Transplanted Hair From Leg To Forehead

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

Female – Hi, I had a body hair transplant (300 grafts)four days ago. I had leg hair moved from my legs to the the top of my forehead to get my forehead to look smaller. I don’t have a hairloss problem, I have a naturally high hairline and am trying to lower it. After the procedure I had lots of numbness, even 3 inches away from the recipient area. Today I have numbness around the recipient area only. Up to an inch away. I am very concerned about shock loss. Does the numbness indicate trauma and that the existing hairs in the numb area will fall out? I’m very worried about this. If there’s something you can tell me that I can do to prevent this, I’d greatly appreciate the help. Please let me know.

First, you should go back to the doctor who did your transplant and ask him/her if there were any issues the time of surgery that may have caused problems. Some sensory defects are often present and usually go away within a few days after the surgery. At times some small nerve endings are severed with the needles used and this can last (rarely) a long time until other nerves take over. There is little to do but to wait it out.

I am curious why you elected to do a leg to forehead hair transplant? This is unusual and probably experimental and you should have been informed of this by your doctor. There is no real data for leg to forehead hair transplants, so predictable results are not something that you can depend upon. I would hope that your doctor told you this.

Female with Hair Too Thin For Transplant

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

I have thin hair all over, I have spent a lot of money on wigs, that are really pretty, but I am severely depressed over my extremely thin hair. Do you know anyone that could help me? I am not a candidate for hair transplant, I went to Bosley Medical and was told my hair was to thin all over to get donor hair. Although I can wear a wig, I want my own hair. I am very sad over this, I am a pretty 34 year old woman with a wig, but without it I feel i look horrible. Please do you know anyone who can help me? Thank You!

Not many women are candidates for hair transplantation, especially those with diffuse telogen effluvium (thinning throughout the scalp including the donor area). Have you tried Rogaine for Women? It would be valuable to you to see a doctor to be absolutely sure that you have no medical conditions that can cause hair thinning. They would be the same conditions as discussed here.

Kevis and IntraUterine Device (IUD)

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

Dear Dr. Rassman,
i have had andorgenetic alopecia for year now. it started at the age of 12 or 13 and now i am 26. i have lost more than half of my hair. it is really devastating. i have been on kevis for about a year now. in the beginning, i felt my hair loss problem was going to be a thing of the past but now i am experiencing a great amount of hair loss. i am confused as to what is the reason. i have had an IUD inserted also about a year ago- it caused great amounts of bleeding. could it be that i now have acquired a low serum ferritin count that is causing this imbalance? i also have irregular menses, could it be a hormonal imbalance caused by the IUD (it was a copper IUD). The reason i ask this is because the IUD caused me to have delayed periods and bleeing for more than a week.
i am really stressed out and do not know if to continue the kevis or not. i am so thankful that you have a website like this for people like me.
thank you

Bleeding and anemia can cause hair loss. Low ferritin can also contribute to hair loss, as well as hormonal abnormalities which you seem to have. Kevis is incidental, I suspect. The active ingedient in Kevis is minoxidil, so I would suggest that you switch to it and simplify what is happening to you. You need to get your doctor very involved in this problem.

Woman’s Hair Loss: LA Times

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

A different pattern to female baldness

The above link is to an interesting article which appeared April 17, 2006 (yesterday) in the Los Angeles Times. The article discusses the differences between male and female hair loss, but offers few viable solutions to the female hair loss problems that face nearly half of women past menopause and many young women. The article paints hair transplantation into a distorted positive view, suggesting it is a solution for many women. In my experience, women who make good hair transplant candidates are few and if the transplant option is played in most women who are not suitable candidates, not only is there often poor results, but the women that are inappropriately transplanted could be worse off than if they were to have left it alone or just put on drugs like minoxidil. I hope that women who read this article do not rush into a surgical solution that is not the answer to their dreams for if they do it may take their dreams and turn them into nightmares.

Why Does Rogaine for Women Contain Only 2% Minoxidil

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

I am a post-menopausal woman with female pattern hair loss. As you can imagine I am desperate to find a fix for this predicament. I’ve noticed that Rogaine for men has 5% minoxidil (sp?) while the women’s version has a maximum of 2%. The men’s version cautions that it is not to be used by women. Is that just because of possible child birth issues which would not be an issue for me?
Thank you.

Minoxidil will work better in women at a higher concentration. I can not tell you why some of the manufacturers recommend less than 5%, but I can tell you that the higher concentrations, although they may be more effective, do have more side effects. This drug is known to drop blood pressure and the more you use of it, the more the possibility of other side effects such as skin irritation.

With regard to use of minoxidil in pregnant women, this is a clear use that is contraindicated. Women must ‘know’ if they are pregnant and should be assured that they are not pregnant if they use this drug.

Androgenetic Alopecia Diagnosis from Scalp Biopsy

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

Dr Rassman,
I’m a 27 y-o female who has experienced major thinning all over the scalp. I wrote to you earlier this year regarding how my low ferritin levels (14-ish for the past 10 years) could impact my hair loss.

I recently received my scalp biopsy results which gave me a diagnosis of “Scalp skin with intermediate and terminal hairs. No significant immunopathology. This suggests an early androgenetic effect”. It also stated that “no clear cut diminution of hairs is apparent”.

Why would this history lead to a diagnosis of androgenetic alopecia rather than CTE? If I don’t have clear cut miniaturization, and my ferritin is so low, could this be true? I am just reluctant to go on Propecia since my insurance won’t cover it for women.

Thanks very much for your time.

These terms chronic (meaning long term) telogen (refers to a part of the hair cycle where hair goes into resting phase) effluvium (means hair shedding) and Androgenetic (means genetic and a weak sex hormonally combined into a single word) Alopecia (means hair loss) are descriptive terms, which in your case does not help. Much of medicine is rooted in the descriptive arena based upon Latin language usage. This makes doctors sound very intelligent, when the actual meaning reflects more of our ignorance. See EHRS for a better understanding of the difference between the two possible diagnoses listed above (chronic telogen effluvium/ CTE and Androgenetic Alopecia). You might identify with this piece: Channel4.com – Women Who Lose Their Hair.

Hair Loss from Pills for Menstrual Cycle?

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

hi! i’m already 25 years old. but then, i never had a normal menstrual cycle. when i had my consultation with an ob-gyne, he/she (since i’ve seen two doctors already) told me that all the tests given to me was normal and they prescribed me with provera pills. but then, as i started to use it for a long period of time, i suddenly felt that i’m starting to lose some of my hairs.i never thought that it can be a side effect of using pills. i went to my dermatologist and told me that my hairs will still grow back. Up to now, i’m having second thoughts on taking any pills that would help me regulate my menstruation since it seems that i’m going to have problems with my hair. can other pills like diane-35 can also cause hair loss? i’m planning to make another appointment with my ob-gyne for provera intake since my last menstruation was last october and then afterwards take diane-35 for my pimples. it’s just that i’m sick and worried of losing my hair. what can i do to prevent hair loss? is it also okay to use a horse shampoo for my hair and minoxidil regroe? they say that it can also make your hair thick. it’s just that i don’t want to lose any more hairs. thank you.

It sounds like you may have a genetic or hormonal cause of your hair loss. The absence of a normal menstrual cycle, which cause you to go on regulatory hormones, can cause hair loss. All of these hormonal supplements will have this as a potential side effect. You need to work with your OB/Gyn doctor to find the right hormones that meet all of your needs with the least risk to your hair.

Many people do use horse shampoos, and minoxidil may work to address some of the hair loss issues. Good luck.

Terrible Itch, Dandruff, Increase in White Hairs

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

Dear Dr. Rassman,

I am a 27 year old Korean female and have always had fair, sensitive skin on my face as well as my scalp. I’ve had slight acne since my teens but lately I have noticed bumps on my scalp that itch quite terribly, followed with dandruff. The dandruff comes and goes in my life, but lately it feels worse. In addition, I have noticed an increase of white hairs, especially near the crown. This is alarming considering I do not have thick hair to begin with. My initial reaction is to pluck the white hairs out but now there are too many to count. I don’t have any unusual stress in my life. I would like to see a doctor but do not know what kind. I am really worried because my hair loss, itchiness of scalp, increase of white hairs near crown, red bumps on scalp, are getting noticably worse. Because I am in South Korea, I am having a difficult time finding a qualified physician to help me at this time. Whatever information you can give me would be greatly appreciated.

I sent you my photos so you can take a look. It doesn’t look so bad at this time but I don’t want to wait until I am bald before I take action!

Please help!

The simple answer is that you may be causing some of your problems. If you are plucking out the white hair and your head is slowly turning white, it is a self-defeating process as eventually you will be completely white and then possibly you will pluck out all of your hair as you become balder and balder. Plucking will produce traction alopecia and the plucking problem may cause some of the bumps you are talking about.

Alopecia on Tyra Banks Show

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

hi my name is Tia and i am 14 for the last 2 weeks my hair has been falling out…then i watched the Tyra Banks show and this girl with alopecia was on…anyways it has been falling out alot like up to 45 pieces a day and i am really sacred i do not ant to go bald ….how do i tell what is wrong plz help me….

It is normal to lose 100-150 hairs each day for the average person. Unless you have some medical disease or have been losing a great deal of weight, you should not worry about it. I don’t watch the Tyra Banks Show, so I couldn’t specifically make references to things that were said on the program, but I did find this link about wigs shown during that episode.

21 Year Old Female with Thinning Hair

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

Im a 21 year old female and have been noticeing my hair getting thinner since december of ’04. I figured it was just shedding and did not relieze a more drastic hair loss until september of 05. I went to two different dermatologists and both said my sclap was fine and to take vitimans. I had bloodwork done and everything came back normal. My mom is 52 with very thick hair and has been double processing it since she was in the 8th grade and my fathers side does not have any hairloss problems either. Im very confused and am worried to loose even more. It started in the front of my head now its March of 06 and im now loosing alot more in the back as well. The doctors said it could be stress .. but i would like to get to the bottom of it before it gets any worse. Is there anything else it could be?

Without seeing your hair loss pattern, I cannot comment on the etiology of your hair loss. You may have genetic female hair loss that has symptoms similar to yours, or other conditions. As you indicated that you are in New York I recommend you see Dr. Robert Bernstein, a hair transplant doctor who happens to be a dermatologist on the Columbia Medical School faculty.

For more information, look up female hair loss in the search engine on the front page of this site and you can read the various questions and answers that will align to your questions. Remember, the more you know when you see a doctor, the more value you will get from the questions you pose and the doctor answers.

Woman with Chronic Telogen Effluvium

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

Hi I am a 44 year old female with chronic TE and a positive hair pull. I had 2 brief incidents in my 30s but this latest one has been continuous for 18 months and I have lost a significant amount of my hair with little or no visible regrowth. All of my hormone tests are normal including thyroid, FSH, LH, estrogen, my testostone is even slightly below normal and my ANA is negative. The only issue I have is low ferritin and I have been taking iron for about a year but can’t seem to get the levels above the low end of normal.

My condition continues to deteriorate despite rogaine and topical steriods. I don’t know where to turn. Any advice would be welcome.

Thanks

There are people who specialize in this. Please let me know where you live and I will try to find someone in your area. For more information see Telogen Effluvium by Elizabeth CW Hughes, MD.

Moved to New Country and Hair Is Falling Out

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

Hi Dr.Rassman,
I been bothered by this problem for almost a year now and couldn’t find way of solving it .I been reding magzines and testimonials about this but need more explaination. I come from the Philippines but residing here in Dubai, U.A.E because i am working here now.I am here for 2 1/2 years now in Dubai.Back in the Philippines i have a healthy hair means shinny and bouncing but my nightmare came to me when I am here now in Dubai my healthy hair becomes lifeless, dull,dry,and i experience hairloss too plus my sclap is very itchy to been trying different medication about it but i don’t seem to see the results.

Admittedly, as a person I easily gets depressed and one year back i did experienced a total depression due to some personal problems. I also heard some stories that one reason of hairloss hair in dubai is the water and the harsh weather of this country .Also, I am quiet afraid of the reality that my mom had a thin hair and i suspect i may have hereditary hair loss.But , I am only 24 to experience such problem, that is why i am consulting you this problem because i really want to know the mean reason of my problem if you could elaborate some of the theory you may have for this; and also could you give a solutions or advise on what should i do .

Thank you very much and I would really appreciate everything if you will send me a reply on my e-mail as soon as possible.

I do not have an answer to your problem. Your depression should be addressed, but being away from home surely adds stress to your life and stress can change the character of hair in some people.

DHT in Women

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

What can you tell me about a product called Ayuervedic. I am a 57 year old African American Female, who has had extensie hair loss since age 20 after a perm. I have been wearing a wig. I have recently met someone I like very much, but I am so ashamed of him learning that I wear a wig because, I am bald.

When will the FDA make drugs available to be purchased by perscription for hair loss? It is my belief that most people who suffer from hair loss, just like acne suffers, are very stressed. In this society we are so judged by appearences that some of us are getting ill from the stress hair loss can cause.

Also can you eloberate on what chemicals in the body cause imbalance. What chemicals cause DHT.

Thank you

It is my understanding Ayuervedic is a holistic approach to health care. I am not very familiar with it other than it is likely a natural supplement type of product. It is not a medicine.

The only FDA approved hair loss medication is topical minoxidil and oral finasteride (Propecia). Propecia is only approved for male patients because it works by blocking DHT formation. DHT is a naturally occuring hormone that is a breakdown of testosterone. Although women also have DHT and testosterone in their body, most causes of hair loss in women are not related to DHT. Even in rare instances that DHT is a factor in a woman’s hair loss, the use of finasteride (Propecia) is probitited in women due to possible birth defects. At 57 years young, I suspect you may not be thinking of becoming pregnant, but Propecia is still restricted for use in woman. Furthermore, DHT is not likely the cause of your hair loss so Propecia would not work for you.

If you are concerned about hair loss, you should make an appointment with your primary care doctor first to rule of any medical causes. If you are still not satisfied, you may consult with a hair transplant doctor. The most important advice or opinion I have for your case is to be honest with your new friend. It is embarassing especially for women to disclose their hair loss, but if your relationship is to blossom it may be one of the first steps.

5% Minoxidil for Women?

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

Hello,
I am a 26 year old female and have been using 2% female minoxidil for a little over 6 months. I wanted to ask if it was safe for a woman to use the Men’s Strength 5%. Please advice.

You should use products as directed on the FDA approved label. 5% minoxidil is not available for women, but they are formulated for men. The women’s formulations are mostly water/alcohol based which makes it easier to style your hair. Most men’s preparations are oil based. You can use the woman’s alcohol base in the morning and the men’s 5% oil base at night. Some drug stores will make up the 5% alcohol base on prescription. Ask your pharmacist. Also, please see this article on HairLossTalk.com.

Female Hair Loss After Anorexia and Bulimia

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

My hair was quite thick when i was younger but I suffered in the past of anorexia and bulimia and my hair got thinner. It has been now less than a year that i am cured but noticed that my hairloss has increased. Is there anything that you can recommend and will my hair get back to its original condition.

First, hair loss comes from many causes so you need to have a complete medical work-up to separate the real diseases that cause hair loss from the genetic programming that we inherit from our family lines. There are many ‘medical’ causes for hair loss and maybe you have one of them, such as hypothyroidism, eczema, alopecia, dieting, malnutrition, autoimmune, drugs, infection, genetics, etc.

  1. Hormone levels for DHEAS, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, and Leutinizing Hormone
  2. Serum Iron, Serum Ferritin, TIBC (Total Iron Binding capacity)
  3. Thyroid Stimulating Hormone (TSH)
  4. VDRL
  5. Complete Blood Count (CBC) to rule out anemia

A good doctor is your first step. The problem with women’s hair loss is that when it occurs, it may precipitate genetic hair loss, the thinning of which may not be reversible. In your particular case, it is possible that your experience with anorexia and bulimia earlier may have ‘triggered’ the genetic process (if you have it). Get your tests done and communicate with your doctor, bonding with him/her so that your problem is theirs as well and be sure that you do not have a precipitating cause of the hair loss.