This is an interesting article published online yesterday focusing upon women’s hair loss, alopecia areata, and some of the interesting research being done by credible people in the field who are looking for the genes that cause hair loss and excessive hair growth.
I am in my early twenties, with two toddlers. A little while after my second child turned 1, my hair started to thin through out the length of my hair. At first, it was only on one side in the back. Then it kinda started to thin on right side. What I am left with is hair that is growing back unevenly and a very small amount that has not broken off. I know my hair grew too fast when I was pregnant. It was so long and all one length, but its not now. I have a very small amount of really long hair that remains, but the rest is shorter. I don’t have bald spots, just a lot of broken hairs. My question: Is this post pregnancy hair loss or some form of it, and how long can this expected before it completely stops. I have never had hair loss issues until now and my daughter is almost 3 now.
What you are experiencing right now is postpartum hair loss and the shorter hair should eventually get longer. You will have to wait (possibly a year or two) to see if your hair becomes fuller. Sometimes, we see changes in the character of hair as we go through different aging periods. Infants have one type of hair, children another, young adults still another, and aging adults will see a thinning of the hair shaft. Although the last phase takes years, it does occur sometime in people in their 20s and 30s. You might see a doctor and get your hair mapped out for miniaturization just to get a base line in case things do not go the way you want. Measurements are important to document when you look for change.
I am a 41-year-old mother of five who’s been experiencing male pattern hair loss (similar in pattern to Dr. Rassman’s photo) for three years. In the past 15 months, the hair loss has advanced significantly. My scalp itches incessantly, especially in the areas of concentrated loss (temples), often waking me at night. I’ve seen three dermatologists, all of whom summarily dismissed me; only one testing my hair, another sending me off with $100 shampoos. I’ve traveled to NYC to see a specialist only to be shuttled out the door with a $950 bill. Extensive bloodwork by an internist showed normal range results.I’ve tried Rogaine 5% and 2%–but scalp irritation intensifies without results. Two questions: (1) Is there a topical or oral product that will eradicate the unbearable itching–I’ve been told itching is characteristic of hereditary hair loss. (2) Could you recommend an ethical, knowledgable expert colleague on the East Coast–would like to know honestly if I’m a candidate for hair transplant or will be taking the wig route. Hair loss certainly stinks! Many thanks for your response.
You may want to look up Dr. Bernstein in New York. He is compassionate and very knowledgable. I can not recommend a treatment when I do not have a diagnosis. It does sound like you are not getting a serious evaluation. Certainly with a $950 bill for an office visit, I would expect far more value than you seem to have gotten.
hi im 23, female and for 3 years now my hair has gradually become noticly thin all over my head i have been told by a dermatologist my scalp is ok and that my hair has only thinned out due to stress but i feel its through dht, as my hair falls out from the root and regrows finner especailly the sides where it was effected first. my hair around the sides of my head to the back of my ears look near enough bald now even though theres hair there. please HELP i feel like i cant cope with my hair loss its effecting my life so much im highly thinking about taking propecia cause my hair is so important to me i dont wont to where a wig the thought of it makes me sick. please note i have polycistic overies and have been told that can cause thinning of the hair, i have also had alot of blood tests except dht which have all come back normal once again pease help me. regards kelly. x
ps, the loss of my hair has caused me to look so unatractive, and was applying to be a model but i now feel it can only be a dream. i wish and wish for a mirical every day.
Polycystic Ovarian Syndrome (PCOS) can produce some masculine hormonal changes, including hair loss on the scalp and hair growth in areas like the face (i.e. upper lip) and some body hair growth. You need to get your hair mapped out for miniaturization to outline just what is happening to your scalp hair, where on the head it is happening, and to what degree. Drugs like finasteride (Propecia) may work, but if you should become pregnant on this drug, there is a likelihood that your child will develop abnormal sexual characteristics like hermaphroditic changes. There is a report in the literature that women with PCOS and hair loss have been helped by finasteride, but be warned not to get pregnant if you go that route. The metrics obtained with mapping of your scalp hair will show the value of any treatment modality, therefore it is critical to get the measurements in hand before any treatment is started. With that positive note, you probably have genetic female hair loss which can impact the course of treatments as well, and just like men with hair loss and finasteride treatments, there are no guarantees that it can work. Any approach to this requires a really good doctor to manage your hormonal problems.
For more info on PCOS, see:
Shortly after my hysterectomy,my hair began to shed. Then, I noticed a balding spot in the crown of my head. Is there a female balding conditions associated with hysterectomies? Any solutions or suggestions
The stress from surgery can cause hair loss in genetically prone women. If you had your ovaries removed, the changes in hormones may produce a imbalance which may lead to your hair loss. Women normally produce male hormones in small quantities and they are offset against the large amounts of female estrogens. With the ovaries gone, the balance is tipped and this could be the cause of your ‘male like’ crown hair loss. Speak with your doctor about hormone replacement therapy.
I am a 64 year old women, suddenly my hair is getting curly in the back of my head. What is causing this? I do have a small pea size cyst on my brain stem. Dr. is not concerned unless it grows. Could this cause the problem?
I don’t know the cause of the sudden change in the character of your hair, but most people would love to be in your situation. As we age, the hair often gets finer with less character, rather than more character. Change in diet could be responsible, but this is pure conjecture on my part. It is possible that a gene for curly hair may not express until later in life due to certain environmental factors. I would doubt that the pea-sized cyst on your brain stem has anything to with it.
I burned my scalp from chemical dying of my hair. I had patches where it burned and scabbed pretty good. A few weeks ago, a chunk of my hair fell out with the the scab, and now there is a smooth surface where that hair was. What can I do? If feels like a crater on my head.
Chemicals may cause temporary hair loss and the chunk of hair that came off with the ‘scab’ is what I would expect. You should allow your scalp to heal and the hair should start growing back within 6 months of the initial injury, hopefully earlier. Sometimes, the hair may not return. In any case, wait a few months to see if hair grows out of your scalp. If you prefer not to see a doctor now for the best advice, expect hair growth after 6-8 months and then see a good doctor if there is no return of the hair.
I am female, 46 years old. I do have many lyme disease symptoms from neurological to joint and cartilage problems to nervousness…too many to list. I was previously on intravenous twice for months at a time. I was diagnosed at least 6 years too late. I have alot of raciness inside of me and I am always thinking of too many things ata time. I am so miserable about my hair. All my hormones are great and my blood tests are fine. Now what? My hair falls out all over, short and long. How do I know if it is Lyme? Can stress cause a diffuse hair loss all the timne for years? What can I do? Is there a world famous hair Dr.? I am so frustrated and unhappy. Please help, thanks!
It is not clear if Lyme Disease is associated with your hair loss, but it may have triggered a stress response that may have set off a cascade that may not be reversible. Stress in itself can be a cause of hair loss. It seems to be a vicious cycle, and unfortunately there is no “cure” for hair loss in women about 80% of the time. If you are this concerned you may want to see a good dermatologist or possibly even a hair transplant surgeon who will map your scalp for miniaturization to make a diagnosis. Be wary of eager doctors who want to sell you a hair transplant surgery.
Dr. RASSMAN
I am 24 years old, female, and I have triangular alopecia, two questions that I have for you are will transplant stay in or continue to fall out and will I pass this on to my children. My hair loss began when I was 15. Thank you for being concerned about a disease which may not be terminal and to some people not that big of a deal. To me sir it has destroyed my self esteem,and in so many ways left feeling all alone.
Triangular alopecia is an inherited genetic defect in the area near where the temple prominences are located. Sometimes it is on just one side and sometimes it is on both sides. It tends to run in families, but not always and it does not often ‘express’ itself in the first generation of those who have it. It may skip many generations so those that have it can not find the family link to it. It might be spontaneous, but there is no way to be sure that it is not somewhere in the family line. This condition is easy to diagnose because of its characteristic appearance and can be transplanted quite effectively. There is no need to have your self esteem destroyed, just get a hair transplant by a good physician who knows how to work with the temple prominences.
Hi, Dr. Rassman,
I would like to say that it is extremely generous of you to be extending help to thousands people out there who are troubled with hair problems.
I just have one short question for you and hope you may help me with it: do people generally recover from seborrheic dermatitis? It has been plaguing me for nine years, and I sometimes wonder if I will ever recover from it.
Thank you for your kind attention!
Yes, people do recover from seborrheic dermatitis if they are compliant with the treatment plan devised by their dermatologists. Some people heal slower than others and some of them do get better. Maybe the question you are asking is if there a cure for it? To that question, I would say “no”, but there are treatments that make it better and more manageable.
I am a woman considering hair transplant surgery. I have hair loss from prior cosmetic surgery. I just read a Q from a man who had more hair loss after hair transplant surgery. You recommeded he take propecia.
Could this type of hair loss happen to me? If so, would you recommend propecia or anything else to prevent it?
If you have lost hair secondary to a cosmetic surgery procedure, it would be worthwhile to determine if you have female genetic hair loss as a cause. Some women with hair loss from a face or brow lift may lose hair without the genetic propensity for it. By mapping our your scalp hair for miniaturization that can be simply determined on an office visit. You need to know this, because there is a different outcome potential between the two. If you do not have genetic hair loss then you can expect that no significant reactive hair loss will occur from a hair transplant. Drugs like Propecia do not work in women and may not be safe for women (not approved by the FDA for either safety or effectiveness in women). Any good doctor should be able to make such an assessment for a hair transplant candidate like you. I see you are in Los Angeles so I would be happy to make that assessment for you in my Los Angeles office. You can contact my office at 800-NEW-HAIR to setup a free consultation.
I’m a 55 year old female suffering with androgenetic alopecia since the age of 13-14. My hair have been very thin on the front and top for a long time, and I’ve gone through menopause in the last 10 years, which has exacerbated the problem.I had a scalp biopsy in February – there is nothing beyond a female pattern balding. I do not wear wigs or systems hiding the bolding spots but will have to if I don’t get a transplant. My dermatologist said I would need not less than 1000 units. I visited one (strip) surgeon and was assured that I have enough donor hair on the back and would need around 1200 units. If both of them are right and I won’t need more than 1200-1600 units, which method would you recommed – FUT or FUE? I have made research on the web and know that women may go through a terrible shock loss during the surgery. Since FUE is less invasive, wouldn’t it be more beneficial for females? I am ready to wait for a year and get a FUE later once the prices go down if it is really more beneficial.
I would appreciate your advise, Dr.Rassman. Thank you so much.
The first issue should be whether or not you are you a candidate for hair transplantation. More than 80% of women are not candidates for hair transplants, because the hair loss is diffuse and the donor area is not healthy (highly miniaturized hairs are often present). First, you need a quantification of how much miniaturization you have and what your donor density is. This is done by mapping your scalp for miniaturization and then you can calculate what can be harvested (methods for harvesting are less important than the decision to transplant of not). Then when you know the value of the donor supply, you need to have an assessment made for the recipient area asking, “Is the amount of good donor hair (total hairs less the miniaturized hair) adequate to address the balding area?”
What is woman’s hair loss anyway? Woman’s hair loss must be approached differently than men’s, as most women rarely lose all of the hair in their affected areas. In fact much of the hair remains, but the thickness of the hair shaft is smaller than normal hair. This reduction of hair thickness (miniaturization) causes the hair to appear thinner.
What does a transplants actually accomplish when a woman has generalized thinning? Because a relatively large area is often subject to thinning, it is important to place the hair in areas where it is cosmetically most significant and where it can augment a specifically “defined†styling plan to increase the appearance of fullness. For this reason, we generally confine the entire transplant process in women to a localized part of the scalp such as behind the “frontal hairline†or “along the partâ€. For those who accept this notion, we will tailor the transplant procedure to meet a specific styling need.
Since hair transplants in women with diffuse hair loss will be transplanted into a part of the scalp that is thin, but not completely bald, there is a risk that some or all of the original hair in this area may be lost. This process is called “telogen effluvium†and is usually (but not always) reversible. In addition, if the donor area continues to thin as the genetic female hair loss progresses, then the transplanted hair will also thin over time, since it came from the same area. Limited transplants in defined areas may be improved by subsequent procedures, but with significant loss, there is a limit to the improvement that can be achieved and for this reason, women are often discouraged from having hair transplants when they come to my office unless they recognize what I just discussed above. In hair transplantation, as in all surgical procedures, it is important to balance the potential gain against the possible risks when making a decision to go forward with the treatment. An educated patient is even more important for a woman who may get no benefit than for a man who may get less of a benefit than he expected.
FUT (strip harvesting) vs FUE/FOX technique (direct follicular extraction with a punch type instrument) is tied to carefully selecting a physician who is capable of doing both methods of harvesting. Be careful of the many physicians who claim that they are experts on this FOX/FUE/FIT technique. I know and trust only a handful of physicians to do this technique. Physicians who are not well trained in this technique can destroy more follicles than they extract and even some of the so called experts, are charletans when they tell the public that they were either one of the founders of this technique or that they ARE the founder and/or the inventor of this technique. I suspect that if you research this expertise on the internet, you will find more than one doctor claiming the ‘inventor’ status of this technique. The percent yield can be as low as 20% of the total transplanted hairs and in women with a great deal of miniaturization, that would be a disaster.
Again I state with great emphasis Let The Buyer Beware!
My Dr. told me that lisinopril doesn’t cause hair loss. You say it does. It is not listed as a side effect, so are you sure it does? I freaking out cuz my hair is falling out. I am 53 years old and had all blood work done and all came back fine. I always had thick thick hair and so does everyone in my family. I am wondering is it menapausual? I have no other syptoms and my periods are still very regular. Will it grow back in or what should I do??? Im so confused because everyone tells you somthing different.
Many drugs can potentially cause hair loss. Most of the times scientists cannot find the exact mechanism of why this happens. Likewise, scientists cannot find the exact cause of hair loss either, because there are so many different factors involved.
I have three important points to make with regards to medications causing hair loss:
- Before identifying a drug as a possible cause of hair loss, you should find other medical causes.
- People take medications for a health problem. You should not stop taking a medication just because you think it may be causing hair loss. Your health should come before your hair (especially if you are not certain that the medication is causing the hair loss).
- Most importantly, you should follow up with your doctor for medication changes and concerns.
If you are taking Lisinopril, you likely have high blood pressure. You should NOT stop taking Lisinopril just because it has a rare side effect that you may or may not be experiencing. Stopping high blood pressure medications puts you at risk for strokes and other serious medical complications. There are other drugs that work just as well for controlling blood pressure as lisinopril. Recent studies suggested some relationship between lisinopril and lung cancer increasing its risk by 14%.
Some women who have genetic hair loss have it appear at about your age. The best way to make this diagnosis is to have your scalp mapped out for miniaturization. If you have genetic female hair loss, then there will be miniaturization over the thinning areas and miniaturization in the ‘rim’ of hair around the side and back of your head. Mapping out your scalp is the key to this diagnosis.
Im am currently 24, both my parents are sixty, with super thick hair still. The past three years i was stressed due to a new job, was dieting, took Yasmin for birth control, used a left over home straightener (relaxer) that i had saved for future use, was in a wedding and had a dresser basically use a curling iron, more like burning iron, and i had wisdom teeth surgery that had nerve damage and i could not eat for several months and still took birth control (Yasmin) during my healing of my curly hair, I was confident that anything i would do would never cause baldness, however, here i am with excessively thin hair at the front and sides of my head. i’ve already been told that i look like i’m in my 30’s instead of 20’s. Will my hair ever restore to its normal thickness? right now it is growing out straight and i have bald spots in the back of my head and the sides of my head are extremely thin and straight, I do not see hair filling in aprocess, and to top it all off I have trichotillomania. Obviously I have issues, but due to the excessive thickness and volume t the sides and front of my head only in the back. i have been eating food with flaxseed. is there anything else i can do to help my hair grow back, and will there ever be a chance for full restoration?
To answer you, I would have to write a book. Yes, you have issues and what you described in your questions cover almost every imaginable problem a woman can have with their hair. If you are honest in this communication, you need to get good medical care. If you have bald spots in the middle of normal hair, then you could have alopecia areata. If you are pulling my leg to test my ability to sort through such complexity, I am sure that some of the readers will not sympathize with your dilemma. Good luck to you.
Hi I’m a 24 yr old female, with some questions I would like to ask you about my hair that is thinning. About 10 months ago I was getting a haircut and the stylist had mentioned to me that my hair was thinning a lil at the crown of my head…It wasn’t very noticable, so I didnt think anything of it, and just went on with my life…I had started taking an Anti-depresent called Cymbalta, and a high blood pressure medicine called Atenolol, at around that time as well. Well in january of 2006 I noticed that my front part of my scalp, maybe from my hairline & back 2 inches was very thin. I couldn’t understand why, because it was an over nite thing, I would have noticed if my hair was thin, and i even look back at christmas pics from the month before and my hair was like usual, so I know it was a very immidiate thing. I had disconntinued my anti-depressent and blood pressure meds, like 1-2 months earlier, because I could no longer afford health insurance, so I had been med free for about a month when I noticed the thinning frontline. its now almost 3 months later and im starting to think the thinning is getting worse in this reigion only…i started to take folic acid and a prenatal pill, because I read folic acid helps with re-growth, but I dont know what to do..I cant see a Dr, for another month untill govt health insurance kicks in, but in the meantime what should I do??..i know I had blood test run before about 8 months ago checking for throid disease, but it came back normal, so could something medical cause this..because no one in my family has a balding problem, my mom is 47 and just started to thin, and thats only because she used many products in her hair for so many years. do you think my hair will grow back or get worse?…I heard it takes about 3 months for the hair growing process to start showing, but its been about that much time and i dont see any improvments…Ive looked through the internet and read some scary stuff that can cause hairloss…but im so down about this, becuase i am soooo young, and I dont know why my hair is falling out…please help me if you could, thanks alot and have a wonderful day.
You are in need of a good doctor and there is no substitute for what the doctor does. Problems like yours can not be managed well by a doctor through the internet, nor can you manage depression and high blood pressure combined with hair loss by yourself. Look through the many posts in this blog on female hair loss to educate yourself and then get a good doctor.
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