those tests here.

The stress from ulcerative colitis could cause hair loss in women who have a hereditary predisposition for hair loss, but there are doctors who specialize in this (I’m not sure if you went to a GP or a UC specialist) that would know more about this than I do. If the hair loss is stress related, it could take up to a year to regrow. The Crohn’s & Colitis Foundation of America site can point you to a specialist that will hopefully be of more help.

Tags: ulcerative colitis, chrons, hairloss, hair loss, female hair loss

Does Omega-3 Cause Hair Growth or Hair Loss? I’ve Read Different Things…

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

(female)
I have been losing my hair for about 8 years. I been told all kinds of things like telogen effluvium and anemia due to fibroids. I was told that a hysterectomy would reverse the condition. It did not and its been 18 months.

I just started taking Omega 3’s 1000mg for hair growth, now I read that it causes hair loss. I have been so depressed from this. I had such beautiful thick hair. Is is true that Omega 3 will make my hair loss worse? I have about 1/2 of my hair left.

Thank You

Fish oilAll women with hair loss need to be checked out by their doctor for hormone imbalances and other conditions that can cause hair loss. Telogen effluvium is a temporary loss, but it’s possible that a hysterectomy could contribute more loss due to the surgical stress.

As for Omega-3 pills, I’ve written before that I don’t think it has anything to do with hair loss, but I don’t know of any good scientific study that discusses possible Omega-3’s role in hair growth or loss.

Tags: hairloss, hair loss, omega-3, fish oil, hair growth

I Can’t Put Eczema Ointment on My Scalp, Because My Hair is in the Way

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

Hi, I’m a 20 year old Korean female. I’ve experienced some Trichotillomania but have recently been pretty good about not pulling. I also have eczema but that too is under control thanks to a few medicines. However, I cannot put the creams/ointments on my scalp due to my hair and that is causing problems.

My scalp is very itchy and flakey and when I brush it or even run my hands through it, more hair than usual comes out. Is there anything I can do to stop this?

If you’re looking for tips on how to apply your eczema treatment, I suppose the National Eczema Association would be the place to start. They have videos and other treatment tips here.

Tags: eczema, shampoo, ointment

Will 5% Minoxidil Foam Work for Frontal Female Hair Loss?

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

(female)
I have intense itching from minoxidil 2%. A previous message by a woman said she had spots and fluid-filled blisters using 2% minoxidil. You recommended 5% foam. I looked at the box of the 5% foam and it is for the back of the head, not for the thinning in front. Will it work for frontal thinning?

Rogaine Foam may work on the frontal scalp, although the FDA recommends it strictly for the crown because it was shown to work best there.

If you have an allergy to an ingredient in the liquid that isn’t in the foam, that might alleviate your intense itch… but otherwise, if you have a sensitive scalp, the 5% concentration might not be the answer since it is stronger than the 2%.

Tags: rogaine, minoxidil, foam, scalp itch, hairloss, hair loss, female hair loss

Do East Asian Women Have a Greater Chance of Developing Hair Loss?

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

Is female genetic hair loss/hair thinning more likely to start in early 20s if you’re of Asian (Korean) heritage? I’ve read that East Asian females have a greater chance of developing diffuse thinning than Caucasians.

No. I’m not aware of any good scientific studies that investigated women with hair loss by ethnic groups. We generally believe that hair loss does not discriminate race, sex, or ethnicity. In other words, it is mostly the same for all populations. You’re not at any greater risk than a Caucasian woman is if the genes are present.

Tags: asian, korean, hairloss, hair loss, female hair loss

Using Estradex in the Long Term?

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

(female)
I would like your expert advice for a product called Estradex. I know you have ingredients already. I have been using this product for a yr and I’m happy with results but I’m worried if any side effects long term could happen? It’s a very expensive product. When I tried to ask my doctor she didn’t even want to know about ingredients and said only recommended product for hairloss is Regaine. I’m just paying every week with no one checking me. Thank you in advance.

Your doctor is correct in that the only proven recommended treatment for female hair loss is Rogaine (known as Regaine in some countries). The generic name for that medication is minoxidil. Now I’ve written about Estradex before, but quite simply, it’s not something that I’m too familiar with because I don’t think it’s sold here in the United States.

I am having a tough time finding an exact ingredient list, but it seems that Estradex is just a boutique version of minoxidil. So essentially, you’re paying for a more expensive version of the product your doctor recommended. Since I don’t know what the exact ingredients are, I’m not sure of long term side effects.

I also don’t understand who you are paying every week or for what reason. If your doctor is going to analyze your hair loss, it doesn’t need to be done on a weekly basis.

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

Can I Still Use Rogaine While Trying to Have a Baby?

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

Hi there,
I have been using 2% Rogaine for over 10 years with great success. I know I can’t use while pregnant- but what if it takes 8-9+ months TO get pregnant? Can I really not use while just trying if I intend to stop immediately once pregnant?
Thanks

This comes from Drugs.com: “Minoxidil topical has been assigned to pregnancy category C by the FDA. Animal studies using oral minoxidil have failed to reveal evidence of teratogenicity, but reduced conception rates and an increased incidence of fetal absorption have been observed in rabbits given 5 times the usual human oral dose. Minoxidil topical should not be administered to pregnant women.”

The key point in the above paragraph that relates to your question is about the rabbits given abnormally high doses of minoxidil. While it is probably not a problem for you to continue using Rogaine while conceiving, I would talk with your obstetrician.

Tags: rogaine, minoxidil, female hair loss, pregnancy

What Makes a Good Female Hair Transplant Candidate?

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

hi,

i am a 17 year old female and my hair is thinning rapidly- to the point where i and others from a certain distance can see bits of my scalp at the top. I was just wondering about the procedure for hair transplants in female, what makes a good female candidate for a hair transplant, and the minimum age for doing so

thanks

A good female hair transplant patient will have:

  1. healthy hair around the back and sides of the head
  2. limited area of thinning or balding (example: frontal hair loss)
  3. medium or heavier hair
  4. good hair densities
  5. good medical health without any diseases that cause hair loss
  6. no medications taken that cause hair loss
  7. tried medical treatments such as minoxidil without results
  8. enough maturity to understand a hair loss Master Plan developed with her doctor for her life’s projected hair loss

Most women have generalized thinning which is not a good condition for a hair transplant. Scalp MicroPigmentation (SMP) works well for treating thinning (see our SMP gallery).

All females should have an extensive medical work-up for hair thinning, as there are conditions such as thyroid disease that can cause the loss. First you need to be checked out to make sure that you do not have some identifiable cause of the hair loss (e.g. extreme fluctuations in your weight). Once your doctor determines a possible cause for your loss, then a treatment path can be developed to attack any identifiable cause (e.g. thyroid disease). Hair restoration procedures such as hair transplantation or SMP should really be last options, not first ones for a 17 year old female.

Tags: hair transplant, pigment, hairloss, hair loss, female hair loss

I’m a Female Teenager That Gets Bullied for Having a Large Forehead

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

(female)
Hi,
I’m 14 and have a huge forehead, I’m not sure if my hair line is too far back but I’m really self conscious about it. I get bullied in school and it hurts! What would you suggest to help?

At 14 years old, you should discuss your issue with your parents. For some people it is normal to have a high forehead (if you indeed have one). There is nothing wrong with this, though I’d suggest perhaps there is something wrong with your peers.

There are hairline lowering surgeries, but that would require your parent’s approval and significant research on your part.

Tags: forehead, hairline, hairline lowering

How Can I Treat Pseudopelade of Brocq?

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

Hello – I’m a 38 year old woman. A few years ago I had a couple of bald patches appear on the top of my head, caused by work stress. About 6 months ago they started itching, I went to a dermatologist yesterday who says I have pseudopelade of brocq. Of which there is no cure, I’m told. The patches are about 2cm by 1cm and about 1cm square. I’ve had to move my parting so that I know no one can see it.

Do you know if there is anything I can do to help it? I’ve heard that derma micro needling can help to regrow? What about some form of tattoo? Any help appreciated.

For those unfamiliar with the term “pseudopelade”, here’s the origin from Medscape — “In 1888, Brocq used the term pseudopelade to describe a unique form of cicatricial alopecia resembling alopecia areata (Pelade is the French term for alopecia areata).”

In short, it is a scarring type of alopecia without a good medical treatment. Micro needling will not work.

Your last option may be Scalp MicroPigmentation (SMP), but that will only color in your scalp. This may work for men who can shave their head to make it look uniform, but for women with any length of their hair surrounding the patches it may not work to maintain a natural appearance. We have treated many scarring alopecia patients with great results using SMP.

Tags: pseudopelade, scarring alopecia, hairloss, hair loss, cicatricial alopecia, smp

I’m Treating HBP and High Cholestoral, But Now I See Female Hair Loss!

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

I am a 56 years young woman with beautiful silver hair. I began taking Lisinopril 40MG for HBP & Pravastatin 20MG for cholesterol 1 1/2 years ago. Shortly thereafter, I noticed that I’m losing my hair at an alarming rate. I am afraid to comb my hair as I would lose hundreds of strand at each session. I am very concerned that if this continues, I will have lost all my hair within the next two years.

PillsWhile the timing of your hair loss beginning may sync up with the start of your medications, I really cannot say for sure if the two are related. It’s possible that it was coincidental timing, and that there is another underlying issue. A partial list of causes for hair loss in women can be found here.

Pravastatin and lisinopril both list hair loss as a rare side effect, but the most common causes of hair loss in women is genetics or an underlying medical problem (not medication). Please see your doctor for your hair loss if it bothers you.

With respect to losing all of your hair within the next two years, that would be quite uncommon… especially if the loss was from medication.

Tags: hairloss, hair loss, female hair loss, lisinopril, pravastatin

In the News – Kim Kardashian’s Hair Loss

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

Snippet from the article:

Kim KardashianShe’s left fans green with envy thanks to her incredible post-pregnancy weight loss.

But it seems that Kim Kardashian’s rush to regain her svelte frame has had an unwanted effect on her hair.

Images of the 33-year-old with her hair tied up in a high bun while out in Los Angeles last week show the extent of what appears to be extreme hair loss, which the reality star seems to have been attempting to cover up with weaves and hair extensions.

Read the rest — Kim Kardashian displays shocking hair loss and extensions after ‘relying on weaves to boost her post-pregnancy thinning locks’

It’s possible that the loss is caused by hormone changes following her recent pregnancy, but hair extensions into weakened hair might be doing more harm to her hair. The loss in the photos seems to be closer to traction alopecia that is commonly seen in people with tight braids or weaves.

Tags: hairloss, hair loss, hollywood, kardashian