Femara and Female Hair Loss

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

Hello Dr. Rassman,

I’m hoping against hope that you have any suggestions for me. I’m 45, and I was diagnosed with stage 2 ER+ breast cancer 2 1/2 years ago. 21 months ago (after bi-lat mastectomy, chemo, rads, and a complete preventative hysterectomy) my oncologist started me on Femara, an aromatase inhibitor.

My hair grew back thick and full and normal after chemo and for 16 months after I started taking the femara — then suddenly 4months ago, it’s been falling out in massive amounts. Mostly in the front and crown. I’m at a loss as I know the femara is removing all estrogen from my body — and many of the hair loss drugs out there can mess with the work of the femara. I’ve started on Rogaine, but I’m not holding out much hope for that. Are there any other treatments that are safe for me? I’m desperate. Thanks so much.

Your priority should be the treatment of your cancer and with regard to your hair loss, you need to speak with your oncologist who has familiarity with hair loss with chemotherapeutic agents. I do not know enough to help you, sorry.

Tags: chemotherapy, chemo, hairloss, hair loss, femara, female, women, woman, aromatase

Alopecia Doctors — Dr. Vera Price or Dr. Richard Strick?

/by William Rassman, M.D./3 /, ,

Hi,

I’m writing to you desperate for answers. About 6 months ago my hairline started to thin and recede rather rapidly after stopping ortho-tri cyclen birth control pills. My general doctor thought that stopping the pill was the cause. About 2 months after seeing the doctor I started to develop a round bald spot above my front hairline. It has slowing progressed over the last 6 months into a spot the size of a quarter with redness and tenderness along with some sporadic itching. I went to see Dr. Vera Price at UCSF in San Francisco. She had her derma pathologist review a biopsy that Dr. Kurgis of Templeton CA had taken and told me it was alopecia areata and not a scarring alopecia. However, this is where I get to my question, I wanted a second opinion because Dr. Kurgis thought it looked more like a scarring kind so I went down to UCLA to see Dr. Richard Strick who also reviewed the same biopsy slides. He said that neither he nor his derma pathologist could clearly read the slides to determine if it was either scarring alopecia or alopecia areata. Which doctor is more knowledgeable about these diseases? Who should I trust Dr. Strick or Price? Please help; I don’t know what to do at this point. Dr. Price said that having another biopsy again is unnecessary and might make it worse and she was certain it’s not scarring, but it keeps spreading every week, little by little and the redness spreads as well. I’m very worried I will have to wear a wig if this does not stop. Thanks for any advice you can offer.

I personally know Dr. Richard Strick, because he is in the Los Angeles area (where I am based), and can speak very highly of him and his work, but I only know of Dr. Vera Price based on her reputation. These are two terrific dermatologists, and I can’t make a decision for you on who to trust more in this situation. You should have asked Dr. Strick about Dr. Price’s recommendations, as he was the last doctor you saw. I wish I could offer you some advice, but these doctors are both highly skilled in dealing with conditions like these and are much more specialized with this than I am.

Tags: price, strick, dermatologist, dermatology, alopecia, hairloss, hair loss, female, women, woman

Body Hair Loss from Stress After Pregnancy Years Earlier?

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

Hello Doctors…
My sister has been losing her hair for 2 years now, she is 22…it all started after she had her first baby…shes been stressed out since then…around 300 hairs fall out a day maybe more…she recently went to a dermatologist and they checked her iron, zinc, and thyroid…they said everything looked good…she is losing body hair or should i say pubic hair and she mentioned something about her eyelashes as well…she gets these red spots on her scalp sometimes…the dermatologist said that her losing her hair is due to the new born she had 2 years ago…is that possible?…i told her to get a second opinion, i mean they should take samples of her scalp or something right?…or could it just be the stress?…i never heard stress making you loss body hair and stuff but i dont know…she decided to get ScalpMed, but i have a feeling it’s not going to work because its not just the scalp that losing hair it’s also everywhere else…what do you think about all this? Thank you for your time.

It is virtually impossible for me to diagnose her over the internet. I think that if she is not satisfied with the one opinion, get another one. Her hair is too important to let this go and what you are describing does sound serious for her hair and psychological state of mind.

Tags: hairloss, hair loss, body hair, pregnancy, pregnant

Would Switching Away From HCTZ Help My Hair Regrow?

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

I am a 60 year old female taking HCTZ and Norvasc for blood pressure control. My doctor increased my HCTZ from 12.5 to 25 last year. For the past year my blond hair has been thinning DRASTICALLY. Neither my family doctor nor the dermatologist I recently consulted connected it with the HCTZ. After reading that hair loss IS a possible side effect, I want to take a different medication that will not have this side effect. My question: Will I be able to regrow the hair I lost when I change to a different medication? Also, my dermatologist is planning to remove several broken blood vessels on my face with a light therapy next week. In one web- article, I read that artificial light shouldn’t be used with HCTZ and that it could cause photosensitivity. Your comments please.

Thank you

You should focus on your medical needs with your doctors and ask your questions to them. I do not know what photosensitivity you are focusing upon that would prevent what you doctor is planning do with the the ‘light’ therapy. Your question about hydrochlorothiazide (HCTZ) and hair loss is addressed at eMedTV – Hydrochlorothiazide and Hair Loss.

Tags: hctz, hydrochlorothiazide, laser, hairloss, hair loss, dermatology

Girls In Haiti Orphanage Are Losing Hair

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

There is a wonderful ministry called “Love a Child” which has an orphange in the country of Haiti. The owner/manager of the orphanage is struggling to help several of her African American orphan girls who are suddenly suffering from hair loss. She has pictures of the girls on her site at loveachild.com

From reading various information on your website and others it seems the only options are:
1. Stop tight hair braids (but it’s too late now)
2. Costly hair implants

Any suggestions or advice you might have to help these precious children would be greatly appreciated.

From the photos in the link you provided, it seems the girls on the site have traction alopecia from wearing tight hair braids for long periods of time. Unfortunately, traction alopecia is permanent and there are no good treatment options. Hair transplantation surgery may help, but it cannot replace all the hair that was lost as even with a hair transplant, the supply of hair may exceed the demand for hair in the balding area.

Tags: girl, female, women, woman, traction alopecia, alopecia, braids

Female Hair Loss from Lexapro or Anesthesia?

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

Hi,

I had two surgeries, one in October 2007 and the other 4 weeks later in November 2007, to remove ovaries and surgical adhesions from a hysterectomy performed in September 2007. I started experiencing numbness and tingling on my upper/lower extremities in February 2008. My physician ordered Lexapro to reduce associated diabetic neurological symptoms. I’ve been on this medication now for 6 weeks and have started losing my hair and now have bald spots. Coincidently, I had hair loss after having undergone anesthesia 2 years ago as well. Is this hair loss due to the anesthesia or Lexapro? I am taking 10mg Lexapro. If this is causing the problem, can you recommend any natural supplements that can help with this issue?

Anesthesia and/or Lexapro (Escitalopram Oxalate) can cause hair loss. If you are having bald spots, sometime surgery and stress can even induce alopecia areata. You need to see a good dermatologist to look at this and determine the cause of your problem. This is not something I can determine via the Internet.

Tags: lexapro, anesthesia, hairloss, hair loss, women, female, woman

Is Women’s Rogaine Making My Hair Loss Worse?

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

ive been using women’s rogaine for about 2.5 months, my hair was just thinning when i started, then in the last few weeks it started to just fall out in my brush, the shower, etc. my hair seems to be very thin, and very easily pulled out, like it’s not holding on to its roots. now my hair is so short I can barely make a pony tail! what’s going on, is this normal from taking the rogaine, and how long before i start seeing real growth, and when will the shedding stop!

thanks

Women's RogaineWe have heard of people who initially lose hair when they start Rogaine (minoxidil), the theory in this process is that Rogaine resets the hair cycle and hair that is falling out is actually the hair follicles going into a dormant stage (telogen and catagen). Have you seen your primary care physician or a physician about your hair loss? I want to make sure that there is not another reason for your thinning hair that may be related to a medical condition or medications.

Generally people do not see the results of Rogaine for 6-12 months. You need a diagnosis for what is causing your hair loss, and this is not something I can offer to you without an examination.

Tags: women, woman, female, rogaine, minoxidil, hair loss, hairloss, catagen, telogen

Telogen Effluvium in Pregnant Woman

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

Dear Dr,

Please help me! I have been suffering from hair loss since Ausgust 2007. I have been diagnosed with Telegon effuvuim , I came off the pill to concieve in august after being on it for 12 years. I am now 7 months pregnant and am so depressed with what is happening. In Dec 2006 I was in hospital due to a hemorage that happened after an infection too so maybe this has something to do with it. My iron stores are pretty low so I’m now on Ferrous Sulphate 200mg and also Spatone Iron Supplements. The loss has happened for 8 months and I’m now losing hope, is there anything I can do? Will this ever stop and most of all will it all grow back? I feel so helpless at the moment, I dread washing and brusing my hair and just hope this will stop. Any advice would be much appreciated.

Thanks

Your history shows a great deal of stress and many of the contributing factors for hair loss, like taking birth control pills some time ago, your pregnancy now, infection, bleeding, and low iron. The hair loss has gone into its telogen phase (sleep phase), but this should abate once you deliver your baby and correct the low iron. I am sure you are being followed by your doctor. I would expect that the hair should regrow some 4-6 months after the birth of your child. I am keeping my fingers crossed for you.

Tags: pregnant, pregnancy, women, woman, female, hairloss, hair loss, telogen, iron

I’m Female, My Doctor Has Me on Propecia for Hair Loss, But I Want Avodart

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

my dermatologist has me on propecia for hairloss. i am 55, female and have read that avodart may give better results. my dr. says she has not heard of avodart. i didn’t mention this was not the intended use of the drug. anyway, i think i may need to find another doctor. do you have anyone in orange county you might recommend?

thanks.

Go seek out another dermatologist. I personally would not treat a 55 year old female with Avodart (dutasteride) unless they had Polycystic Ovarian Syndrome (PCOS) or a similar problem.

Tags: dustasteride, avodart, hairloss, hair loss, female, women, woman

My Doctor Is Giving Me Cortisone Shots for Small Hair Loss Patch

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

I have a small patch of hairloss on my scalp. My doctor has started cortisone injections to the location and has suggested that I also use Women’s Rogaine in addition. Is this a common practice? I am concerned because the instructions on the Rogaine box says not to use it for patched of hair loss or non-hereditary hair loss. Is using Rogain with Cortisone injections normal?

I don’t like to get between a patient and a doctor who knows more about that patient than a one line question asked to a hair loss blog. In other words, I would suggest that you cross examine your doctor about this. I really am not the right person to ask advice in this situation, as you aren’t my patient and I simply don’t know enough about your medical history to give a proper response.

Tags: cortisone, shot, injection, hairloss, hair loss, rogaine, minoxidil, female, women, woman

Clobex and Female Hair Loss?

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

(female) 2 years ago I was diagnosed with psoriasis on the scalp. I’ve had intermittent “flares” which responded moderately well to Taclonex but last sat. I tried Clobex. I let the ointment set overnight and then when I washed my hair the next evening my hair began to fall out in clumps and is now coming out diffusely EVERYWHERE on my scalp. I am just a few days from being bald. Could the Clobex have caused my entire head (not just the patch I applied it to), to go into a telogen effluvium like state? Will my hair grow back? Also, I just had the patch biopsied (never has been before) to confirm psoriasis. Ive been battling fatigue, night sweats, mod. weight loss, some angular chelosis, and am 25? Should I insist on a fungal culture, ANA, Lyme titer. Something is up….Ive used clobex before without these symptoms. Thanks so much.

Clobex is a steroid shampoo, but hair falling out in clumps to a point of complete baldness with night sweats, fatigue, weight loss, etc is NOT NORMAL. You should not be seeking advice here on the Internet. You need to find a doctor and get an examination and diagnosis, along with an explanation of what may be going on.

Tags: clobex, steroid, shampoo, psoriasis, hairloss, hair loss, female, women, woman

Female Model Having Thinning Hair in Crown

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

I’m a 27 year old black female that use to model, I’m thinking about starting it back, but I have a little problem. Around the middle of the month the back crown of my head gets really sore, and I have noticed that my hair is actually thin up there. The rest of my hair is a great length and very thin also, thou I feel that it may not be the chemical of a relaxer because the rest of my hair is great. But the middle and the back seems to not want to grow and is coming out. what should i do.

You need a doctor to examine you to give you an opinion. Unfortunately, this is not something that I can do over the internet. Hair loss in women is a complex issue. It is possible that there was a chemical burn on one or two areas and not on the entire scalp.

Tags: black, female, women, woman, hairloss, hair loss

Olux-E and Hair Regrowth?

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

My dermatologist prescibed Olux-E to treat my scalp for hair loss but I have seen no noticeable improvement in hair growth. What success stories are there for women that use Olux-E?

Olux-E is clobetasol propionate foam and this is a very potent topical steroid and it is used to treat a variety of severe skin conditions (e.g., psoriasis, eczema, dermatitis, allergies, rash). Clobetasol reduces the swelling, itching, and redness that can occur in skin conditions such as autoimmune diseases like psoriasis.

Steroids will have no impact on female genetic hair loss, but may work in specific alopecias that are autoimmune induced, like alopecia areata. Potent steroids placed on the skin will get absorbed by the body and any chronic use of this medication can impact the adrenal gland and produce side effects from their use. In other words, Olux-E will not work if you have genetic hair loss, but may work if it is alopecia areata. Since I don’t know enough about your case, I couldn’t tell you if it would work for you.

Tags: olux-e, foam, hairloss, hair loss, alopecia, female, women, woman, steroid

Female Hair Loss Still Continuing Over a Year After Chemical Damage

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

Hi Doc,

I’ve read a whole lot of your answers here, and I did your advice of waiting for months in order to see if my hairloss due to chemical damage will stop.

It’s been 14 months since my hair started shedding abnormally. Between then and now, I’ve been to several dermatologist visits. All my lab works came back normal, and the doctor said he does not see any scarring. To date, my hair is still shedding badly, and the worse thing is, a lot of short thin ones (looks like new growths) falling out too. I had very very thick hair before the incident, and now, I could honestly say half of it is gone. My scalp has gone scaly and flacky too.

My question is, since it looks like my new growths are falling out too, does it mean that my hair is still not recovering from the damage or that hairloss is going to be permanent for me? I have been extra careful handling my hair now, but hair just keeps coming out even just with gentle strokes. Very different from how my hair was before.

I would really appreciate your insights on this. If this question has been answered already, please provide me with a link.

Thanks a lot!!!

24 y.o. female

If the hair does not return after 8-12 months following chemical burns, it may be permanent. You should be under a doctor’s care. The use of minoxidil may help, but that can not be my recommendation, as I am not your doctor. I have seen some women with chemical burns and all I know is that they can produce significant permanent hair loss. Your doctor is in a better position to judge that I am. Have you had biopsies, and were they reviewed by a good dermatopathologist?

Tags: chemical burn, chemical, burn, hairloss, hair loss, female, women, woman

Klonopin and Female Hair Loss

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

Hi Dr. Rassman,

I recently saw my dermatologist over concern about thinning hair. I started taking the anti-convulsant klonopin almost a year ago, a few months after I cut off about 15 inches of dense hair to nill, so I didn’t pay attention to thinning the whole past year. My dermatologist looked at my part line at noted that my part was defiitely bigger on the top than on the back of my head. I also notified her that the hair on my forearms and legs were thicker since starting the klonopin. She said that it could be one of three things:

1) a really stressful year,
2) androgenic alopecia emerging (I’m 30) independently, or
3) drug induced alopecia and hirsutism caused by the klonopin with the klonopin possibly unmasking androgenic alopecia early.

She said that if the cause was drug related, even in the case of unmasking AGA early, alopecia would be reversible once I stopped taking the drug, reversible that is until I reached menopause and then it would reemerge. My maternal grandmother has the thinning hair but she didn’t get it until she menopausal. Is my dermatologist incorrect in assuming if the klonopin unmasked AGA, the hair will automtically grow back for the next ten years or so, after I stop taking the drug? I don’t understand this as I’ve read several places on the web that “unmasking” of AGA implies that hair growth is not going to revive temporarily if you stop taking a drug. I got really excited when she said if that was the case my hair would grow back the way it was until I reached menopause. Her plan for me was to get me off klonopin and see what happens, it would take about 3 months to taper off this drug, and then several months after that to see if it grows back. that if it doesn’t grow back it’s classic AGA having nothing to do with the klonopin as an early trigger at all. IN the meantime if it is there something I should do as a preventive factor, like go out and purchase rogaine and see if it works? Your input would be very much appreciated.

KlonopinIt sounds like your dermatologist has it covered and you should follow her advice. If you’d like a true second opinion, you’ll have to find another dermatologist in your area. Klonopin, like other benzodiazepines, can cause hair loss in some people.

I realize it isn’t what you were hoping to get out of me, but I don’t have nearly as much experience with Klonopin (clonazepam) as it seems your dermatologist does to add any significant value to what you have discussed here… though I appreciate you sharing your experience and wish you luck.

Tags: klonopin, clonazepam, benzodiazepine, hairloss, hair loss