16 Year Old Girl’s Shrinking Widow’s Peak

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

Hi I’m a female and only 16 but my question is about my widow’s peak. Well, it used to be the same length as the rest of my hair but after messing with it for the past few years its gotten shorter and shorter and now its become a habit and I can’t stop messing with it. I just want to know if it will ever grow out again if I stop twirling it with my fingers? Or is there anything else I can do to make it grow out again? It’s become so short that if I dont use serum or other products like hairspray to keep it down it just sticks out. Please help!

If you play with the widow’s peak, it may produce some level of traction alopecia and that could cause you to lose your widow’s peak. Even if you don’t play and tug on it, it may still disappear. The shape of hairlines may change as you get out of your teenage years.

Tags: hairline, widow’s peak, female hair loss, hairloss, hair loss, teen

Young Girl Is Losing Hair

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

Dear Dr. Rassman,

I have a question.. I have a nine year old sister who has been losing a lot of hair for about four months now. She loses a lot when combing her hair, putting up in a pony tail, and when showering. She loses the most hair when she showers. She doesn’t have any bald spots, but my mom and I are getting really worried. What do you think the reason might be? Should we consult this with her doctor? I would really appreciate your help. Thank you.

Yes, I’d definitely would have her doctor take a look. There could be many causes for hair loss in women including an iron deficiency (if she is presently menstruating). The showering isn’t causing the hair loss, as you probably suspect, but constantly combing the hair can cause it to come out.

Tags: hairloss, hair loss, female hair loss, girl

In the News – Sarah Palin’s Stress and Hair Loss

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

Snippet from the article:

Can stress really cause hair loss?

Yes. Studies on both laboratory mice and disembodied human hair follicles have shown that external stresses can cause hair loss. Researchers have exposed otherwise healthy mice to mouse-repelling sounds at 15-second intervals for 24 hours. The follicles of the stressed mice went dormant significantly faster than their more relaxed cousins. No such experiment has been conducted on people, but scientists do know that if you expose human hair follicles to substance P, a stress-related neurochemical, they will also become dormant.

Sarah PalinRead the rest — Slate: Can Stress Really Make Your Hair Fall Out?

The article references a recent tabloid-style story (in the New York Times) about soon-to-be-former Alaska Governor Sarah Palin’s mystery hair thinning, and wonders if it is due to stress (telogen effluvium), alopecia areata, or genetic hair loss. I haven’t seen the hair loss they’re talking about, but if I had to guess, I’d put my money on it being stress-related.

Tags: sarah palin, stress, telogen effluvium, hairloss, hair loss, alaska, politics

Can a Woman Use Avodart After a Hysterectomy?

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

i have had significant hair loss at my crown and have heard that the bp med aldactone has helped. i do have high bp and was planning on starting on meds for the bp. what are your thoughts on this. also what about avodart? i am 43 and have had a hysterectomy so have no chance of pregnancy.

This is a situation where you are asking for medical advice, but I’m sorry, this isn’t something I can answer. You can take anything, but taking medications recommended by your doctor will be part of your medical plan for health.

Tags: avodart, dutasteride, female hair loss, hysterectomy, hairloss, hair loss

Could IVF Cause Hair Loss?

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

I am 41 and have gone through many series of ivf treatments. Now that I have not been on these injectables for a year, I have noticed this past year a small nickel sized bald spots on my scalp. Starting out as a dime now up to a nickel I am getting nervous. I have 3 of them now. Could IVF have had anything to do with this? I have been to my dr last year and this year for blood tests, but everything came back great. I have “invested” in shampoo’s, vitamins, follicle treatments and nothing has worked. Even my hair hasn’t “grown” in a year. I actually stopped highlighting it for 6 months and nothing. My next step is woman’s rogaine, but the box states not for patchy hair loss. Can I use it? What can I do next?

Thanks for your help

While I highly doubt in vitro fertilization (IVF) causes hair loss, if what you described was generalized, I would expect that the massive hormone manipulations that occur with IVF could cause diffuse hair loss. The descriptive nature of “nickle sized bald spots” is suggestive of conditions like alopecia areata. I would recommend seeing your dermatologist for a definitive diagnosis. If it is alopecia areata there is no definitive medical treatment, but the diagnosis methods are well established. Based upon the cause of the bald spot, the regrowth may be anticipated.

Tags: in vitro fertilization, ivf, hairloss, hair loss, female hair loss, alopecia areata

My Daughter Has Been Losing Hair Since She Was an Infant

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

My daughter started losing hair across the back of her head as an infant (like many do, from turning their head in their crib). It was breaking as much as it was falling out. It continued to break and be brittle. I was told by her pediatricians that she would grow out of it, and that nothing could be done. 4 years ago a dermatologist could not diagnose her either. She is 13 years old now and her hair has never been 100% haelthy, although she has had times when it was better than others. A week and a half ago she tried using Head and Shoulders shampoo, thinking it might help. As of last night, on the top and across the back of her head there is nearly no hair. She is not “bald” back there per se, but the hair there is less that 1/8 of an inch long. Another trip to a different dermatologist this morning revealed nothing. He had no idea, other than that it was “extreme, and apparently rare” and he did not know what the cause was. He suggested a peanut oil treatment and biotin. I’m considering asking her pediatrician to run some blood tests, but am not sure what to request. Hormones, vitamin deficiency, thyroid? Any insight you can give me would be much appreciated. Obviously at the age of 13 this is devastating for her. Thank you.

I can appreciate that it is very devastating to your child. Unfortunately, I really have no input here aside from the fact that you seem to be taking the right steps and seeing specialists. You may benefit from still another opinion with another dermatologist or a hair transplant doctor who might give you a different perspective after an examination. I would like to help, but I am not her doctor and the blog is not an appropriate medium for such.

Tags: child, hair loss, hairloss, infant, daughter

Common Blood Tests for Female Hair Loss

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

I have total head miniaturization and half my sideburns seem to have miniaturized. I was diagnosed with DUPA but I want to be sure that my miniaturization is not being caused by hormonal imbalances or malnutrition. I am going to get the urine analysis 2 rule out malnutrition as a cause and I’ve already checked my iron and thyroid. Can you give me a list of hormones you think I should check and also could you recommend any doctors that are knowledgeable in this area in the new york area?

I haven’t seen your hair loss, but it is always good to get a second opinion. Some common blood tests for female hair loss:

  • Sex Hormone tests
  • SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
  • Estradiol is a sex hormone
  • FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
  • LH (Luteinizing Hormone) is a sex hormone
  • Free Testosterone
  • Total Testosterone
  • ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
  • TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
  • Test Iron status
  • TIBC (Total Iron Binding Capacity)
  • Ferritin
  • Iron

In the NY area, I would see Dr. Robert Bernstein. Tell him I said hello!

Tags: hormones, female hairloss, dupa, bernstein, hairloss, hair loss

Blood Pressure Medication and Female Hair Loss?

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

(female) I have been taking Hyzaar 50/12.5, a high blood pressure medication, for several years and I am experiencing balding in the top of my head and thinning around the edges; before taking this medication I had a full head of hair. Is there a high blood pressure medication that would possible not cause hair loss or thinning?

Hyzaar is known to cause hair loss in some people (“alopecia” is listed as a side effect). The pill is a combination of hydrochlorothiazide (HCTZ) and losartan, and I’ve written about HCTZ before. That being said, blood pressure medication is not generally the first thing doctors look for when evaluating hair loss in women. There are many other medical conditions that contribute to hair loss in women and these should be evaluated by your primary care physician. Some (but not all) of the causes can be anemia, thyroid conditions, menopause, genetic, lupus, etc. (see here).

Tags: blood pressure, hbp, hairloss, hair loss, female hair loss, hctz, hyzaar

Woman Experiencing Nerve Problems in Scalp After Hair Transplant

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

(female)
I have skin cancer which required graft closures. I have had MOH’s surgery and grafts twice and once (one year ago this past March) I had hair transplantation from the nape of my neck. Approximately two months after the surgery the right side of my scalp regained feeling but the left side did not. It still hasn’t so I told my plastic surgeon and he injected a steroid thinking it was scar tissue. While he was examining my scalp (after the injection, which did not work) he touched an area of my scalp on the left side that shot pain up to the top of my head probably right on the occipital nerve (greater). He didn’t know what to do so I went to see a neurologist who told me that some of the lesser occipital nerves are not as deep and are in fact at scalp level. My scalp (at the donor site) is so tight it is difficult to move my head to the right and down. Now he says I have cervical dystonia. I don’t believe that because in my research I found nothing that even resembles what I am feeling or going through. What do you think?

Persistent pain and/or numbness is a relatively rare risk of hair transplant surgery from small nerve damage. It is always stated in our pre-surgery consent form that we go over with our patients. Tightness of the scalp is also a side effect of a hair transplant surgery. The more surgeries you have, the more risk you may have of tightness or nerve damage. As your neurologist explained to you, some of your nerves may have been cut/irritated during the surgery and this may be contributing to your problems. I really have no way of knowing, though.

Tags: hair transplant, hair loss, hairloss, nerve damage, nerve, pain

Can Chemical Relaxers Done Professionally and Correctly Still Cause Hair Loss?

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

Can chemical relaxers applied properly by a professional at a salon cause hair loss? It seems as though every question here about chemical relaxers involve doing it yourself or messing up and burning the scalp.

Professionals make mistakes on occasion so the use of relaxers always put you at risk for chemical burns. In the hands of experienced professionals, I would think that the risks are minimal.

With that said, I just met with a nice lady who had a professional use a relaxer on her hair about a year ago, and ended up with two thumb-print type bald spots that appeared after a 6 month course of treating open burn wounds on her scalp. I will be transplanting those thumb-print bare areas shortly.

Tags: chemical relaxer, chemical burn, hairloss, hair loss, female hair loss

In the News – Receding Hair in Older Women

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

Snippet from the article:

Mavis Bradley has always prided herself on her appearance. ‘Ever since I was a young girl, I’ve always followed what’s in fashion and tried to look my best,’ she says.

Despite this, she accepted that growing old gracefully would also change the way she looked. So when her eyebrows gradually faded away a few years ago, she put it down to old age.

‘Because that had happened, when I noticed about four years ago that my hair looked a little thinner at the front, I didn’t pay much attention. I presumed it came with old age.’

In fact, Mavis was suffering from a type of alopecia that affects post-menopausal women, damaging the hair follicles so that the hair falls out and cannot grow back.

Read the full article — Receding hair, the new epidemic in older women

Bad hair days turn into bad hair years as some people’s hair change as they age. The article covers some interesting points.

Tags: female hair loss, hair loss, hairloss

I’m Worried About My Mom’s Severe Hair Loss

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

Hi my mom is 65 and recently she has been experiencing a severe loss of hair and scalp irritation at the crown of her head. It is quite noticeable the hair loss is about the size of a small bowl. Clumps are also left on her pillow when she awakes/washes her hair.

She has been to GP and natualpath and on thyroid tablets to cleanse system as well as steriod topical cream to easer the itching and severe hotness of the area. This has been quite disconcerning for her. She also says that besides the severe heart in her head she wants to pull the air out to relieve the pressure. The doctor has sent her for biopsies as well as to see the ear /nose/throat specialists and they say there is no specific information they can give.

Any suggestions? Thanks, I hate to see my mom is such discomfort it unnerves me as I can’t relieve it as even head massage hurts her.

I understand your feelings and sympathize. You want to comfort your mother and it’s tough to see her in pain. She needs to complete the biopsies and then take her to see a dermatologist to evaluate her hair loss. I really can not help her here, as this is too complex to handle without an exam and the internet has its limitations.

Tags: female hair loss, hairloss, hair loss

Will Female Donor Hair Fall Out?

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

Is it true that female donor hair that is transplanted does not become permanent and may eventually fall out of the transplanted area whereas male transplanted hair will never fall out?

Whatever happens to the donor area will happen to the transplanted hairs in their new location. Female genetic alopecia is often diffuse and when it progresses, it impacts the donor area with miniaturization that is progressive, so you will see that impact in the recipient area for donor hair as the miniaturization progresses. In most men, the donor area is spared from miniaturization, so when this hair is transplanted into the recipient area it reflects that stability seen in the donor area and is not lost. In other words, men have that ring of hair around their heads (often called the permanent zone), whereas women aren’t going to necessarily have that same permanent area.

Tags: female hair loss, hairloss, hair loss, donor hair

Hair Loss and Lupus of the Skin?

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

I’m a 43 year old African American female. I’ve used hair products all my adult life. In addition, I wore weaves from braiding and sewing tracks on my hair to gluing tracks on my hair. To braiding my hair as well. I used extensive heat from flat irons to hair dryers. Everything has come to a halt. The top portion of my hair is bald in the crown area of my head in many large spots. I had a small spot for years smack dead in the middle of my crown area and never thought anything of it. Well a month ago my hairstylist noticed the small spot is no longer there. There are huge spots now that is red and is tender. For years my scalp always felt irritated very strange… Even when I brushed my hair my scalp would hurt. I recently got rid of all the hair products that contain Sodium Laurel Sulfate and Sodium Laurel Lereth Sulfate. I purchased all natural shampoos and conditioners.

Well I went to see a Dermatologist. He kept saying something about a band…? Dead hair follicles that will not grow back. Well they did the Biopsy and now I wait. He thinks it might be Lupus of the skin…. WHAT !@&^*()(*_( What is that… My first cousin has Lupus (enternal). I’m stumped…. I am wearing wigs because my hair is not long enough to cover the bald spots… What a mess…. Your thoughts Doctor?

You will know more when the biopsy comes back. If you don’t have Lupus, you have many causes for hair loss all listed in your first paragraph of your email to me. This is a complicated problem that will have to be evaluated with you sitting right in front of me and my obtaining the biopsy from your dermatologist. For more info, look to the Lupus Foundation of America‘s Lupus of the Skin page.

Tags: lupus, skin, cutaneous lupus, hairloss, hair loss

Female Hair Loss After Appendectomy?

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

Dear sir,

about 3 months ago, my girlfriend (33 years old) was submitted to a surgery in order to remove a benign uterine myoma, treat an inguinal hernia and remove the appendix. Now she is having some hair loss localized at the top of her head where we can see about 3 cm of her scalp (there is no hair loss at the sides or front). she went to a dermatologist and he asked for a blood test to see if she is anaemic (the test is ok, she isn’t anaemic) and says that this situation is temporary due to the surgery, but I’m a little sceptical after what I have read in this blog and in other web sites as well.

Her mother, father and sister don’t have hair loss, but on the other hand a few years ago she started to have a few hairs in her chin.

So my questions are: what kind of tests do you suggest her to do , and is this a case for a dermatologist or an endocrinologist?

thank you

I would start with a primary care doctor who can do some basic tests to rule out anemia and thyroid causes. You said she’s been tested for anemia though and was OK there… but the primary care doctor will then be able to refer your girlfriend to the appropriate specialist if other basic tests are done. In other words, my advice is to start with the primary care doctor and take it one step at a time.

Generally, major surgeries or general anesthesia can sometimes precipitate hair loss (called telogen effluvium) in some men and women, but some of the autoimmune alopecias can be stimulated from the stress of a surgery as well. The hair loss is generally temporary and can take as long as a year to normalize. It is thought that such surgery or general anesthesia is a “triggering” factor in a genetic predisposition to hair loss. If this is the case, you won’t know for a year or so.

Tags: appendix, appendectomy, hairloss, hair loss, female hair loss