Kenalog and Female Hair Loss

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

I’m a 32 year old mother of 3 and first noticed an increase in the amount of hair I was losing on a daily basis about 2 1/2 to 3 years ago. I had a lot of hair so I wasn’t too worried about it at first, but the hair loss continued and now I have a significant decrease in hair volume. I went to see two dermatologist. The first one told me it was hereditary and to use Womens Rogaine. He didn’t even touch or look closely at my scalp. He also said if I did’nt tell him what was wrong that he would never guess I was losing hair, which didn’t make me feel better because I can tell the difference. I never tried the Rogaine. The other diagnosed me with telogen effluvium and recommended I take a injection of Kenalog. Which after about a year of weighing the benefits and risks decided to get the shot. It’s been about three months now and haven’t noticed any decrease in hairloss or any regrowth. It sure has messed up my menstral cycle though. I really would appreciate any advice you might have. It is really depressing as a young woman to go through hairloss. Thank you for your time.

Telogen effluvium generally has a spontaneous recovery in 6 to 12 months. It is precipitated by hormonal, emotional, or medical stressors. Aside from seeing a dermatologist, you may want to get a complete medical physical to rule out other medical causes of female hair loss (such as eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics).

Kenalog is sometimes used for hair loss, however its efficacy is not well studied and I do not believe that it works unless the hair loss is in the autoimmune category. Telogen effluvium and steroids are poorly linked for benefits, and as you said, it is messing around with your hormone balance and menstrual cycle. Unfortunately, even with a good diagnosis, you may still find that there are no suitable treatments available. At least you will be educated and can then avoid ineffective medications or treatments so that you do not have to suffer from adverse drug effects. Don’t get ahead of yourself though. See a doctor to have other causes ruled out first.

“Knowledge is power.” –Francis Bacon

Iron Levels

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

Hi, my hair has been falling out for a few months now and has become thin around the temples and forehead, I also get an itchy scalp. I went to my doctor who ordered blood tests which show low iron stores of 19ug/l range (20-160) my iron saturation is 15% range (20-45) I have been taking iron pills and multi-vitamins for a month now. How long will it take to build up my iron stores and see growth in the thin areas. Thanks

From the iron studies, it appears that you have an iron deficiency, which may lead to hair loss. I am assuming that you are a woman, so please forgive me if I am mistaken. Bleeding causes iron deficiency and with your monthly blood loss, the iron must be replaced. Meat offers iron and is a good way to add iron to your diet. Iron deficiency can be from malabsorption if you have anything pertaining to diseases of your digestive system. Make sure you drink orange juice and Vit-C with iron to help with iron absorption. You need to continue to take your iron pill and repeat the blood work to see if your iron level has become normalized. Even then, it will take many months before your hair follicles respond with fuller hair.

Isotretinoin and Hair Loss

/by William Rassman, M.D./5 /,

Hello! I am a 24 year old female who is experiencing hair loss from isotretinoin, and was wondering what I can possibly do to help my hair stop falling out. I’ve been of the medication for a month now, and my hair started falling out about 2 months ago. I’ve now lost about half of my hair, and I’m really worried because it hasn’t slowed! My dermatoligist said there’s nothing that can be done except wait it out. I also know how freakish it’s going to look when it starts coming back in. I had long, blond, thick hair and now it’s so thin and starting to be noticeable. I tried Rogaine- used 4 bottles in 3 weeks and it didn’t seem to help. I just bought Nioxin shampoo/conditioner to try- I am desperate! Is there anything I can do- vitamins I can take, treatments, shampoo- that will help? Thank you so much!

Oh, I was on a very high dose, over 3 mg/kg of body weight; I figure that’s why I’m having this side effect.

Unfortunately, some people do experience temporary hair loss from isotretinoin. Taking a multi-vitamin may help. I agree with your dermatologist that there is not much that you can do right now and that you must wait it out. However, you might want to have blood work done to rule out other causes of hair loss for women like hypothyroidism, anemia, crash diet, contraceptive pills, and dermatitis.

My Hair Loss Stopped During Prenancy

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

Hi,
I just turned 25 and I have been dealing with hair loss for the past 7 years. I have been to many doctors for help, but it seems that no one has the answer. I have been tested 3 times for my thyroid and tested once for my female hormones, and everything came back fine. I have been using rogaine for about 1 year now but my hair is still falling out. I have had two children and during both pregancies the hair loss would completely stop, but within a few weeks after giving birth the hair loss would come back even worse then before. I have been told that my hair loss is do to child birth and it will go away in 6-12 months, well here it is years later and it still has not stopped. I don’t know that else to do or where else to go, can you please help me?

Thanks for you time.

Clearly the hormone changes with your pregnancy stops the hair loss. This is good. Your history indicates that after the pregnancy, you return to the hair loss problems you have always had. Not much to add and I would expect more of the same. What does your dermatologist say about your problem?

How Will The Doctor Know To Diagnose My Female Hair Loss?

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

well i have this thinning problem for the past 4 years. it was started when i conceiving my daughter 4 years back. i was prescribed chronostim for my hairloss and i used it for 2 months and my hairloss stop for a year (2005). the problem seems to show again about a few month ago roughtly on January 2006. the hair loss is diffuse and can be seen clearly on the crown. i started using minoxidil a month ago and my hair still falling.

To be honest i would like to have the hair transplant for the crown only so that it can look more dense.

my question is whether i am the right candidate for the hair transplant?. how will the doctor know that my donor area is not affected by AGA since females always have a diffuse thinning?

A doctor should look at your donor area with a hair densitometer to look for miniaturization. The greater the miniaturization, the worse the donor hair will be for hair transplants.

The important thing to understand is that women are generally not good candidates for hair transplantation, because the ‘donor hair’ is not healthy. If there is an area of good donor hair and the balding area is small enough to make a difference with a limited supply of your ‘good’ hair, then hair transplants MAY work, but you run risks that include the failure of the hair to grow enough to make a difference, and even experiencing hair loss with the transplants (this a real risk). You need to be able to trust that the doctor is not just taking your money for a quick sell, leaving you no better or even worse off once you empty your purse.

ScalpMed, Diane 35, and Hair Loss

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

Hi there,

I’m a 25 year old female. Four years ago, I took Diane 35 for about 6 months. During that time, I noticed hair falling out. My doctor at the time said that it was a “normal cycle”, and not to worry. At the end of the 6 months, though, I had lost about 60% of my hair. Not in patches, luckily, but just all over my head. It hasn’t grown back. It could be genetic, cause females on my father’s side have thing hair, but it’s so frustrating having HAD it thick before.

Do you have any recommendations? I’m thinking about going on Scalp Med to sort of provide a “boost” to the hair follicles, but I’d imagine that because it’s essentially Rogaine, it will stop regrowth if I stop medication.

I appreciate any advice you can give me.

Minoxidil might help, but what are you really treating? You need to get a diagnosis to find out if you have genetic hair loss. To get that diagnosis, you need to have your scalp mapped out for miniaturization. You also need to be sure that you do not have other causes of female hair loss, which include eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics, etc.

ScalpMed might help, but what is in it beyond the minoxidil? Diane 35 has hormonal effects (Antiandrogen / Estrogen) so messing around with your hormones may be positive or negative. It varies per person.

Lose 10% of My Hair From Shock Loss After Hairline Lowering?

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

Hi, I would like your opinion on lowering my hairline (I’m female).Dr. ‘X’ in Australia stated that i may lose 10% of my hair from the shock loss due to the new implanted hairs? Why do some say there won’t be any shock loss and others say there will be? It is the only reason delaying me to proceed with the procedure. Dr do you travel to Sydney etc or could give any recommendations? Also would you suggest i get the fox procedure rather then the traditional way? Is there any benefits of this procedure over the conventional way? Thank you. Kindest Regards.

The answer is, “It depends.” If you have genetic female hair loss (which actually usually maintains the frontal hairline in women) shock loss is possible and when it occurs in women, it is rarely permanent. If you are trying to lower your hairline because you have had a forehead/brow/face lift then hair transplants work very well (see Female Hairline Restoration After Brow Lift). If you don’t like how your face is framed, because you were genetically programmed to have a high hairline and have no other underlying medical conditions, then a hairline lowering procedure is a good surgery to fix this. Shock loss is rarely a problem in this type of surgery.

As for the other, FOX/FUE may or may not be a better option for you, again just depending on your reasons for getting it done in the first place. These FOX/FUE procedures are fairly expensive. I would suggest that you send me photographs and tell me something about yourself so I can give you direct advice that fits your agenda.

Topronil and Hair Loss

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

i am a 50 yr old women and i have just recently started loosing quite abit of hair like in groups of like 10 hairs at each stroke of comb or brush and i was wondering if it would be caused by the drug topronil? not sure if i am spelling it right. it seems that this just started about 1 month into using this drug i cant believe how much i have lost could you please help?

If you saw an increase in hair loss upon starting a medication and there is no ‘need’ for that medication, you should consult with your doctor about stopping it. Topronil, however, does not show hair loss as one of its side effects.

Rogaine, Advecia Questions

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

I am female, currently taking Diovan/hct and Synthorid. I have tried Rogaine, however I had a reaction from it (my face became very puffy and swollen). Once I stopped, the swelling stopped. Do you think I would have the same reaction with minoxidil? There is also a product called Advecia. Any feedback on this would be greatly appreciated. The hair loss is so depressing. Thank you for your time

Advecia (according to the search I performed online), contains:

  • Saw Palmetto Extract 4:1 37.5 mg
  • Green Tea Extract 600 mg
  • Phytosterol Complex
  • Beta Sitosteral 125 mg
  • L- Arginine 1500 mg
  • L-Lysine 600 mg
  • Grape Seed Extract
  • Proanthocyanidins 265 mg

Frankly, I don’t have any idea if this works. Your guess is as good as mine.

With regard to minoxidil, the symptoms you listed are known side effects possibly reflecting either an allergy to the medications or an unusual topical reaction to it.

Did Rogaine For Women Increase My Hair Loss?

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

Hello,

I am a 26 year old female. I went to the doctor roughly 6 months ago when I noticed my hair thinning on my crown. I was told that there was nothing wrong and to just use Rogaine. I started using Rogaine however, since I have been using it my hair has thinned out even more, it has become more noticeable. And it seems like if all of my hair is thinning and not just on the crown Can Rogaine have increased my hair thinning? Should I increase the strength and use the Men’s?

Thank you!

There are two possible explanations to your further thinning of hair after using Rogaine. The first one is that it might be a continuing course of your hair loss with or without using Rogaine. On the other hand, Rogaine may induce further hair loss a few weeks or months after initial usage by increasing the hair cycling. This should pass in about 4-6 months. If it is effectively working to cause your body to discard the old thin hair shaft in preparation for growing thicker hair shaft in the future, this could explain it.

Synthroid and Female Hair Loss

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

I had thick and fast growing hair until I started taking syntrhoid for an underactive thyroid. The doctor says the medicine is not to blame but it just seems too coincidental to me. But, I am losing most of my hair in the front part of my scalp and I feel these tiny pimple like bumps on my scalp. I do not have dandruff but am wondering if this could be something else. I take no other medications and I am 56 years old, female. MY Mother and Grandmother both had and have thinning hair but it is in the back and they were both on all sorts of heart and blood pressure medicine. My 58 year old sister and brother are having no hair problems. Any suggestions would be appreciated.

Patients with hypothyroidism tends to have hair loss, and hair loss is a known side effect of Synthroid. I would certainly take this up with your doctor. There are many other causes for female hair loss as well, such as stress, crash diets, oral contraceptive pills, beta blockers, coumadin, psoriasis, and inflammatory diseases.

Emotional 13 Year Old Girl

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

hi. right now, i have a perm from curly to straight. i am 13 yrs old girl and if would be cery nice of you if you would pleeeease help me. i went on a winter vacation with my family for 3 days. the second day i went to the pool with out a cap. after a while i went up to my hotel room by myself, then i blew dry my hair. after the vacation was over i went home to wash the chlorine out of my hair which were V05 conditioner and shampoo. after i washed it, i blew dry my hair some more. later in about a few weeks, every time i comb my hair a whole chunk of hair came out every single day for 3 weeks. it came from the back of my head. i just noticed when my hair dresser said it looked like a short boys hair cut and i started to cry for weeks. i did not want to go out in puplic expecially in school where my friends had good looking then i did. i felt jealous and lonley because a few had longer hair than me, straight with out a perm. and i don’t really want to show my natural hair because it’s crazy looking. so if you would pleeeeease help to grow it back faster i’ll feel much better again and take better care of a perm. thank you so much

You sound very emotional, and that is understandable seeing as how you are a young teenager. When my daughter was your age, I saw these range of emotions firsthand. Please know that losing hair is normal (average person loses about 100-150 hairs per day) so that if you are seeing such numbers of hairs being lost, you are just seeing something that you may not have noticed before. If you are healthy and have no medical problems, then there is no reason for significant hair loss. First, you need to talk with your parents and tell them what you are experiencing. Then they may take you to a good dermatologist who can evaluate your hair to find out if the loss you are experiencing is above the normal daily loss for an adult. The best advice I can give you is to reach out and ask those who love you to help you through this experience.

Female Started Losing Her Hair at 13

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

i am a 17 year old (almost 18) female and have been experiencing hair loss since i was about 13. i used to have thick curly hair and now its very thin, i have to wear it half up in a clip to keep the thinning spots hidden (even though my whole head is thinning). my father is going bald and his brother and father are completely bald. i do not have any thyroid or hormone problems nor do i have any iron problems. i have been to dermitologists and they perscribed me monoxidil which i used when i was approx. 14 and stopped after about a half a year to a year because i hated using it and my hair loss was not completely noticble. now at 17 its pretty bad and i began using the monoxidil again, i started about a month ago. no one can explain my hair thinning and why a lot of it falls out after i shower and brush it. at first when i was 13-14 i didnt care because it was not noticable, but now i cant take it, im in high school almost uniiveristy and i dont know what to do! its been happening for 5 years without slowing or stopping..is there anything you can offer that will help me? pleasee im desperate, all my friends have thick hair and i hate the fact that i dont and mine falls out and is noticibly thin.

You have done your research concerning female hair loss. Have the dermatologist biopsy your scalp to see if you have an inflammatory process occuring which cause your hair loss. Find out if there are there any miniaturized hairs in the donor area, which is in the back of your head, and how much miniaturization you have everwhere else on your scalp. Are there any noticeble spots on your head? Has your hair loss been stabilized or has it become more progressive? I am limited to what I can do over the internet. Be sure to get a good, caring doctor to help guide you through what you are now experiencing.

My Hair Only Grows When In Braids

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

hello Dr.,

i’ve been having hair problems since a was a little girl. my hair only grew when i had braids. whenever i removed them, the hair would fall out. so, upset and in my late 20ies, i decided to shave my head and kept them short until my early 30ies.

i began hair treatment at this salon where i actually saw result. my hair was finally growing without the breads and i finally looked like a feminine black woman. after a couple of months, hell broke loose. it started falling again. now, my receeding line is pushing back and my already large forehead got even larger.

i trully don’t know what to do. you see, i am already a little tomboyish so not having hair, makes me feel very uncomfortable in my body. i rarely go out now and if i do, i either wear a hat or use mascara to cover the front of my hair.

what to do? implant for me is financially impossible but i am putting some money aside for it. i saw a Dr. in Canada, who is willing to implant for 2500$ but he has no knowlegde of what is wrong with me and doesn’t seem interested in finding out.

please take care of me. right now, i am using Ducray Anastim products. i can manage to send you a picture of the disaster if you want.

kindly!

A while ago I wrote a piece on a syndrome that may reflect an element of your problem (see What Is Body Dysmorphic Disorder?).

I can make no sense of what you are telling me, because it is not logical to my mind. If you found a doctor willing to do a hair transplant for $2,500 without a diagnosis, it is like giving that doctor $2,500 with a doubtful end point that will make you happy. If you insist on parting with $2,500, give it to a good charity and you will get more pleasure than having some ‘hack’ doctor take your money. You need to get a good doctor to help you with your possible dysmorphic situation and also get some good tests to determine what is really going on. I would be pleased to get pictures and upon receiving them, I will get back with you for some general advice, but what you need is a hands-on, caring doctor who is not trying to put his hands in your purse.

Woman Losing Eyelashes and Eyebrow Hairs

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

Hello. I am a 23 year old female who started to notice I was losing my hair about a year and a half ago – which was a half a year after having been severly ill with mono. I am not sure if that is directly related to my hair loss, but I have heard it’s true for other people. Since then, I have tried 2% Minoxidil (plus a supplement pill suggested by the Hair Club for Men and Women), Spironolactone (recommended by a dermatologist), and now a Progesterone cream plus the Minoxidil. Not only have I not seen any new hairs growing back, but I have noticed a dramatic increase in my hair loss, along with the loss of eyelashes and eyebrow hairs. I am very discouraged and am running out of hope, time, and money. Any advice as to what is wrong would be helpful and appreciated.

Thank You.

ps – I was tested for hypothyroidism, but it was negative. Also, there is no history of hair loss in my family, so I really don’t think it is alopecia.

If you feel that the medications you are taking may be contributing to your progressive hair loss, then you should should discuss stopping them with the doctor who prescribed them. You problem sounds complex, certainly too complex for internet management. Be sure that your medical work up is complete and covers eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics, etc.