Benicar and Minoxidil

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

I am a 62 yr. old woman who has been using Minoxydil for about 15 years since I had always had very thin hair and its usage really helped prevent fallout and even made my hair a bit thicker.

About 3 months ago, my doctor prescribed a blood pressure medication (Benicar) and it appears to be causing terrible hair loss (even though I am still using the Minoxydil). I will speak to the dr. about the hair loss but is it harmful to continue using the Minoxydil if I am taking BP medications? I am hoping to find a medication that will not have this side effect. I look forward to your answer as this is very depressing and worrisome

BenicarBenicar causes hair loss in 1% of patients… so it is quite rare. Speak with your doctors and see if there is an alternative medication that he/she would consider. The blood pressure impact of topical minoxidil should not be enough to impact your blood pressure management, but again, discuss this with the physician that is already treating your blood pressure.

Tags: minoxidil, benicar, blood pressure, hbp, hair loss, hairloss, female hair loss

Woman Took Avodart for a Year, Now Wants to Get Pregnant

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

I am a woman who was taking avodart for hair loss. I took this for approximately 1 year, with no visible results. I stopped taking avodart in January this year.

I am thinking of becoming pregnant. How long to I have to wait before avodart is completely out of my system? I understand this drug has a long half-life.

Check with your doctor. The half life of this drug is about 3-4 months, which means it may hang around for a couple of years at some level in your blood stream. Dutasteride (Avodart) is known to produce sexual development problems in the first trimester of pregnancy when taken by women.

Tags: avodart, dutasteride, pregnancy, pregnant, hairloss, hair loss

Will I Have Hair Loss After My Hysterectomy?

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

I am having a hysterectomy July 31st and was instructed to stop taking my birth control pills which I did as of March. In the meantime, I ruptured both of my achilles tendons and had major surgery. I started losing my hair not too long after the surgery and thought the hair loss was due to the surgery. After reading some comments online, I realized that the hair loss is probably due to having stopped taking the pill. Now I’m concerned that with this major surgery and another coming up soon, I will continue to lose more and more hair. Is there anything I can do to stop the hair loss? I am terrified of going bald!

I doubt that you will become bald. Reactive hair loss after a major surgery is often cyclical and often will return if you are one of the unlucky people to experience. There is no way to prevent this in those that have experienced it in the past.

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

Are Young Women Losing More Hair Lately?

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

Hi Doctor – What do you think is causing young women (teens and 20’s) to lose hair? I see more young women thinning. Any thoughts? My daughters (17) hair has thinned gradually for over a year with no regrowth. The doctor tells me that it is not AGA because her hair density is the same all over her entire head. I find that I’m looking at everyone’s head these days and this is what I am seeing.

I don’t think that there is any difference in young women now or in any time in the past, but I believe you are more attuned to observing what might have passed you by before your daughter reported a problem. If you are concerned about androgenic alopecia (AGA), you can obtain a genetic test to determine if she has the gene for female balding.

Tags: hairloss, hair loss, female hair loss

Inflammation and Female Hair Loss

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

I recently saw this on the local news here in LA. It seems to be a finding/treatment for women. I was wondering if you knew any more information about this and if so, would these topical steroids work for men? NBC Los Angeles

Treating hair loss with steroids for “inflammation” is nothing new. People have tried applying steroid cream and doctors have tried INJECTING steroids to the scalp to encourage hair growth. In my opinion, these treatments do not work as I have seen patients who actually LOST hair from such treatment. Hair loss is genetic in most women and men. There are of course medical issues such as anemia, thyroid issues, etc… particularly more in female cases.

Tags: female hair loss, hairloss, hair loss, inflammation, steroid

Oral Antiandrogens for Female Hair Loss

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

Hi
I was wondering what your opinion is of this study? Thank you!

Treatment of Female Pattern Hair Loss with Oral Antiandrogens

I referenced this article before — Treatments Available for Female Hair Loss

The conclusion of the authors suggest that there is merit in the use of antiandrogens, but the study is not statistically significant. Since my earlier reference 2 and a half years ago, our ability to separate women into two classes (those who are sensitive or not sensitive to antiandrogens) through the use of new genetic tests holds great promise for the future management of women’s hair loss. It is possible that in those women who had the best response to antiandrogens are women who have a high sensitivity to the antiandrogens as determined by genetic test (see HairDX). The study should be repeated with the genetic groups separated.

Tags: antiandrogens, hairloss, hair loss, female hair loss, hairdx, genetic

Hair Transplant in 21 Year Old Woman is Criminal

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

I had a transplant in August, 2007. Needless to say it has been over a year and a half, and to my sadness and distress, I have yet to see ANY results. I had a full head of hair going into the surgery, and I went to Mexico with the doctors of a medical institute there, maybe that was my first mistake.. I was 21, and I am a female, and now I find I might not even have been a good candidate to begin with. The doctor just looked at me and told me that I was a good candidate. My hair had a diffuse thinning, but still there was quite a bit of hair stil left, something I wish I would have appreciated before. After the surgery, my hair fell out. I was patient, thinking it was shock loss and it would be temporary, but it has been more than a YEAR and the hair never came back. Fortunately I can use powders like Topikk all over my head to fake a full head of hair, something not necessary before, and my hair is much thinner than before. Does this seem like shock loss and is it permanent? I am upset over this and stressed out, but I would like to know what the future holds for me. Any help given would be greatly appreciated. Thank you.

This is quite unfortunate. Hair transplantation on a 21 year old woman is usually performed by doctors who want the money and do not care about the patient’s welfare. Indeed, about 80% of women with hair loss are not candidates for hair transplants and may suffer the same outcome that you did. You should have had a full medical work-up to include many blood tests for medical conditions that could cause female hair loss. There is even a genetic test for the inherited form of genetic hair loss. This remains a buyer beware market.

It might be worthwhile visiting me in my Los Angeles office. I could then confirm for you what may be going on and possibly give you some insights into what may happen to you in the future. I may even be able to suggest treatments for your hair loss. As your surgery was over 20 months ago, you should’ve seen some growth by now if the surgery was successful.

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

Common Age for Female Hair Loss to Start?

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

Hi Dr. Rassman,
Searching the internet and various websites I always seem to hear/read about women who have severe diffuse hair loss and have developed female pattern baldness when they are around 20-years-old. Is this very common? Some information I’ve come across says it’s very very common while other says it rarely happens. Do you have any statistics on it?

I am not aware of statistics, but from my experience, women often follow the females in the family that have genetic balding in the time of onset and the pattern. There is a strong one-to-one link between mother and daughter in this condition and it is not infrequent to see it in your mother’s mother or aunts. Female genetic hair loss is not common in very young women, but in each decade, the frequency rises until menopause when almost 50% of women experience the problem. We see hair loss after pregnancy in many of these women as well.

Tags: female hair loss, hairloss, hair loss

Female Hair Loss in the Back of Neck

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

(female)
Dear Dr. Rassman,

The hair on the back of my neck is disappearing and I have no idea why. It started in the end of January 2009. It’s getting thinner from the middle and outwards and creates a parting in the shape of a crooked L (down and off to the side. The hair at the very base is short and thinner and doesn’t seem to grow (at least not very long terminal) I’m not sure if this description is enough for you, but I am at a loss of what to do! Do you think this will subside with time and then the hair will grow back again? I know neck hair tends to grow slower.

Neck hair genetics are different than scalp hair genetics and unfortunately there is little that can be done other than the possible use of minoxidil. I do not believe that I have seen anything written in the medical literature on the loss of female neck hair, but there are many men who show it so why not women? Send me a series of photos and maybe I will understand more of your problem.

  • What is your age and state of health?
  • Are you taking birth control pills or other medications that can cause hair loss?
  • Could it be that you had a tight hair style that pulled on the hairs at the base of the skull, causing traction alopecia?

You get the idea here — a single description of a problem without my ability to ask questions with a good medical history leaves me in a difficult position to help. Consider a visit to my office and then at the least, I can perform my usual extensive examination of your scalp and neck.

Tags: female hair loss, hairloss, hair loss, neck hair

Predisone Caused Giant Clumps of Hair Loss in Woman

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

(female)
I had an allergic reaction about a year ago and they put me on prednisone 50mg. I had to take 8 of those for 3 days and then every 3 days I go down 1 pill. It took about 3 weeks to get off of them and then as soon as I started taking them my hair started to thin. Then eventually it was coming out in giant clumps. It took about 2 months for me to lose all of my hair. Is that normal for that amount of meds I was given? To lose that much hair in that little of time?

Steroids (like prednisone) are a cause for hair loss. You need a good doctor to analyze you, your general health, and your overall hormone balance. This can not be done over the internet.

Tags: steroid, prednisone, female hair loss, hair loss, hairloss

Spironolactone Caused Melasma So I Stopped — When Will My Hair Fall Out?

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

(female)
I am withdrawing from spironolactone after developing melasma. I have been on it 18 months. How soon should I expect more hair to start falling out again?
Thank you.

Complications of spironolactone treatment includes melasma (skin pigmentation on the face — see here).

Unfortunately, I can not help answer your question because I know absolutely nothing about what is wrong with you, why you were treated with the medication (was it just for hair loss?), age, etc. I’d talk to your prescribing doctor, who has the benefit of knowing your medical history.

Tags: spironolactone, melasma, hairloss, hair loss

Progesterone Injections and Female Hair Loss

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

3 weeks ago I’ve stopped taking the fertility PROGESTRONE known as PIO injections, Progynova 2mg- Tiny light blue tablets that are taken orally to help build the lining of the womb. and Ultrogestan Progesterone-creamy white pills that can be taken rally or inserted vaginally. I did both.

I’m African American with very thick strong natural hair, and now, my hair is falling out by the handful. my hair egges are going bald. I never went through no crap like this. My hair went from very thick to very thin.

Am I able to get a lawsuit? How long will it take for my hair to grow back? When will all the medications be cleared out my system and for my hormones to go back to normal. I’m way to young for menepose affects and that is what one of the medications does. thanks so much for your help. I am experiencing boldily sharp pains too from that medication after I have stopped taking it.

One has to be careful when treating medical conditions in a patient that requires hormones and has genetic hair loss. The connection between hormones and hair loss are published all over the web. Progynova (estradiol valerate) is also known as Delestrogen, and the side effects do include hair loss (full list here).

Although I can not give you legal advice, I would suggest that you have a long talk with your doctor and review the “informed consent” sheet he should’ve given you before starting you on hormone treatments. I am hopeful that your doctor at least discussed the side effects of such treatments.

Tags: progynova, delestrogen, estradiol valerate, progesterone, hairloss, hair loss, female hair loss, estrogen, hormone

Lowering a Woman’s Hairline by Using Hair Transplants (with Photos)

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

This woman was born with a high hairline, which appears more common in women than in men. These women see it in their early teens and they have few alternatives to surgery. There are two approaches to the surgery:

  1. A hair transplant, which is performed like a typical man’s hair transplant when his hairline rises either by a high maturing hairline or just genetic balding (which almost always starts in the front).
  2. A surgical hairline lowering procedure (like a reverse brow lift) commonly done by plastic surgeons. The advantage of the hairline lowering procedure is that the results are instantaneous and once the swelling has gone away, the hairline is located in its new position. On occasion, a scar forms at the leading edge requiring a limited hair transplant to hide it.

The patient shown below opted for the 1st method (transplant) and had 1432 grafts about 18 months ago. She is quite pleased with the results of a single transplant session (performed by Dr. Jae Pak). Sometimes when a person has very fine dark hair and white skin, a second session is required to obtain the desired results. Click the photos below to enlarge.

After hair transplant of 1432 grafts

 

Before

 

Tags: hair loss, hairloss, hair transplant, surgery, hairline lowering, female hair transplant

Balding 22 Year Old Woman (with Photos)

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

This 22 year old patient came to see me for hair loss she’s been experiencing for the past 2 years. She did all of the right things, saw two dermatologists, and received a complete medical work-up for a variety of disease entities and vitamin deficiencies and was found to be normal. What I told her is as follows:

  1. Obtain a new test for androgen sensitivity of her hair based upon a genetic test
  2. If she is sensitive to androgen, we might try her on an androgen blocker such as finasteride or dutasteride in the hope that this will block enough of the androgen to allow better hair growth.

The science is minimal that support this thesis, but it is better to try to block the androgens on women who are positive to the genetic test for androgen sensitivity than to put all women on the drugs.

In addition, as we could not offer her an immediate benefit with drugs, we used a concealer treatment on her hair and showed her how to do this herself. Her comment after the application of DermMatch was, “I have been reborn”.

I apologize for the blurriness of the before photo. Click the photos below to enlarge. Before (left); After (right)

 

Tags: dermmatch, concealer, hairloss, hair loss, female hair loss, photos

Female Hairline Corner Restored (with Photos)

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

Many women lose hair or see thinning in their frontal corner hairline. This female patient had such a problem on one side, which was transplanted with 600 grafts. She had a wonderful result by her assessment and mine.

Before photo on the left / After photo on the right. Click to enlarge.

 

Tags: hair transplant, hairloss, hair loss, female hair loss, corner, hairline