Iron Deficiency, Birth Control, Hair Loss

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

Is it true that iron deficiency in women can cause hair loss that may appear to be AGA? If so, does supplementation actually help?

Also, do you know if oral birth control pills (Ortho-tricycline lo) can cause progressive hair loss while on them. I am not refering to hair loss after discontinuing but progressive loss over time.

Iron deficiency with or without anemia has been reported as a cause of hair loss. Hair loss seen in iron deficient patients is typically more diffuse. In patients who are prone to male pattern baldness, iron deficiency can speed up the hair loss process.

Birth control pills or medications that manipulate the estrogen balance can cause hair loss as well. Although any medication containing estrogen may cause hair loss, the opposite also occurs and in some situations estrogen may be protective. Excessive hair loss (telogen effluvium) could be often seen in withdrawal from estrogen, or in postpartum phase and can last about a year after the baby is born.

Tags: birth control, iron, anemia, hairloss, hair loss, estrogen

Female Hair Loss After Hysterectomy

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

I am 54 years old and had a total hysterectomy 1.5 years ago. I started HRT right away (premarin), but it gave me migraines. Three months ago my Dr ran blood work and started me on HRT natural cream, by prescription, which contains triest, testosterone and progesterone. I noticed within the last 2 months that my hair has gone from VERY thick to very thin. Now I am noticing that the top front of my head is looking even thinner, perhaps balding. I also take 1 mg of Adavant daily since my hysterectomy, and 300 mg of neurontin for night
sweats/heat flashes. Can any of this be causing my hair loss?

Many of the things you mention, including the surgery and the medications, can be the cause of your hair loss. You need to meet in-person with an expert on the subject to (1) stop what is happening to you, and (2) try to reverse it.

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

60+ Year Old Female — Hair Transplant Possibility?

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

I’m a 66 year old female taking thyroid and blood pressure pills for an underactive thyroid and high blood pressure. Would having hair transplantation be successful at this age? How much would it cost? My hair has become thin and brittle, as well sparse. Please let me know what is the possibility of a successful transplant without complications.

To answer the question, I would want to understand the quality of your donor area and the degree of miniaturization you have in the hair of that permanent zone. Then I would want to know the extent of the hair loss and the size of the area that you want to treat. I would want to map out your scalp for miniaturization as I would need to know that information in order to ascertain if you will be helped or hurt by a hair transplant. Evaluating women for hair transplants is a real art combined with science. I met a doctor at the recent annual International Society of Hair Restoration Surgeons meeting that told me that their medical group did surgery on better than 95% of women who came to them. I would suspect that the doctor has terrible results and many unhappy patients. Get a good doctor who knows about this and get yourself evaluated properly.

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

Cyst Removal on Head Causing Female Hair Loss?

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

i have been on the depo shot for about a year now and have noticed that my hair on the top of my head is thinning. now i didnt notice this until about august i think it was after i had a cyst removed from my head. it is by the area where it was removed but all they did to remove it was make an incision and it was tough coming out so they had to pull and dig a little. my question is could that removal of that cyst have caused this and in either case, will it grow back?

Any procedure in the scalp may trigger hair loss at the surgical site. Two main factors may cause this local hair loss:

  1. Shock loss: If you are predisposed to balding, you may have already had miniaturization to some degree and the surgery on the scalp may have only facilitated the process of hair loss. This phenomenon is called shock loss, and it may or may not be reversible. It varies per person.
  2. Undermining the edges of incision: In order to remove a mass or cyst from the scalp or sometimes to reduce the tension of the skin edges, the surgeon may cut some of the hair follicles. Dissection of hair usually results in permanent baldness in the affected area. This baldness in a scarred area is similar to the hair loss that patients get after a craniotomy or scalp trauma.

My suggestion is to wait it out for 6 months. If the bald area doesn’t grow hair during this period, the baldness may be permanent. At that point, if the location of the scar is noticeable, you may want to see a hair transplant surgeon. The treatment options for this condition will be either to primarily remove it if the scar is small enough, or to use hair transplant to fill the bald area if it is too large.

Tags: hairloss, hair loss, cyst, shock loss, shockloss, hairtransplant, hair transplant, scalp

Vitamin A & D and Female Hair Loss

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

(female) regarding hair loss. I have tried it all, propecia, rogaine, the works. what i’d like to know is, I take loads of vitamins and supplements. I have hashimoto’s which I read I should take among others Vit.A and/or omega 3 fish oils. I was taking 5,000-10,000 of A and 400 iu of D. Then I thought I should get my a & d from fish oil instead. I take (2) 2500 Vit a and 250 vit.d a day.My question now becomes this. Would I need to take the same amount of Vit.a & d in the fish oil as in a regular a/d capsule which is from say carotene. I know a & d can become toxic and causes loss of hair and I’m wondering if that is my problem. What is a safe amount?? And which/ or both do you suggest.

As a rule, a normal healthy diet should provide you with ALL the essential vitamins and minerals for a normal healthy person. Millions of dollars are spent on marketing supplements to a health conscious society and it gives a skewed perspective on our health and subliminally gives us the message that we need to take these extra supplements to make us better (lose weight, grow hair, increase our sex drive, build muscle, feel happy, get smarter, reverse aging, etc). As long as things are not done in the extreme and it seems to help, there is nothing wrong with taking supplements. But there is no hard medical science to support majority of the claims.

With respect to Propecia, it is only FDA approved for male pattern hair loss in men. It is not approved for women. For more information on the use of Propecia in women, see: Treatments Available for Female Hair Loss. With respect to Rogaine, you can try it out, but it would take about a year to notice any benefit. I do not know if you had tried it for a year before you abandoned it. With respect to vitamins and supplements, if they work for you, then I see no reason to change the regimen. With respect to your thyroid condition, you should follow up with the doctor who is overseeing your treatment and follow his recommendation. It is not something you cure with just supplements.

Tags: hairloss, hair loss, female, women, woman, propecia, finasteride, rogaine, minoxidil, supplements, vitamin

Errin, Pregnancy, and Hair Loss

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

I am taking Errin Tablets 28’s and I wanted to know if there is a correlation between losing hair and this particular contraceptive? I had a baby 4 1/2 months ago. I’ve had my thyroid and iron levels checked. It has thinned out everywhere, but there is concentrated hair loss at my widow’s peak that goes back a couple of inches in sort of a circular hair loss formation. I have always been a hair farmer so this is scaring me.

Your hair loss is most likely related to your pregnancy and the fact that you had a baby just 4.5 months ago. About 90% of your hair is growing at any given time and 10% of your hair follicles are in a resting phase. That is the reason we normally lose some hair everyday. If it gets excessive, we call it telogen effluvium. One occasion that we often see telogen effluvium is after pregnancy. Telogen effluvium is especially seen between months one to five following pregnancy, when the load of estrogen is removed. It is usually seen in 40 to 50% of women after pregnancy, and like most of the changes in pregnancy, it is temporary. Wait 4 to 6 months and you should grow your hair back. Meanwhile, make sure you are taking sufficient minerals and vitamins on a daily basis.

Any other cause of imbalance in estrogen level may increase hair loss. Scalp hair loss is reported in users of oral birth control pills containing norethindrone and ethinyl estradiol, like Errin tablets (Brevicon, Norinyl, Norethindrone), although their association with hair loss has not been completely confirmed yet. If you think your hair loss may be related to birth control pills, stop the pill and use another birth control method. You should also discuss this with your doctor.

Tags: female, women, woman, hairloss, hair loss, pregnancy, pregnant, errin, norethindrone, estrogen

90 Year Old Woman Has Severely Itchy Scalp, Hair Loss

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

My mother-in-law is 90. She has been having a severe itch problem, dry scalp, and loss of hair. She has been to Her family Dr. and to a Dermatologist and they just say it is dry shin. She has a Rx cream to apply. I’m mainly concerned about her scalp. It is so very dry. I have given her a treatment for conditioning the hair. Also had her use Selsun Blue shampoo several times. It doesn’t seem to be getting better and the hair loss seems to be getting worse. She scratches her head so much that she gets sores. Is this just part of getting older or some other problem? Dr. here haven’t helped much. Do you have an answer? We would appreciate any help you can give.

Thank you so very much!

In dermatology, there is a humorous anecdote when referring to skin problems. It goes something like this — “If it is dry, wet it; if it is wet, dry it.” I would focus on shampoos and conditioners that are made for dry skin. Sometimes, I recommend a good quality hand lotion be gently rubbed into the scalp. Then with a shampoo an hour later, wash off the scalp with a shampoo for dry skin, following by a conditioner for dry skin. See if this works.

Tags: dermatology, skin, dry, shampoo, hairloss, hair loss

Female Hair Loss from Ortho Evra?

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

I’ve been getting an increased amount of emails from women that are experiencing hair loss and are under the belief that it could be their birth control. Although I have discussed various birth control pills and hair loss in the past, it is worth posting again for new readers. Here’s one recent email…

I am a 24 year old female. I took Ortho Evra for about 4 years, until I realized that i was experiencing many of the side effects (I had no idea they were all related to the medication). One of the most troubling is the rate and the amount of hair I have lost. I have been off the patch for about a year now..and my hair keeps falling out (patches on a daily basis). Apart from cold medicine, I dont take any medications, and I just don’t know what to do to get my hair back. Please, please tell me there is something i can do. Please help me, i am so scared!!!

First off, you should have your hair mapped out for miniaturization as part of the work-up for female hair loss to evaluate and quantify the degree and distribution of miniaturized hairs which may indicate genetic hair loss characteristics and patterns.

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. Any family doctor can do this.

You started off asking about Ortho Evra, so I might answer that this drug can cause hair loss, as well as increased facial or body hair growth (hirsutism). It seems that you can not win with any drug.

Tags: hairloss, hair loss, female, women, woman, birth control, orthoevra, ortho evra

Teen Girl Losing Hair, Wonders If It Is Cancer

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

Im a 14 year old girl and about 2 weeks ago I cut my hair myself. I always do so I didnt think anything wrong was going to happen. But now any time I run my hand though my hair I have like a hair ball and it’s starting to scare me because I used to have really thick hair. My mom has thin hair. Could i have cancer? My grandmother has a history of it.

Based on what you’re telling me, I doubt that you have cancer. If there is a family history of cancer (ovaries, breast, uterus) then you should find out if your family has the gene for such cancers. If that is the case, you can get checked out for the cancer gene as well. If it is not in the family, I doubt that you need to get the genetic test. I remember when I was in medical school, each and every time I found out the details of a disease, I seem to have developed the symptoms of that disease. Eventually, I learned to disassociate my learning from my life and I stopped getting the weird diseases. At 14 years old, cancer is unusual, but that is a matter you should discuss with your parents and your doctor.

Tags: teen, female, woman, women, girl, hairloss, hair loss, cancer

5 Year Old Daughter’s Hair Won’t Grow — What Can We Do?

/by William Rassman, M.D./19 /, ,

My 5 year old daughter’s hair will not grow. The sides (around her ears) grow longer than the very back and top of her head. We have tried trimming it, (she does not have enough to trim any more than an 1/8 of an inch at a time), we have tried shampoos to strengthen it etc. When I run my hands through her hair, it comes out. We have taken her to a local doctor who had no answers for us. She is almost six and we are scared that this is going to become an issue with her soon. We do not know where to go at this point? Any suggestions?

There are a number of genetic diseases that could be responsible. A good dermatologist should evaluate her. An example of a genetic disease can be read about here — Gene Glitch May Up Inherited Hair Loss.

Tags: dermatologist, hairloss, hair loss

2 Weeks After Using Hair Dye, My Hair Is Falling Out!

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

I’m a 28 year old female who has always had very long, thick and strong hair. I’ve dyed it for YEARS. Now, suddenly, my hair is falling out and baldness is not found on the woman’s side of my family. After I brush and after I wash I can literally pull out the hair by the handful. It’s scaring me to death. I dyed my hair about 5 weeks ago, and 3 weeks ago is when I began to notice this. Could it be connected? My scalp didn’t feel burned or hurt, so origially didn’t think it could be related to the coloring. However, I at a loss and I’m loosing my cool. Please help! Thanks so much.

It is normal to lose 100 hairs a day. You might consider stopping the hair coloring process to try to surround what is happening. That being said, I am sure you are noticing more hair falling out than what you are used to. It may be a phase or it may be a sign of a medical illness or a genetic balding process. Genetic balding does not necessary mean that your mother or father were balding. 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. You may benefit from a miniaturization study to examine your hair under a hair densitometer to document the health of your hair.

Tags: hairloss, hair loss, color, dye, female, woman, women

Hair Was Pulled, I’m Afraid It Loosened

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

Hi,
During an unfortunate incident,about 2 days ago, someone pulled my hair very hard and she didn’t let go for quite a while. I have long hair, so she wrapped her fingers into it and maintained a strong grip. It really hurt and a lot of hair came out afterward. The hair on that side seems much thinner now, and my scalp really hurts. I am really upset and I am not sure of what to do. I have been extra gentle with my hair since then. I am wondering if it will grow back, and I am afraid that other hairs may have been loosened. What can I do to help it to grow back? Are there any suppliments or topical treatments that might help?

Also, I am 35 (female) and have some gray hairs. I am worried that more of the hair might come in gray. Is there anything I can do to keep my hair’s natural color if it grows back?
Thank you.

You may have some local trauma associated with the hair pulling and may lose some hair, but it is more than likely that your hair will grow back. It is just a matter of time (which can be weeks to as long as 6 months). I have seen one patient who had his hair transplants pulled out in a mugging. It all grew back within 6 months.

As for the color when it grows back — if it grows in gray, you can color it. That’s the only solution I can recommend for “treating” gray hair.

Tags: hairloss, hair loss, trauma, pull, fight

Crash Diet and Female Hair Loss

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

In the passed 3 weeks my hair has been falling out. I know it is from crash dieting. Last week I started eating better (more calories) and taking vitimins. How long is my hair going to continue to fall out in large quantities. I am 46 years old, female. I have always had beautiful thick hair. It is at least 50% thinner now than it was three weeks ago. Please help me with this.

Thank you very much

A crash diet, as you have found out the hard way, is unhealthy. It can lead to malnutrition and stress your body in many ways — in your case, your hair fell out. Unfortunately, such stress can set off a cascade of events that may be hard to reverse. If you were genetically predisposed to hair loss, the stress of the crash diet may have kicked started your hair loss. If this is the case, this is hard to reverse. The only thing you can do is get yourself on a balanced diet and even consider getting a regular physical exam by your doctor. I cannot say if your hair will grow back but you will know in about 6 months or so. Only time can tell.

Tags: crash diet, diet, hairloss, hair loss

What Can I Ask My Doctor? Nobody Has Any Clue How to Help Me!

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

(female) I think the biggest frustration is the fact that we search sites and find answers like: You should ask a local doctor… but the problem is that doctors either don’t know or don’t take the time to find out. I have been “undiagnosed” for almost 2 years. Severe hair loss (50%) burning scalp after hair fall, outer eyebrow loss, fatigue, hair growth on arms, visual changes, etc. but no abnormal hormone tests, no thyroid issues. It makes no sense and I can’t just keep asking doctors because they truly don’t know. I need to find out if I had TE and I was genetically predispositioned to FPB and it is DHT I need to be targeting or whatever. It gets very old when you watch your hair fall with no hope of stopping it. Please let me know if there is anything else (disease) I can research. Thank you.

I am sorry to read of your frustration and its unfortunate that this isn’t the first time I’ve read or heard similar stories. Its quite often, in fact. Even as a hair specialist, I sometimes do not have all the answers as to what is causing the hair loss. Many times doctors are just acting like mechanics. They fix a problem without fully understanding the cause.

In your case, the symptoms of visual changes, hair growth on your arms, fatigue, and burning sensation are very troubling to me. You need to find a doctor (I realize that is the hard part) that can sit down with you and find what is going on with you and explore all possibilities from Lupis to Multiple Sclerosis to Sarcoidosis to other female diseases like Chronic Telogen Effluvium. Many of these conditions require a biopsy and the diagnosis can be made under a microscope. There’s little I can do via the internet without examining you, and I don’t have any local recommendations in your area. I wish there was more I could say to help, but at this point my hands are tied.

Tags: hairloss, hair loss, disease, doctor, physician

Just Started Losing Hair a Year After Pregnancy

/by William Rassman, M.D./4 /, ,

I am a 31 year old female with a 17 month old son. At about the time he turned one, I started to notice hair loss. It’s all over my head, and has caused my hair to thin a lot. It is still happening. I have been to the doctor and was tested for thyroid. It was negative. What I am wondering is, could this hair loss still be related to my pregnancy? It has also been an extremely stressful time – but could this long period of hairloss be related to stress? Will my hair grow back? And can continued stress mean continued hair loss?

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. 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. Your scalp should also be mapped out for miniaturization to define patterns in genetic hair loss that are typical for women. Pregnancy can activate genetic hair loss in some women.

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