Hair Loss from Anesthesia?

/by William Rassman, M.D./10 /

I am 27 years old and female, and I have always had really thick hair. Around 6 months ago, I started noticing my hair was coming out a lot when I washed, or brushed it. My hairstylist also noticed, and asked me if I had surgey, and if I had anestisia? I did about 10 months ago. I was wondering if that could be linked to it? I have also noticed that my eye on one side feels like it is straining if I look side to side or up or down, and I have expierinced migraines frequently lately. So, maybe it is stress. Either way, your imput would be greatly appreciated.

Yes, the stress from anesthesia and surgery itself can cause hair loss, but it is temporary most of the time, particularly for women. In term of anesthesia, I am not certain if the anesthetic chemical itself causes direct hair loss or just the stress associated with the surgery, although I think that the stress may be a more significant factor in predisposed women. You may have female genetic hair loss and mapping out your scalp and hair for miniaturization might help establish or rule out this diagnosis with objective measurements. Repeating the analysis may have value after 6 months has passed if the first measurements are not definitively able to make the diagnosis.

Cortisone Shots and Hair Loss?

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

Would cortazone shots cause hair to fall out in large quanities? I had a shot about 2 weeks ago, would this cause it. or maybe my age 55 in mentapause time something to do with it?

On occasion, cortisone shots into the head can precipitate hair loss. In women who are predisposed to genetic hair loss (in those who do not have an autoimmune cause of the hair loss), cortisone may add to the many precipitating factors for hair loss, which occurs more frequently in post menopausal women. Any stress can precipitate the process. Although some doctors use steroids to treat hair loss, I do not understand the rationale for such use, unless there are autoimmune influences suspected as a cause of hair loss.

Hair Loss from Wigs

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

Hi,

I am a 52 year old African American female, who has had the struggle of being bald most of my life. When I was 12 I had a severe case of chicken pox, and left me scarred all over. Fortunately, I recoved with the skin, but the disease left large bald spots all over my scalp. I have worn wigs .. seems like forever.

The problem is no one has ever been able to help me through the years, and the wigs that I always wore, are taking out the remaining hair I have left on my head.

Is there someone I can see, to help me with this problem. I have used medications, hair weaves, etc to no avail.

Thanks

Wearing a wig for many years can cause further hair loss as a result of the traction caused by the wigs. Traction Alopecia is common in wig wearers, those who wear turbins, and even in those women who pulled their hair into tight pony tails. Send your photos or if you are planning a trip to Los Angeles, visit my office so that I could better evaluate your situation. There are a few questions I need to answer, but can’t do so until I can see your hair loss. These questions include: What is your donor supply like? Is there enough hair for redistribution with hair transplants?

Bald After Radiation for Brain Tumor

/by William Rassman, M.D./12 /,

Had breast cancer, surgery, chemo, radiation. Then had a brain tumor that they thought could be taken out without radiation (kills follicles, and absolutely left me BALD! I was a hairdresser that went to graduate school with beautiful long blond hair. I CAN NOT find another woman that is as bald as I am. My whole head is permantently BALD. I tried every product on the market and nothing helped because the follicles were killed by total head radiation. I can not work, stay away from longterm partner that I knew since 1973 that I was in love with. I don’t work, have no friends left (my move, because I could not stand their pity). Stopped going to my support groups, and have tremendous stress now. My son is alone too, diagnosed with diabetes after given a medication for bi-polar disorder. I was adopted, and my family has never called me. So I am left completely bald – wear wigs w/pajamas if I have to go out. Thank you for letting me write this since I feel like a grieving “bald” widow !

I was left totally bald 4 years ago from head radiation after removal of a brain tumor. I cannot find another woman as young as I am, or ever older that me, that this happened to. Totally stressed out and won’t go out of the house. Probably will lose my house. Have NO self esteem. Tried everything, creams, lotions with no results. Hair Club for Men and Women (HCMW) are hostile to women, could not afford permanent program. Have alot of wigs, but NO SELF CONFIDENCE/ SELF ESTEEM and have just about given up on the hope of a solution.
Thank you.

Have no pictures/ HCMW took pics of top and back ! I kept asking to talk to someone that had my extent of permanent hair loss that they kept telling me about – but did not for a year. Instead they had me talk to a potential client. Very sad.

There is no cure for what you are describing. You had bouts of cancer and beat it. That should tell you that your glass is half full, not half empty. We are the writers, directors, and actors in our own lives. Sometime we need help to do that job and a good psychiatrist/psychologist or counselor may help you direct your ‘play’. Get the help you need and make your life come out they way you want it to be. I have seen many handicapped people who have overcome many liabilities. A relative of mine died from breast cancer and she went through hell trying to beat it. Her life was taken and yours was gifted to you. Do you think that there was a purpose to your survival? Take a look at National Alopecia Areata Foundation. What this should show you is that there are many people working on your type of problem and many people managing their lives with it. Their glass is half full.

I met a lady with alopecia universalis (no hair on any part of her body from genetic causes) who wore a wig and used make-up for eyebrows and lashes for her eyes. Her alopecia could not be detected at all (she chose to look like a hairy woman), and she was fashionable and dynamic in her social and professional life (radio show host and former spokesperson for the alopecia afflicted). She told me that she made a decision that her alopcia was just a handicap and she quickly came to deal with her life when she was young. Living life for life’s value was more important than obsessing over a problem for which there was no cure. She was victorious, something I wish for you.

Discoid Lupus and Hair Loss

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

Female. I was diagnosed with Discoid Lupus Erythematosus about 4 years ago. It started out as a little bald spot, now most of my hear on the top is gone. I am not sure what to do, I have at the cortizone shots, I have used the clobex shampoo,noting is working. I am constatly getting new bald spots it appears to always be active. Is there anything I can do to slow down the hair loss? I have kept my hair short for almost 20 years. I am tryin to let it grow back enough to be able to push the front part of my hair back to cover up the spots.

Autoimmune diseases are a known cause of hair loss and a difficult problem to control. To get control of the hair loss means getting control of the autoimmune disease. This requires the expert hands of a doctor specializing in such diseases, such as a dermatologist with a particular interest in this.

Hair transplantation works if the disease in the scalp has been inactive for a number of years and this is best determined by biopsies along the edge of the bald area where normal hair may exist. The presence of inflammatory cells may show active disease (from your history this is your case) so a number of areas must be biopsied (must wait until the disease becomes inactive). When the disease become inactive in the scalp (it may remain active elsewhere), biopsies will show that it is inactive. With inactivity present for at least 2 years, a series of test hair transplants will show if the skin will support hair transplant. Representative areas must be selected for the test transplants and FUE can be the source of the transplanted donor hair. Before embarking on this process, however, a supply/demand assessment must be made with goals clearly defined. With a disease only 4 years old, it is probable that you will have to wait some time before undergoing any type of restoration assessment and hopefully when it reverses, you will see some hair return in the affected areas as an indication that inactivity in the scalp may be on the horizon for you.

I have successfully transplanted a series of patients with inactive alopecia areata with nice results. I would suspect that you might be a candidate some day if you are fortunate enough for the process to stop progressing in your scalp. I have no other suggestions for the moment other than continue with your treating physician and have hope.

Hair Transplant After Alopecia?

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

I have several bald spots at the back of my head.I went to see an MD and a blood test was done all are normal and MD said that i am having alopecia. What is the approximate price of hair transplantation? i am only 26 years old / female and i don’t want to be bald this early in life. please respond. thanks

There are many types of alopecia. If you have one of the autoimmune causes of hair loss (that is what it sounds like), then hair transplantation does not work until the disease has burned out (generally you must wait for at least a couple of years and be certain that the autoimmune process has ended often requiring a biopsy). I need more information on the type of alopecia you have. See the Female Hair Loss category for the answers to your concerns that may have already been written.

Prescribed Propecia for Women

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

I have been prescribed propecia, but have not filled the prescription. I am balding on the crown of my head tremedously and have always had my hair chemically permed for the past 15 years. What can you tell me about females using propecia and would rogaine for females would be something I should consider? What type of doctor can I see for my baldness?

Propecia is not prescribed or recommended for women. If you get pregnant on the drug, there is known side effects that will impact your baby’s sex organ formation. Propecia is not shown safe and effective in women, especially those with tendencies for cancer of the breast, ovary or uterus. Rogaine, on the other hand, is approved for women as it is safe and it may be effective in women for hair loss (the response is variable). I would not take the risk of taking the Propecia, whatever that risk is, especially important to note if pregnancy is possible.

African American Hair Expert

/by William Rassman, M.D./7 /,

I’m an African American female and want to know which is better for my hair, pressing with a hot comb or using a non lye relaxer (like Precise). Also, I have hair loss and hair is very thin. I had a hair restoration in June 2005 by Bosley. Can you please recommend things I can do to improve my hair? Do you consider yourself an expert in dealing with African American hair?

I believe that I was the first person to place follicular units into an African American and started the trend that allowed for the use of small grafts in African hair types. As you may know, hair transplantation is a ‘peg in a hole’ surgery, but African hair is curly (like a cork screw) and therefore placing it into a round hole can be a difficult challenge to the inexperienced hair transplant surgeon. I guess that would make me an expert for transplants into African American hair types.

With regard to your other question, I am not an expert in the best ways to ‘relax’ hair, but I see problems with those individuals who have this done improperly. I am an expert in the complications of such treatments. I would have to examine you to make any recommendations.

Female Hair Loss from Diet Pills?

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

I am getting bald in the top of my head and also on the left side of my head. Not sure what the problem. I was told that if you took a lot of diet pills in your younger days (of which I did) that would cause it. Please help me on this matter. It is very embrassing to go bald at the age of 42. Not that is matters but I am a black female.

Actually, race and sex do matter since certain backgrounds tend to produce certain types of hair loss. In your case, diet pills taken many years ago are not high on my list of causes for hair loss, although extreme diets and conditions such as anorexia and bulimia definitely do weaken hair and cause loss. For a final and accurate answer, you would really have to be examined and tested by a hair doctor (get your scalp mapped out for miniaturization) or a dermatologist, but I suspect you might want to review the many previous blog entries about Female Hair Loss to understand the various causes of hair loss that must be considered.

On a more positive note, hair loss in certain hair types (for example African-American hair or kinky/curly hair types) gets better results from replacement surgery and/or other treatments. Depending on what type of hair loss you have, you may still have many options for treatment, so don’t despair!

Is Stress Causing Gray, Lifeless Hair?

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

Hello –

Recently, I’ve had a heavier load of stress in my life within my marriage. Last night when I got my hair colored my stylist asked me what’s been going on in my world? The reason she asked, is because I was intensly more grey than normal on the crown of my scalp & the sides, my hair was lifeless and dull and when she washed my hair after coloring, she noticed alot of hair on the drain. I’ve noticed my hair greying much faster and the same thing with washing my hair at home in the shower, lots of hair on the drain. I’m 37 years old and female.
My question is: Is my hair greying faster, texture of my hair lifeless and dull and the hair loss on the drain due to heavy stress? Thanks for any help you can give.

Genetic female hair loss can be precipitated by stress which can also bring on the graying process as well. Changes in the character of the hair also occurs as we age, as well as from the stress. Sounds like you need to surround your stress better. Also see a good doctor for the diagnosis of genetic female hair loss.

Tachycardia from Minoxidil?

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

What is the likelihood minoxidil caused an episode of tachychardia where patient is a healthy 48 year old female with no cardiac history or risk factors who used it on her scalp for a week prior and whose symptoms did not recur upon cessation of use?

There may be a direct association between tachycardia (fast heart rate) and minoxidil (which is a hypotensive agent that drops blood pressure). Many people complain of dizziness with this drug and what they are probably experiencing is a small drop in their blood pressure. When blood pressure drops, the first thing the body does to compensate for it is to increase the heart rate, so your symptoms fit nicely into the physiology of the cardiovascular system.

Diffuse Thinning in Female

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

Dr. Rassman – I am a 41 yr. old female and have been experiencing diffuse thinning. I noticed this happening about 5 months ago and have been on an endless quest ever since and no one can seem to offer help. I have been told to try everything from hair transplants to ScalpMed, (which I saw your response to), Rogain and then not to use any of those treatments. I have seen 3 dermatologists, 1 holistic doctor, 2 GP’s, and an endocrinologist. I have had every blood test as described and nothing has been found. My 2 uncles on my mothers side are bald although my parents, sister and brother do no have thinning. I have scalp psoriasis mainly on the crown and sides of my head. I recently had a scalp biopsy and interestingly enough the pathology report stated that, “on the basis of this punch boipsy, the favored finding is psoriasis/sebopsoriasis, findings of alopecia are not present in this biopsy, and negative for scarring alopecia, lupus or any known inflammatory dermatosis (other than the psoriasis). I am currently using Clobex shampoo and lotion, not at the same time, and I know that I can only be on these for short periods of time due to the side effects, and that they can cause hair loss. I have sent photos to Dr. Bauman in Florida and he suggested the hair transplant. If someone would have told me 6 months ago that I needed a hair transplant, I never would have believed them. My problem is my hair is still thinning, and before I lose it all I would like to stop it. I am losing about 150 hairs a day and I have heard anything over 50 is extreme. I have done extensive research and still I have no answers. I understand that when the plaques get bad enough it can cause hair loss and that I need to get the psoriasis under control, however I have received so much contradictory information, I don’t know who or what to believe anymore. Is there someone that you can recommend here locally that may help? This entire situation is taking a toll on my health and marriage. Thank you.

First, I would like to acknowledge that you have a problem significant enough to affect your mental health. I have dealth with many patients in your circumstance. In your case, Psoriasis does not cause hair loss unless you pull on the scales, thereby producing traction alopecia. What you have done (including the biopsy) seems reasonable. If you have diffuse hair loss impacting even the sides and back of your head, and continue to shed hair, I do not recommend hair transplantation, for you will be transplanting some of the impacted hairs, not just the recipient area. Doing a hair transplant for a patient who is currently experiencing active Telogen Effluvium is bound to fail. Through the internet, it is impossible to treat you without examining you. If you live in California, consider visiting one of my offices (in Los Angeles or San Jose). If not, send me photographs to the email address on the Contact page and I will see if I can help you any further. Please avoid hair transplants until there is a clear plan in front of you.

Low Iron and B12 Causing Miniaturization?

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

Hi,
First I would like to thank you for providing this site, it has help me a great deal. Here is my question. I am a 31 year old female suffering from hair loss, and as of yet I do not know the definite cause. My question is concerning all that I have read about the possibility of vitamin deficiency causing hair loss in women. My doctor runs routine bloodwork every year, and for approximately the past 10 years I have had low iron, low B12, and my last set of tests, last year, did show that I also have an overactive thyroid. Throughout this time I have never taken the supplements that were advised by my doctor, I am now regretting that, and have since started. Now to the question, with being low in iron and b12 for so long cause miniaturization? I have miniaturization hairs throught my entire head, and very thin on the crown, and this is why I am questioning the effects of vitamins and hair loss. From what I have read miniaturization and thinning at the crown usually indicates AGA, however I did read once that low iron could mimic AGA with miniaturization. And I am hoping that this hair loss that I have is from low vitamins for a long period of time, and not AGA.
Thank you so much in advance.

Yes, low iron and B12 can cause hair loss. Get a good doctor to take charge of you, as that is the best approach to the problem.

Hair is Thin After Highlighting

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

I am a 47 year old woman who had slight graying hair. My hairdresser talked me into highlighting my hair. She used a volume 20 bleach and a toner. 24 hours later I had itching, burning and swelling and saw my allergist. He put me on prednisone for a week and cortisone lotions. A month later my hair feels like cotton as the strands of hair are thinner, breaking off at the crown and generally coming out at the root after washing/combing.

What if anything can I now do? Obviously, I will never again use chemicals on my hair.

You have likely had a chemical Alopecia (hair loss) with a skin reaction. I know exactly what you are going through (having had a spiral perm in the eighties with the same thing happen) and although it is likely all your hair will grow back just as it was, it will take time, especially if you wear your hair long. Avoiding harsh shampoos and conditioning your hair regularly may help the hair that is there, but little will help it grow faster which is what really needs to happen. Concealing options like hats, scarves, and Toppik are all options as well. If this condition persists past 6 months, I would recommend a follow-up visit to your doctor to determine if anything else is going on.

Hair Loss After Brow Lift

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

I really appreciate your informative and straight-forward approach to our hair concerns.

I have had a brow lift a little over a month ago. While the surgery was for the most part very successful, I was not prepared for the hair loss that preceeded it. I was told by the surgeon that my hairline would actually be lower afterwards. That was NOT the case.

The hair loss is along the incision line. It is more “loss” than just thinning. I was told not to worry that it would grow back.

My questions are:

1. What is the chances that the hair will return?
2. Would Propecia help?
3. About how long does the scalp normally stay numb?
4. How long should I wait to see regrowth before having hair restoration to correct it?
5. After hair restoration, how long will it be before I can do strenuous exercise and swim?

Thank you

There is a good chance that some or all of the hair will return, but brow lift scars are often detectable due to some widening of the scar when the incision was done behind the hairline and hair loss risks when the incision is done in front of the hairline to lower it. Sometimes during the type of procedure you had, the blood flow to the hair follicles can be interrupted resulting in a temporary loss. Occasionally it is permanent, but in most cases you should be able to see some regrowth within 3-6 months. Most doctors will wait up to a year before giving up on seeing some growth return, and that is about the time you can consider a hair transplant surgeon to correct it if needed.

As for your other questions, if you had a hair restoration procedure, you would need to wait a week before resuming very strenuous exercise and you’d need to wait until the wound has completely healed before swimming. Propecia is a DHT blocker which prevents male pattern/genetic hair loss and it is not proven safe for women, so it will not help. The scalp numbness does not usually last more than a year (often weeks or month and is rarely permanent). Finally, time is really the most important commodity for you to evaluate your loss/regrowth. Wait for the regrowth and follow-up frequently with your surgeon.

Of interest, this complication is the most common reason women get hair transplantation (at least in our hair restoration practice), which does not reflect its incidence (of let’s say in 100 women with brow lifts), but it does tell you that it is not an uncommon problem.