Prednisone Stopped My Hair Loss?

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

I am 38 (female) and have had thinning hair for a while. I was prescribed Prednisone for a different problem (poison oak) and went through the treatment process. I noticed while on the drug for awhile that my hair stopped falling out. Have you ever heard of this? It seems that every other time prednisone is mentioned, it causes hair to fall out rather than stopping it. I’m wondering if a low level dosage is ever prescribed as a treatment for hair loss. Once I finished the prednisone, my hair started falling out again.

There are many causes of hair loss other than classic genetic female hair loss (alopecia areata, various autoimmune processes, etc..) that might be helped with steroids, while the genetic process might be harmed by these same drugs. You need to have a good working diagnosis made by a competent dermatologist to ascertain what you have. Steroids can be dangerous when used long term, so be sure you are properly managed by a good doctor.

Birth Control Pills Causing Hair Loss?

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

Hi! I’m 21 years old and female. In feb 2004 I started taking birth control pills, and 3 months after starting them, i started losing hair. Then after 7 months of using them i stopped, because my hair was falling out in clumps. No I have been off more than a year and i still dont see any improvement. Doctors have made bloodtests, and they were OK! Hair loss is diffuse all over and they have a little white tip at the end. In my family no one has hair problems, not even my two grandfathers or my father! Is it normal to lose hair for such a long time ? i truly believe i am going to bald soon :(
Thank you for your time!

Please see my previous post about Depo-Provera which answers the question about birth control pills and hair loss. Unfortunately, some women with hormone changes can precipitate female genetic hair loss and once it has started, it may not be reversed ‘if it was to be in her cards’. About 30% of women over 50 are affected by this genetic process. Although we can reasonably accept hair loss as normal in men, women have a unique type of suffering because it is another ‘attack’ on their feminity in a society that is heavily hair conscious and weighted to beauty and youth. When a young women get genetic hair loss prematurely (I fully realize that it is always premature for a woman of any age), then it is the worst type of insult that flaunts aging very painfully. What the male and female genetic hair loss is, is the ‘miniaturization’ of the hair (the thin hair that becomes even thinner as the process advances), but the location of this miniaturization is different in women than in men. Men have it develop in patterns (front to back) while women generally have it all over the head: front, top, back and sides. Some women will retain the frontal 1/2 inch of hair as healthy, even with the process of miniaturization everywhere else.

When you discussed that your tests are completely normal, I would raise the issues of Thyroid and pituitary function, as well as the absence of circulating angrogens, amongst other causes. Some doctors talk about chronic effluviums or the presence of diffuse alopecia areata (you need to have a dermatologist evaluate this).

Minoxidil does work on some women, often better than men. Some men have a diffuse patterned hair loss like women (about 1-2% of men) but some of these men are helped by Propecia (about half) while that drug has not been determined to be safe for women and even when experimentally given to women by a handful of doctors, few if any benefits were observed.

Female Genetic Hair Loss

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

Hello,

I am a 25 year old woman and I have been losing my hair since the age of 12. All of the women in my family have been affected, but I am the first to lose it as such a young age and actually have it the worst. I am generally bald in the front and have thin hair everywhere else, but it’s not bald. I currently am using a weave, but I’ve noticed that is has actually become worse and I’d really like to lose the weave and have a natural hair line. Is New Hair catered for men only, and if not, can I be helped?

Desperate in Brooklyn

First of all, you should see a good doctor who knows about hair loss in women. Since you are in New York, I would recommend you set up an appointment with Dr. Robert Bernstein at (201) 585-1115. He has offices in Manhattan and New Jersey and can address your unique problem. It sounds like you do have genetic female hair loss, but first let’s get an expert to determine it. You must have a full check-up to determine if you have any metabolic diseases as well. For more questions and answers about female hair loss, please click here for previous blog entries.

Kidney Stone Medication and Hair Loss

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

I had saline breast implants in June of 2004. Six weeks later, I went through a terribly stressful period (unrelated to the surgery). Four months later, I began to lose my head hair AND the hair on my legs stopped growing. I went to a dermatologist and was told I had Telogen Effluvium and it would resolve itself in a few months. It has been over a year since the initial loss began and still I am losing the hair on my head in greater volumes (still a diffuse spread though). The leg hair began to regrow four months ago. I do take Urocit-K for kidney stone prevention and I had 3 surgeries this year for stones. Is that the reason? Will my hair ever get back to normal? And, could the implants be responsible for the hair loss? Thank you.

Dr. Moldwin is Assistant Professor of Urology at the Albert Einstein College of Medicine, and is Director of The Interstitial Cystitis Center at Long Island Jewish Medical Center in New Hyde Park, NY. He is actively involved in IC research and is a member of the ICA’s Medical Advisory Board. During the December 1998 meeting at the Southeast Florida ICA Support Group, Dr. Moldwin addressed a similar question to yours. He stated: “Most of the side effects that patients encounter occur about 3% of the time. One problem people often worry about is hair loss. It is not a generalized hair loss. It tends to be in spots. Keep in mind that everybody has some daily hair loss. It’s probably a wise idea to monitor your ‘normal’ hair loss on your hairbrush for about a week prior to starting Elmiron. Significant increases in hair loss beyond your ‘baseline’ might be due to the medication. I think that in the past many people had stopped their Elmiron needlessly since they looked at their hairbrush for the first time 2-3 weeks into therapy. They saw hair in their brush (which was, of course normal hair loss) and immediately related this finding to their medication. By the way, in the unlikely event that hair loss occurs, it’s recovered with stopping the medication.”

I think that he said what you needed to hear. You should have your scalp hair examined by a competent hair specialist to determine the degree of miniaturization that is present through the various areas. This is an important baseline to establish for long term planning purposes.

Spironolactones and Hair Loss in Women

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

Are you familiar with using spironoclactone topically for hairloss???? one DR. said it might be the closet thing to cure we have. IT is antiandrogen , which stops DHT at the point on scalp with attacking the follice. I would like to know if you think it worth trying in a lotion on the scalp??? Please respond With you professional opinion. THANKS

Yes, I am familiar with Spironolactones use for hair loss. They have been around for some time. Medline states “Spironolactone, a ‘water pill,’ is used to treat high blood pressure and fluid retention caused by various conditions, including heart disease. It causes the kidneys to eliminate unneeded water and salt from the body into the urine. Spironolactone is also used to treat certain patients with hyperaldosteronism and in certain patients with low potassium levels.”

This is a potent medication and has had some reported impact on fascial hair in women. There are some doctors who use this in conjunction with other medications including Minoxidil, which is an anti-hypertensive medication. Although side effects from spironolactone are not common, they can occur and include: upset stomach, vomiting, diarrhea, stomach pain, frequent urination, dizziness, headache, enlarged or painful breasts, irregular menstrual periods, drowsiness, muscle weakness or cramps, rapid, excessive weight loss, fatigue, slow or irregular heartbeat, sore throat, unusual bruising or bleeding, yellowing of the skin or eyes, skin rash, vomiting blood, fever, and confusion. I do not believe that this is a viable treatment for hair loss as there is no objective evidence that it works in female hair loss, but it is used by some doctors to treat women with hair loss.

Hair Not Growing Back After Chemotherapy

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

Dr. Rassman,
I am a woman who finished an intense bout of chemotherapy and radiation about a year and a half ago. Since then most of my hair has grown back on the sides and back of the head. The center top and crown is still very bald. My dermatologist says it is a typical female balding pattern. Can you give me feedback on this subject? Is it possible I could be a candidate for hair transplants? Thank you.

Your dermatologist sounds correct. Some women develop patterned loss, which is less common than unpatterned loss. Hair transplants work better in patterned loss, assuming that your donor hair is adequate in quantity and quality. If there is diffuse thinning in the sides and back, you may not have enough supply for a transplant. A good assessment by a competent hair surgeon will give you insights into your supply for quality hair transplants.

Depo-Provera Caused Hair Loss?

/by William Rassman, M.D./8 /,

I took a shot of deproprovera 2 1/2 years ago, and 3 months after I decided not to get another shot (b/c of weight gain and shoulder/neck aches) may hair started falling out like crazy, now it is 2 1/2 years later and it is still falling out, about 30-50 in the shower/combing out every morning. I’m down to about 1/2 the hair I had 2 years ago. Any advice? It is so frustrating. My 3 sisters have not hair loss issues (in fact 2 of them complain about too thick of hair). My mother’s hair has thinned the last 5 years because she is on strong cancer/rheumatoid arthritis drugs, but no problems before that (all my male/female relatives have hair also–my dad’s is thick at 68 years old–no bald men in my family, and woman all have hair too. Help. 2 dermatologists say I have TE and to ride it out.

Depo-Provera is a contraceptive and has hair loss as a known side effect (between 1-5% of women), as do many birth control pills. Female genetic hair loss does not follow the patterns of genetic inheritance that run on the male side of the family, but it is not unusual for women who have genetic hair loss to have other women (mothers, aunts, sisters, grandmothers) with similar histories and findings.

Southwest Florida Doctor Recommendation?

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

I’m 36, female, and have been losing hair for 8 years. My hair has always been fine and thin, and I inherited my father’s “receding” hairline. Now to be losing hair on top of this is awful. I’m new to the are and seriously considering transplants. I just saw a dermatologist who took a biopsy and said it’s female pattern hairloss, use Rogaine, there’s no other hope. I want to see a real professional who is caring, sympathetic, and willing to work with me to discover the best option of treatment. Can you recommend someone in southwest Florida please? Thanks

Ask your dermatologist to recommend a doctor in your area. A direct referral is always the best way to go. Dr. Bernard Nesbaum is a hair transplant doctor in Florida who has considerable experience with women and he is a dermatologist. You might want to check with him. You can get the doctors in Florida by looking at ISHRS.org.

Female Hair Loss – What To Do?

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

i am a 47 year old female experiencing hair loss. My mother has thinning hair at 73.

My history… Back in my early 20’s I experienced hair loss after moving far from home and leaving my parents…. Hair grew back after a while. Started thinning in early 40’s…would shed quite a bit and then it would seem to thicken back up. 2004, went through bad divorce and began experiencing thinning more rapidly…. after a year it got a little better.. I am under alot of stress and it has started thinning rapidly.

I went for consultation to hair transplant facility and had committed to transplant in another city where their was a surgical facility but after doing some reading and research I backed out. I don’t know what to do. I think I should locate a doctor who specializes in hair loss to see if some of this is from stress or other medical condition. I have been on bioidential progesterone treatment for 5 months…don’t know if that could be part of it…

My question is ….should I seek medical attention 1st to rule out any medical cause… I feel I’m the only woman who’s going through this.. I appreciate your input.

I am under the impression that the person you visited who recommended a hair transplant was not a doctor. If so, then it sounds like the hair transplant recommendation was only a salesperson wanting to make a sale, and they may not have had your best interest at heart. You need to see a doctor, a good doctor. A dermatologist is often the best and hopeffully you will find one that is knowledgeable about hair loss in women. What you are describing is female genetic hair loss which is the cause in 70% of females with hair loss. The medications you are taking may be contributing to the loss. A hair transplant for you, without understanding the process, is absolutely the wrong thing to do.

Testosterone Causing Female Hair Loss?

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

I have noticed this last year that my hair has receded DRASTICALLY.I am a 47 year old woman and have been taking hormone replacement for the last 8 years…Could the testosterone that I take monthly play a part in the hair loss because the testosterone makes hair grow in other places…several other places. I am so shocked and embarresed by my hair loss….the only place that it is recedeing is at the hairline on both sides and it is so so noticeable…please advise me as to ANYTHING that I could possible do to stop this or correct it. I am in a very desperate need for some help.I am a healthy, active, and am told a attractive woman and I run 2 Communictation’s business that demand that I deal with the public & I can’t stand this. I have plenty of hair everywhere else. Please advise me. I will await a reply from you. I am sending some picturs that were taking about 6 months ago…it wasn’t as bad then but it is now.
Thank You

Testosterone is a known cause for female hair loss in women with a genetic predisposition to genetic balding. Testosterone is broken down to DHT, and DHT is the other male hormone that promotes genetic hair loss in those patients. You also sound stressed, and stress in these predisposed people adds to the hair loss problem. I always tell men that there are 4 causes of male pattern loss: (1) genetics, (2) male hormones, (3) stress and (4) time. If you are genetically predisposed, you have then all four of these. The use of DHT blockers may have value, but this medication is not cleared for safety by the FDA for use in women. Effectiveness is still an open issue here. Other causes of hair loss include: crash diets, tight ponytails/braids/weaves/extension (more common in African young girls), thyroid disorders, pregnancy, going on or off birth control and even a surgical procedure of any time which may include a general anesthesia. Get a knowledgeable doctor and talk to him/her about this answer.

Hair Loss 1 Year After Pregnancy

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

I am 32 years old & had my 3rd child 1 year ago, in August. Approximately 4 years ago I was treated for multiple symptoms of malnutrition from losing too much weight too fast. Ridges in my fingernails, major hairloss, hardened areas under the skin on my face & finally an MRI was ordered for an orange sized induration on my hip- it was negative. I got the issue under control & resolved all of these problems. I gained nearly 100lbs with my last child & now a year later my hair has begun to fall out at an alarming rate. I am not dieting & have slowly lost some weight from the pregnancy but in a healthy way. I take no hormones or birth control & I am not on any other meds. I am also in nursing school clinicals which I started 5 days after the baby came. Would I be more likely to suffer hair loss, having a history of it, than I would normally be, related to stress or diet? With it being a little over a year since the birth, I didn’t attribute it to post-baby hairloss, could it be? Thanks for any advice you may have.

You have many variables here which are hard to put together. You clearly recognize that hair loss can occur with pregnancy along with malnutrition. You also recognize that pregnancy hair loss often reverses after a year or sometimes two. I would ask for many tests to rule in or out a series of medical conditions such as thyroid disease, which does start post-pregnancy in some women. The relationship with these hormonal diseases can also cause hair loss, particularly when combined with the genetic predisposition for female genetic hair loss.

Be sure that you are evaluated by a good generalist doctor first, then get your hair graded for miniaturization and patterned hair loss. These may fit together to point or narrow down the possible diagnosis. Start with a good, well-trusted doctor who cares about your overall well being.

ScalpMed

/by William Rassman, M.D./468 /, ,

PLEASE NOTE: I do not sell ScalpMed. I’ve been getting quite a few angry emails from people stating that they feel deceived by this product, that they want their money back, etc — but I have no relationship with ScalpMed’s manufacturers. I can’t help get your money back, nor can I offer much advice about this product. It is not FDA approved and I would not recommend it for that reason alone.

 

Let me begin by letting you know my situation. I am a 22-yr.-old female who has been diagnosed with both AGA and alopecia areata. My dermatologist tried steroid shots in one of the areata spots but they didn’t cause any growth.

That said: this morning I saw an infomercial for a product called “Scalpmed.” I don’t usually give infomercials a second thought, but I thought, what the hey, I’ll ask Dr. Rassman about this one. The product is *supposedly* for women and men, contains the highest FDA-approved dose of minoxidil, and does not cause sexual side effects or dry out the hair or scalp. The website admits that individual results will vary but offers a full refund of the purchase price (less shipping and handling, of course) if one is not satisfied.

Just thought I’d ask if you’ve heard of this, and, more specifically, if you’ve heard of this scorching anyone’s scalp off or anything similar. Don’t worry, I don’t intend to make any rash phone calls :D

It took a bit of research and a call to a consultant for FDA issues to answer this question properly. I could not find Scalp Med or Vitadil in the FDA database. The website says, “These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.” If this product were FDA approved, the FDA would certainly evaluate the labeling for the product. The second statement is part of the FDA definition of a drug. The second part, “Affects the structure or any function of the body of man” is relevant to the use of this product. It is strange that the first part of the website says it is FDA approved while the second part says the FDA has not evaluated the labeling. This is clearly an inconsistency that indicates that you should take what is claimed here suspiciously.

The website says that “Vitadil-5A and Vitadil-2A are FDA-approved formulas for hair growth.” The company may be saying that they used a formula that had been approved for another company. This is possible. However, a company cannot just copy the formula of an FDA approved product. The company must submit an Abbreviated New Drug Application (ANDA) and may be required to do bioequivalence studies before the FDA will approve it for this company. The company also has to meet Good Manufacturing Practices (GMP) as well.

I always end such comments suggesting as a consumer you must ‘BEWARE’ and be your own protector. The government can not always enforce its regulations in a timely manner to protect you.

15 Year Old Female with High Hairline

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

Im fifteen years old with a weird high hairline. It is goes into an ‘n’ shape like my hairline is receding. I’ve been made fun so much and I need to find a surgery quick!

There is never a ‘quick’ answer for a 15 year old. If you are like my daughter was in her teens, yesterday is never soon enough, but if you have a high hairline, it can be treated (see previous blog answer on this subject in High Hairlines in Women). If you bring your parents in to a competent plastic surgeon’s office or a hair specialist like me, we can discuss what can and should be done to deal with your concerns. At the same time, a specialist’s opinion is valuable in itself.

Am I a Female Hair Transplant Candidate?

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

I have MPB running rampant in my family. I am a 42 yr old female who is experiencing diffuse shedding mostly in the summer months. It seems to let up after that. I have noticed an overall change in texture from when I was in my 20’s & 30’s and also it’s not as thick (# of hairs total) by maybe 25% or so.

I heard females weren’t as good of candidates as men since the thinning is diffuse therefore hair taken from a donor site might also thin eventually. That said, what female would be a good candidate for transplantation if any? I’m not a supporter of any drug. Your comments & info?

Humans as a general rule, have asynchronous hair loss (not tied to seasonality) but that rule could vary for you. Hair transplants in women should be confined to women who have a healthy donor area (enough to supply the need), localized hair thinning or loss, or those that have hair loss from other causes such as traction alopecia (common in black women who had their hair pulled very tight when they were children), hair loss from cosmetic surgery, etc…

You need to have a doctor who is ethical and can judge the value of a hair transplant for you. I generally do not recommend hair transplants for about 80% of women because they do not fulfill the above criteria. What is important to me is that if I recommend a transplant, then I would want the patient to be happy and meet realistic expectations. It is the doctor’s responsibility to set those expectations properly.