Zelnorm, Birth Control, Diet and Hair Loss in Teenage Female

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

i am 19 years old / female. when i was younger, in my middle teen years i had thick, thick hair, now its so thin. whenever i take a shower i lose so much hair its ridiculous. i’ve been using mousse for my hair for a long time. i started really using it when i was about 14-15 years old, but now i use it frequently in my hair but i never put in on my scalp. i always put it in the middle to the ends of my hair. i colored my hair once and that was when i was 15-16 yrs. old, and i’ve been smoking marijuana for about 2-3 years, but not every day. i also started two new pills, one is a birth control pill levora. i’ve been taking that for a year and the other the one is zelnorm. ive been taking that for 4 months now. my question is what could be the cause of this? my mother has noticed my hair loss, and i’m scared i could go bald at a young age. i’ve lost so much hair in the past year or two. could what i’m doing or taking be the cause or what????

Birth control pill could potentially cause hair loss. However, Zelnorm does not directly cause hair loss. Zelnorm is for (Irritable Bowel Syndrome) IBS with constipation symptoms. Patients with IBS may have a nutrient deficiency leading to hair loss, so a focus upon your diet may be appropriate. There are many causes for female hair loss. I recommend that you visit your physician for blood work to rule out anemia and hypothyroidism, which could also potentially cause hair loss. The general causes for hair loss are hypothyroidism, alopecia areata, androgenic alopecia, repeatedly over plucking, eyebrows lifting, trichotillomania, stress, chemotherapy, radiation, eczema, seborrhea, scleroderma, lupus, hormonal imbalance, psoriasis, parasites, fungal, autoimmune disorders, poor diet, poor nutrients, burn, trauma, leprosy, and drugs. The common medications which may cause hair loss are beta-blocker, coumadin, oral contraceptive pill, antibiotics and chemo-medications.

Genetic hair loss starts in some women as early as 17-19 years of age. You need a complete examination for miniaturization to make the diagnosis, one way or the other. Get a good hair doctor, as that is critical for you to have a better understanding of what is happening to you.

Female Hair Loss from Iron Deficiency?

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

I am 29 years old and am losing hair. After the shower I can see lot of hair fallen around. In my diet, I dont include iron-rich food. Would it be a possible reason for hair loss? Can you suggest a good diet for preventing hair loss?

Speak to your doctor and have your iron levels measured. This is an important step if you think that you have an iron deficiency, a common occurrence in women. Historically, women needed to eat meat to replace the iron they lose from menstruation which is why iron deficiency is not uncommon in women. A good general diet with red meat may be all that you need if your iron levels are bordering on the low level, otherwise, see you doctor and get his/her recommendation. If you have hair loss, then as I’ve suggested many times in this blog, you need a good examination for miniaturization to get the best diagnosis for cause.

Should I Start Using Rogaine for Women?

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

I am a 27 year old, female of indian ethnicity. I always had extremely thick hair, but have noticed over the last 5-7 years, a dramatic reduction in my thickness (probably half the thickness it used to be). Admittedly my hair is probably still considered thick, but I am concerned that at the rate of my hair loss it could become dramatically worse, and want to prevent this from happening. My mother’s hair has dramatically thinned (you can see her scalp visibly) and I am hoping that is not what I am getting. I do notice slight regrowth but this does not seem sufficient to be replacing all my lost hair.

I notice that I lose a lot of hair in the shower, when I style my hair, and anytime I just pull my hair together, and also see that I lose strands of hair throughout the day (my floor perpetually has a lot of hair on it and my clothes usually grab a fair number of hairs as well). I have been perpetually on different antibiotics for acne for about the last 10 years (not sure if this is an influence).

I want to start using Rogaine for Women but am not sure if I am too young for this, and also dont want to use this unnecessarily. Can you please tell me if I can/should be using a product like this? Also, should I see a doctor regarding this (what type of doctor is best), and what tests should I be asking for? Any feedback you have would be appreciated.

Self-diagnosis is difficult for me to recommend, because if you have a medical condition causing the hair loss, then you will not get a proper diagnosis. As I’ve said before, there many reasons for hair loss in women, including hypothyroidism, ezcema, alopecia areata, telogen effluvium, lupus, drugs, stress, crash diet, and infections. As you will see when reviewing the list of problems, hair loss in women is not as straight forward as in most men. Before starting more medications, you should get a metric (measurement) to get your scalp mapped out for miniaturization to determine if you have premature genetic balding for women.

A good dermatologist or family doctor can perform the basic blood tests and a dermatologist will be able to do biopsies when appropriate. Rogaine for Women may work if you do not have one of the medical conditions listed above.

Thinning Hairline in African-American Woman

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

I am a 42 y/o black female. My hair started thinning around the hairline about 2 years ago. At first I thought it was some of the chemicals being used by my hair stylist. I have changed to another stylist, but the problem persits. I recently went to a dermatologist who started me on Rogaine. However, the site for Rogaine states that it is for hairloss in the top of the scalp. Is there any treatments that will help thinning hair around the hairline? I understand that this is uncommon for women? Please help, this has effected me emotionally.

There are a few important issues to address in your question. The first thing to note is that all salons use similar chemicals so you might want to stop chemically treating your hair altogether for several months to see if it recovers. The second issue is whether or not you have a tight braid/ponytail type of hairstyle or have had recent facial plastic surgery (like a brow or a face lift) since both of these can result in the hairline thinning you describe. You are correct in that women rarely lose their hairline with female pattern/genetic hair loss, but it can happen and that is why you should be examined by a doctor who specializes in hair with an indepth assessment for miniaturization.

Finally, Rogaine has been studied best at the top of the scalp, but I have seen some hairline results in women so it is worth a try. Unfortunately for women, there are no medical alternatives for thinning hair other than Rogaine. It is also noteworthy that hairloss can profoundly affect a woman’s emotional health, much more so than with men although men suffer hairloss more commonly. I would urge you not only to proactively address the hair loss, but to take steps to treat the emotional impact it is having on you as well.

Hair Loss from Tuberculosis?

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

My 17 years old daughter was diagnosed with inactive tuberculosis about 8 months ago and has been taking INH. However, about 18 months ago she started losing her hair. Could this be caused by the tuberculosis alone?

I have written on this medication with tuberculosis before (see Tuberculosis Drug and Hair Loss). The disease itself is a wasting disorder which is known to produce hair loss, as with other wasting disorders. The same recommendations I made before apply: good diet and appropriate vitamin therapy. A full work-up for female hair loss is in order here as there are many diseases that cause hair loss in women (see Female Hair Loss category). Read these pages carefully and seek out a good doctor to follow through with a thorough examination of your daughter. Also, you might want her to see a hair specialist who will study her for female genetic hair loss and assess the miniaturization of her hair to see if the pattern is typical of female genetic hair loss.

Female Hair Loss — What to Do?

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

I have been losing my hair for years. I’ve been a sucker for many high priced hoaxes and am now to the point where the comb over is barely hiding it anymore. I’ve lost so much of my hair on the front/top and am ashamed to even look in the mirror, I feel like crying each morning when I style my hair. When people look at me I can’t help but feel like they are laughing, I’m only 30. I had asked my doctor awhile back (when I was about 22-23), but his advice to me was to learn to live with it, there’s nothing that can be done for hair loss. Please, is there any product out there that you would recommend for me to research, (I know in the medical world you can’t recommend a product for me to try), so all I’m asking for is a point in the right direction. Every time I try I just feel more defeated, there are so many products out there, I know most of them are little more than snake oil. Please please help–I don’t know where else to turn for an unbiased recommendation.

I hesitated to write an answer to you because I did not want to contribute to the many failures of treatments you have experienced. It sounds like you are accepting your balding without having a medical work-up. Please review the many pages of answers in the Female Hair Loss category, and then get a good doctor who will work as a professional in helping you to surround the diagnosis and treatment for your hair loss. Good luck.

Hair Thickness Changes by Seasons

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

I had really thick hair up until I was 16 years old. Since then it is about 1/3 the thickness. I have tried vitamins and have tried to eat alot of protein etc to help. I am 52 (female) and after all these years I cannot help but notice a pattern. During the winter months after December my hair will have regrowth with new hair and actually thicken to the point that my scalp is not visible. Is is possible that cold and sinus medicines such as sudafed, cough syrups, and antibiotics [non penicilin] have ingredients that would contribute to hair growth? As soon as the weather heats up in the summer my hair starts falling out again by the brush full. What do you think? Thank you for your time and consideration.

What you say is logical, it is just not what we normally see in humans. Why humans have developed asynchronous hair growth, why we do not grow and shed hair all at once and the evolution of this is not known. What you are suggesting is that in you there is some seasonal variation in your hair density and that shedding may occur as the seasons get warmer, I do not doubt your observations, but I do not have a basis for understanding it. I am convinced that in the summer when we sweat a great deal and get our hair wet from sweat, we may actually produce more friction when we brush or comb the hair. That might account for the hair that comes out when you brush your hair in the summer. Also, some people wash their hair more frequently in the summer when they are out and about because they get it ‘dirty’ more easily. That might explain what you are observing. Clearly, there is a suggestion that there is some middle ground in your history and that some climate problems do occur in the summer in your situation. Do you live in a warm/hot climate?

Tryptophan and Hair Loss?

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

I am a 39 year old female experiencing hairloss all over, with more concentration in the frontal area. I became infertile with low estrogen in my early 30s, went on testosterone cream supplement for 8-9 months after that, but primarily suspect that my hair loss is due to the L-tryptophan I’ve been taking for the last 2 years for my mood, which has worked wonderfully for me as an antidepressant (from 1000 mg to 2500 mg.).

If I get off the Tryptophan will my hair grow back? Otherwise, I may need a referral for a doctor in the San Jose or San Francisco Bay Area, and to find another anti-depressant…that doesn’t cause hair loss???

Thank you

There are some suggestions that tryptophan can cause hair loss and yet other suggestions that it does not effect hair loss. As a metabolic intermediate in the conversion of tryptophan into serotonin (5-HTP), some believe that in selective sensitive patients it may cause hair loss in its derivative form. Chemotoxicity is not my specialty and this is frankly beyond my skills and knowledge. Your conclusions on finding a doctor that can manage your anti-depressant medications is appropriate, but I do not have a referral for you. Sorry I couldn’t be of more help.

When Does Stress Become a Factor in Hair Loss?

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

i am a 23 year old woman, who has always had VERY thick curly hair. I have noticed that my hair is much thinner and requires many more wraps of the hair tie to put it up in a pony tail. I am very upset and wondered if you had any clue what is going on. I do not have a receeding hair line or anything. how stressed out does a person have to be inorder to affect their hair? thanks

The internet is no place to get a good examination of your head, scalp, and hair. A good dermatologist should be a starting point. Some people get hair changes with age that is not necessarily diseased hair, and others get hair thinning and loss from medical problems (see Female Hair Loss on this site to see other posts that reference the many medical conditions that can cause hair loss). You need a good doctor to make an assessment of you and your problem. If you have genetic female hair loss, then hair loss can be a problem anytime you experience stress.

Stress and Alopecia Universalis

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

I keep reading that stress is not a factor in Alopecia Universalis but my daughter who just turned 20 began losing her hair a year ago, a few months after her sister died in a car accident and now is totally bald, lost most body hair and eyebrows. We all know it is from the shock and trauma…why doesn’t the medical profession accept that and what is the prognoisis now that it has happened?

I can not comment on what you were told, but I know that such genetic conditions, which may occur normally in those with the impacted genes, can be accelerated by stress. You are correct, in a sense, that stress can precipitate what genetically would have come with time.

Treating Alopecia with Acupuncture

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

hi dr. rassman! i came across your website and i found it to be very helpful. im a 14 year old girl and about a month ago i was made aware of a bald patch at the crown of my head about the size of a 10p.a few days ago,i noticed that it had grown to about 2inches by half an inch. this is the only patch that i am aware of. im only 14 and i am sooo soo depressed about it and am constantly crying about my hairloss. ive been to see several doctors and i know there is no cure accounted for. today i went to a chinese health practice and went for a consultation with a chinese doctor, i was asked many questions about my diet and health and then acupuncture was suggested to me. i was very shocked and scared but went ahead with the acupuncture session there and then. and i was given a selection of herbal remedies to help with the alopecia also. what i would like to know is, how effective is acupuncture for the treatment of alopecia as i am extremely confused and scared as whether or not go ahead with regular acupunture. i am absolutely terrified of needles and i know i will be crying the whole way through, but if there is that possibility of my hair growing back again, i would definitly go ahead with the treatment. please please give me any advice you can im very scared that i will lose more hair and im confused as to what to do about it! please help im desperate

Acupunture should not help hair loss. Patches of hair loss are often caused by alopecia areata and this should be one of the diagnoses to consider. It sounds like you need a competent medical doctor to examine your case. It is impossible for me to make the diagnosis without seeing you, but if you send me digital photos to the address on the Contact page, I might be able to make a suggestion in the differential diagnosis.

Alopecia and Pregnancy

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

Hello,
I got alopecia and I am 4 months pregnant. I have started using fluort lotion as it helped me 5 years back, but I worry if it will have side effects because I am pregnant now. Will it effect my baby’s growth? I am very worried. Please help me out.

I would be hesitent to use things that can be absorbed into your body (transepidermal absorption) as they may harm your baby. Hair loss in pregnancy is not uncommon, most of the time it will reverse after the baby is born (give it up to a year post partum). On occasion, pregnancy may precipitate the onset of female genetic balding, but until a year has passed after the baby is born, do not focus too much on that possibility. Good nutrition is critical both to the baby’s welfare and health, as well as your hair health.

Sarcoidosis and Female Hair Loss

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

Female – In 1986 I was on a high dose of prednisone for sarcoidosis.The disease affected my eyes and my lungs.Within 3 weeks of taking the medication, my hair was thinning. I ended up being on the drug for a year. Needless to say all my hair fell out. Even after being off the drug, my hair never grew back. To this day I am still bald. I do believe that the sarcoidosis was started from fumes. I worked with a very strong glue and liquid rubber at work. Some of my co-workers were having nose bleeds also .I find the whole ordeal very upsetting. But I didn’t know how to prove the the fumes were the cause of my problem. Being on prednisone has been a life time nightmare for me. I kept the hair loss a secret for 14 years.I wore wigs or glued on weaves. I finally decided to tell my family in 2000. This situation has caused me much grief. I can’t date because I’m afraid that the person will reject me because of no hair. Thank for reading this.

Your hair loss maybe due to both Sarcoidosis and steroid. Sarcoidosis involves inflammation that produces tiny lumps of cells in various organs in your body. The lumps are called granulomas because they look like grains of sugar or sand. Sarcoidosis can occur in almost any part of your body, although it usually affects some organs more than others. Thus, in theory, Sarcoidosis could cause hair loss. I am not certain about fumes causing sarcoidosis, but that is clearly a distinct possibility and more research would be a good idea (not something that I can do through the site). You may want to see a dermatologist and ask for a referral to a toxicologist for better evaluation of your hair loss and possibly biopsy the scalp to rule out inflammation and disease that may cause your hair loss. Good luck and please let me know the outcome from the referral sources I discussed here.

Female Thinning Hair and Kevis

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

I am a 41 year woman and for the past two years I have noticed my hair beginning to thin. My Mother (67) and Aunt (58) both have thinning hair which did not begin until their fifties. I am hypothyroid but it has been well undercontrol for 8+ years now. The texture of my hair has changed significantly over the past 3 years or so, much less thickness etc. I do not want to see my hair thin anymore if I can avoid it, would I see a dermatologist or an endocrinologist for this issue? Also there is a “natural” hair loss product called Kevis on the market that is suppose to stimulate new hair growth – do you have any experiecnce or knowledge of this product? Thank you

There is no scientific data to support Kevis is any different than minixodil, which is actually the active ingredient in Kevis (but many times more expensive). Minoxidil comes in generic form or Rogaine (brand name). Use the minoxidil made for women, which has alcohol and is easier to style your hair with, rather than the variety made for men.

If the thinning is already in two members of your family who turned through menopause, then it is likely that this will also be your fate. I would like to see that you have an accurate diagnosis, which can be obtained by mapping out our scalp for miniaturization. In addition to pointing to the diagnosis, it should clearly show the degree of hair loss and give you a good baseline for future comparisons. Please be sure that you are medically OK; read through the Female Hair Loss category for more info.

Daughter Has Psoriasis and Hair Loss

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

Dear Dr. Rassman,

My daughter is 26 and has scalp psoraisis since the age of 15. The worrying thing is that the hair-line parting her hair in the centre is wide about 1/2 inch and clearly bald. The rest of her hair area seems normal. I gather from your feedback that psoraisis does’nt cause balding. What can she do to reverse her bald hair-line? Svensson was consulted and they have their usual hair commercial treatment. Will they be able to do something to adress her problem, albeit costly. I am 53 and bald, and the wife also 53 is losing hair along female hair loss pattern. Is there a connection of our problem with my daughter’s hair problem? Really appreciate your feedback.

Although psoriasis does not cause balding directly, balding from genetic causes can be occuring. With both your wife and daughter having hair loss, you might assume that hair loss is in the female family line. I suspect that other women also have similar problems. First, take a look at the Female Hair Loss category of this blog.

Please send me pictures to the email address on the Contact page and I would be happy to give you my opinion. It is very difficult to diagnose women over the internet, but the pattern of hair loss you are defining for your daughter is a pattern I have seen from time to time in genetic hair loss. Your daughter may be following your wife’s pattern of genetic balding. Check with your wife about her earliest symptoms of hair loss.