Losing Hair After Having a Baby 15 Months Ago

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

I had a baby 15 months ago and had TE. Hair loss has been fluctuating for the last 15 months and my hair did grow back after TE, but now lose probably 120 a day (dermatologist told me to take a count)I still feel like my hair is thinning. Two dermatologists told me I did not have AGA but I feel like something is going on. Would I be losing more hair if I had AGA? Where do I go for answers?

If you are seeing a good dermatologist, that is the place to be. They understand hair loss from a disease point of view and know how to go about diagnosing it well. Hair loss in women can sometimes be caused by underlying medical conditions, so it is important for you to be evaluated by your own physician before we proceed. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone. The following laboratory tests are often useful if underlying problems are suspected: Estradiol, FSH, LH, SHBG, Prolactin, T4, TSH, ANA, Iron, TIBC, Ferritin, Free and Total Testosterone. If your doctor has any questions, please encourage him/her to call me. We would appreciate a note from your physician that you are medically cleared for surgery.

Post partum hair loss sometimes may take up to two years to reverse, providing that there is not other defined cause.

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

Almost Completely Bald from a Perm

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

Hi doctors,
Can a perm cause hair loss? My mother had her hair styled professionally a month ago and it now looks like she’s losing her hair. I don’t know if the style just made existing thin patches more visible or if the perm could actually cause the hair loss.

Thank you

SalonI saw a lady just the other day who was wearing a ‘full helmet’ wig. When she took it off, she had almost no hair anywhere on her head. She looked like she had just had extensive chemotherapy, but in reality she had a perm some 5 years ago. The perm brought on an immediate reaction with about 95% of her hair gone within a month. The hair never returned. Unfortunately, there was nothing I could offer her to help her. What impressed me was the totality of her hairlessness from something simple as a day visit to her hair dresser. She was so concerned about exposing her hairless scalp to me, that I did not ask her to allow the use of her photographs, even from behind.

As for your mother’s hair loss, I wouldn’t be able to know what the cause is just based on the email you sent. It is possible that she had existing hair loss, or the styling could’ve caused it. There are a number of factors that could be the reason for her thinning hair.

Tags: hairloss, hair loss, perm, style, female, woman, women

A Bald Spot in Female After Hair Extensions Removed

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

My 27 year old daughter just called me frantic about some bald spots that were found in her hair. Her story sounds nutty, but please listen and let me know what I might can tell her that will help to calm her down. She had cut her hair pretty short and truthfully loved it, but her husband thought it looked a little butch. Unfortunately, this made her feel self conscious, so she had longer hair added to hers. From what I understand the hair pieces were glued in. Those were taken out today and she is hysterical because she now has bald spots. So, can you possibly tell me anything we can do to help point her in a direction to try and seek some help.

It sounds like the glue pulled out hair. If this is just a short, one time episode, the hair should grow back. Constant traction over longer periods of time can cause permanent hair loss. I would recommend waiting 6-8 months and after the hair goes through a cycle (worst case) the hair should grow back. Otherwise, she should see someone within my specialty for consideration of a small hair transplant procedure, but waiting for up to a year is better just in case it does grow back. The usual wait time is under 6 months, but I say a year to be safe.

Tags: hairloss, hair loss, bald spot, glue, extensions, female, woman, women

Limitation for a Perm in an Aging Woman?

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

I am peri-menopausal (50 years old) and was wondering if getting a perm would hold, as with all the hormonal changes I am and will be facing may affect this?

Having a ‘perm’ should add body to your hair and make it easier to style. The hormonal changes you are experiencing and will experience in the future should not be a factor in your stying decisions (to have or not have a perm).

Tags: perm, hair, female, women, woman

I Didn’t Know Weaves and Wigs Would Make My Traction Alopecia Worse!

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

I’m a 38 yr old black female. My hair started thinning in the crown about 10 yrs ago. I started braiding it to keep out the chemicals. About 3 1/2 years ago I was diagnosed with traction alopecia. Had never heard of it before. I started wearing weaves and wigs to cover up the ugliness. I never realized that this would make my situation worse. Now the balding has spread to the top and front of my head. Is it too late for a hair transplant that would work. The hair on the sides and back is relatively thick, but it seems so unhealthy. At the rate I’m going I feel like I should just shave my head bald and call it a day. I feel so ugly. I did see a dermatogolist for the diagnosis, but I never got any advise on what I should do to help the situation. Can you recommend anyone to see on this side of the country??

If you are diagnosed with traction alopecia, you need to keep your hair short with no weaves and wigs. After stopping the insult, you should wait for at least six months and see if your hair regrows. In many cases, traction alopecia may cause permanent damage to the hair follicle and may not reversible. Repeating the evaluation of your hair after this period of time will show the areas of permanent hair loss. At that point, a hair transplant specialist can evaluate you for further treatment options if the hair failed to grow back. Then, if you are using a wig, be sure that it is converted to clips to prevent the transplants from developing traction alopecia.

Tags: traction, alopecia, hairloss, hair loss, weave, wig

Doctor Said I “Probably” Have Female Pattern Baldness

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

I am a 24 year old female. After a 7 minute consultation with a dermatologist I was diagnosed as “probably” having female pattern baldness, and I could try rogaine. Yeah, I’m looking for another doctor who might be interested in looking into exactly what’s happening and treatment options beyond minoxidil.

My question though is, some of the hairs that I shed have a weird kink in them about 1.5 inches down. I have my hair dyed and have done for about 6 years but the kink doesn’t seem to fit into any dying or styling pattern so I was curious as to whether this might be an indication of what is causing my balding?

Female pattern baldness is discussed in many posts in this blog (see Female Hair Loss). In this condition, hair is miniaturized in a pattern that may or may not be similar to the man’s pattern. The more common type of balding/thinning is female unpatterned hair loss where the hair loss is spread throughout the scalp without a clear pattern. The donor area (the fringe area around the back and sides of the hair) is often included in the balding process when the process is unpatterned and the quality of the donor hair is poor because of the high degree of miniaturization present, so women do not make good candidates for a hair transplant in the this unpatterned form. In some women, the donor area is not uniformly thin, but over time it may become thin. So if a hair transplant doctor uses this hair for a hair transplant, when the process of thinning spreads, the transplanted hair may become thin or fall out.

Diagnosis of this unpatterned condition is not always easy and the other causes of hair loss, such as iron deficiency, thyroid disorders, and autoimmune diseases should be ruled out before making the diagnosis of female pattern baldness. Above all, the patient’s hair needs to be mapped for miniaturization to confirm the diagnosis.

Kinks in your hair may be related to the miniaturization that may at times change the hair’s character and color. Again, if in doubt see a hair specialist to confirm your diagnosis and to get started on proper treatment.

Tags: hairloss, hair loss, female, women, woman, balding, baldness

Iron Deficiency and Female Hair Loss

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

Black 42 yr old female: Have several medical conditions fibroids, take cardia xt for irregular heartbeat. I have been to two dermatologist here have had a biopsy of the scalp.The doctor just ruled as thinning hair.?? I have for the past 3 years been balding in the crown of my head and thinning only on the left side of my head. I get the bumps on my scalp with puss. I also have a low iron deficiency. Could all or one thing be making my hair fall out and not grow?

Iron chainsIron deficiency typically causes diffuse hair loss in patients, but be sure that this is all you have by obtaining a complete evaluation by a good doctor. This condition can also trigger pattern hair loss in genetically prone patients. Treatment of iron deficiency is easy with supplemental iron (don’t pick it up at the local scrap iron dealer — wink, wink). You need to complete your treatment course and wait six months to see if your hair grows back.

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

Hair Loss is Causing My Depression

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

I had beautiful hair my entire life. I received compliments weekly on it; it was that nice. I took SYNTHROID for 6 months when my thyroid problem was only borderline and I should NOT have taken it. 99.9% of the subsequent doctors said I should not have taken it. My hair changed completely. I took the drug MAY 05 through NOV 05. It changed the texture, the thickness, I now have a see-through head of hair (especilally on top) and I am depressed. I saw 35 doctors, 2 trichologists and 1 supposed “expert” who said I was in the shedding phase and it would stop. After 16 months, he said it was “long” but would go back to normal. Not true. Has not happened. My life is not the same and I quit my job over this. I haven’t worked since. I have been taking sulfur and fish oil gels every day – the hair was holding steady but still bad until OCT 2006 when things hit the fan and the top got super thin and fallout was twice as bad. I am scared I will be bald and never have a life again. I feel like a monster. My marriage isn’t too great either due to my unceasing depression. I need to be in a study group or with a group of scientists who study hair. I cannot go on. Please…help. Thank you.

Synthroid could be a cause of hair loss. If it was the only cause of hair loss in your case, it should have been reversed with stopping the medication by now. Since you stopped taking it more than a year ago and did not grow your hair back, you must have some other factors involved and thus need a thorough evaluation.

It is proven that hair loss can increase the level of anxiety and cause depression in several studies that have performed in Europe (see PubMed – Psychological aspects of hair disease). The only thing I can recommend is a medical evaluation to have a proper diagnosis. You need to get started on appropriate treatment with a hair specialist. Diagnosis of hair loss is not always simple and it takes a great deal of patience on your part to work through diagnosis and the slowness of treating the problem. You must have a good doctor to do this with. Good luck.

Tags: hairloss, hair loss, depression, synthroid, depressed

Loestrin and Female Hair Loss

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

I’m confused about birth control – please help! I started taking Loestrin 5 weeks ago and noticed 2 weeks ago I’m losing lots of hair. I figure it’s due to the start of the birth control. So I’ve been reading up on it and find conflicting information. Can you tell me if I should stop the birth control or stay on it, hoping the hair loss will stop on it’s own (that’s what my doctor recommends). Does birth control CAUSE hair loss or does it HELP to keep it from happening? I can’t decide if I’m making it worse by continuing my birth control. Currently, I’m taking it, recovering from having a baby 9 months ago, and taking Rogaine per the advice of my doctor, to speed along hair growth. She feels it’s temporary and it will grow back. Any advice?

Birth control pills contribute to hair loss in some women. The decision to take it with that side effect, should be something between you and your doctor. Sometimes, other birth control pills may have less hair loss effects, but you need to discuss this with your doctor.

Tags: bcp, birth control, hairloss, hair loss, loestrin, female, women, woman

58 Year Old Woman Looking to Take Propecia

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

I’m a 58 year old woman, who is getting a lot of hair loss near the front of my head. This has been going on for about 6 months, and I’m not sure if I should start Propecia (correct spelling?) or Minoxidil. I’m hypothroid,and take a combination of armour thyroid, and synthroid, the latter being more a culprit in hair loss I’ve read. If my being hypothyroid will always keep me losing hair, is there any point to starting a hair serum/medication?

Women after menopause have been the subject of one of the studies on finasteride (Propecia). The study, involving 137 post-menopausal women with androgenetic alopecia (male pattern baldness) who were treated with Propecia vs. placebo for 12 months, could not demonstrate effectiveness of Propecia. Another study shows it might help, but the statistics are just not there. Minoxidil is the only FDA approved medication for women with hair loss at this point.

Hypothyroid condition and synthroid are both blamed for hair loss. Although hypothyroid disorders may increase hair loss, I assume your thyroid hormone level is corrected being on thyroid medications. If in doubt, discuss it with your endocrinologist. As I said before, there is no systemic medication for treatment of hair loss in women now.

Tags: hairloss, hair loss, thyroid, hypothyroid, synthroid, female, women, woman, finasteride, propecia, proscar

Female with DUPA, Allergic to Minoxidil

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

Dear Dr.
I am 23 year old female who has been suffering from diffuse unpatented alopecia for the past 9 years. I have tried minoxidil, but I was and still is allergic to it. Although I am not a good candidate for surgery, I underwent transplantation and of course there were no results or improvements. It has emotionally brought me down and I keep wearing extentions to hide it.

Of course, I am disturbed that you had a surgery at all. I hope that your doctor told you that there would be no benefit from such a surgery. You are fortunate if you had no negative effects, because at times people who have surgery with Diffuse Unpatterned Alopecia (DUPA) get into real problems both in the donor site and the recipient site. Extensions will produce more alopecia (we call this traction alopecia), which means that for the short term benefit of looking fuller, you will eventually lose whatever good hair you have left. Wigs may work better for you and the use of special products like DermMatch and Toppik may have more value in that they will not cause hair loss. If you are allergic to minoxidil, there is no real benefit to other medications in a woman of your age.

Tags: dupa, alopecia, hairtransplant, hair transplant, hairloss, hair loss, women, woman, female

Why Is Minoxidil Foam Not FDA Approved for Women?

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

Why are certain minoxidil products approved only for men and not women?

Do minoxidil products work on the frontal part of the scalp as well as on the vertex?

I have a 21 yr old daughter who has hair loss. The thinning is most noticeable on the front of her scalp so I want to apply there, as well as on vertex. I would like to try the new Pfizer foam product because the topical solution is difficult to apply and makes her hair look greasy. It seems more goes on her hair than her scalp. But the Pfizer web site for the foam product says the foam is for men only and only for the vertex of the scalp. If minoxidil topical solutions work on the frontal part of scalp, why doesn’t the foam? Is it just that Pfizer’s studies on this product submitted and approved by the FDA only looked at application to the vertex?

You guessed it. The drug company can only claim what they can prove. By not making any statements about frontal use or women’s use, it does not mean that it is not safe nor effective. The risk (minimal) is yours for making the decision.

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

Hair Loss, Skin Rash, and Excessive Pubic Hair Sweat

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

It appears no one has helped me with my current condition. Approximately two years ago, my hair started shedding drastically. My doctor thought it was my hormones because I just had a baby. A thyroid test has been performed but test came back normal. Now I have a rash on my leg which looks like I’ve been burned. The derm said it could be a fungal infection but the culture came back negative. I don’t have a clue what the problem is but very concerned as I haven’t gotten a diagnosis yet. My pubic hairs sweat just like underarm sweat. I have to use deodarant down below because its very strong smelling which its coming from the pubic hairs. Any suggestions on what other test could be performed?

Hair loss after having a baby is a common problem. Hair should grow back with time.

It is virtually impossible to tell you what your rash is without an examination. It sounds like you are doing the right thing by seeing a dermatologist.

With respect to your pubic hair and the strong smell, I would also suggest that you discuss this problem with your dermatologist. There are a number of conditions that will cause excessive sweating and a smell (frequently an over-growth of certain bacteria in the gland itself) can be caused by such bacterial growth. Like bad breath is a bacterial growth problem, our sweat glands ‘breathe’ (metaphorically speaking)

Tags: hairloss, hair loss, pubic, sweat, rash, female, women, woman, pregnancy, pregnant

Losing Eyelashes

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

I have noticed that my eyelashes are not only thinning out but on the lower lashes they are gone. My hair is thinning as well. I have made no changes in my lifestyle. The only change concerning my eyelashes is that I started using Estee Lauder mascara. Any suggestions to stop the loss and will the lashes grow back?

Best to leave it alone for a period of 6 months, not applying anything to them. It could be the gentle pulling of the brush or the mascara itself. Give it time to go through a hair cycle and then re-evaluate your situation.

Tags: hairloss, hair loss, eyelash

Pseudopelade and Hair Loss in Women

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

I am a 47 year old female with a very strong history of family baldness.Initially(for 1 1/2 years) i ignored the hair loss.Putting it down to the very stressful period in my life.However when the bald patches couldn’t be ignored anymore I went to see the doctor. Was first diagnosed as areata alopecia and then cicatricial alopecia.Another docter then diagnosed it as pseudopalade. What is the differerence between these alopecias and what is the treatment for pseudopalade? What can be done to cover the bald patches.

Many of these autoimmune diseases are related to each other. Pseudopelade is another type of scarring alopecia. This is the world in which the dermatologist is supreme. Look at what dermatologist and world-class hair transplant doc Robert Bernstein said about the various diseases that are related: BernsteinMedical – The Diagnosis of Hair Loss in Women.

Tags: pseudopelade, alopecia, hairloss, hair loss, female, woman, women