Florida Hair Doctor Recommendation?

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

I am menopausable, early sixites, and experiencing extreme hair loss. My once thick, course hair is now fine, thin and receding. Many dermatologist in the area do not consult on hair loss. Can you recommend someone in Jacksonville Florida who specialized in women’s hair loss? Thank you

The ISHRS (International Society of Hair Restoration Surgery) membership shows two doctors who are members of the society. I would look to this society as those who are members have focused heavily on the learning process made available through them. Marina Pizarro, 904-246-2024, may be worth interviewing as she has a website at hairloss.md which will give you some information on her background.

Is Weight The Cause of My Hair Loss?

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

I am 21 years old girl. My hair were extremly good, thick, heavy two years back. My friends used to make fun of me that I used to wear a wig. Then I had two operations (teeth and rhinoplasty). For one year nothing happened but then my hair started falling. I had a haircut and it made my hair look better. But even then my hair continued falling and is still falling out.

I have one more problem, I am underweight. My height is 5 ‘7 ” and my weight is 47 kgs (104 lbs). I eat potatoes etc but dont put on weight. Is this the cause of hair loss? My hair is exposed to the sun for most of day because I am an university student. But I am sure its not the reason because I know many people who work in sun but dont affected. Please help me for that. Can you please give me advice that I can make up at home. I dont wanna go to parlours at this age. Plus please mail me the solution preferebly

It sounds to me that you might have either a medical condition (disease) causing the hair loss and possibly the low weight as well, or a dietary/eating disorder. You need a good doctor to evaluate your overall health. Malnutrition, although rare in the United States, is seen with Bulimia. In foreign countries where adequate vitamins and nutrition are problems, hair loss is seen with some frequency. You need to get a good doctor and get to the root of your problem.

Bald Spots in African American Women

/by William Rassman, M.D./18 /, ,

I and my daughter have severe bald spots. My other daughter has a bald spot also. Not as severe as ours. My daughter is devasted. I think she can be saved from what I am experiencing. I personally feel that there is something in our system. No other family members have this disorder. We have been unsuccessful in locating a doctor who is familiar with Black Hair care or disorders. Can you help us. I now wear a wig. My daughters do various things from sew-ins to wigs. If you provide address I will mail pictures. Thank you.

If there are spots of hair loss in you and your daughters, you should start off by seeing a dermatologist. There are genetic conditions that fit the description of what you are talking about. Please see a good dermatologist.

Female Hair Loss and Stress

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

I am a 52 year old female. My hair has been thinning since the age of about 35. For the past year I have been using cold laser at a medical facility in Oakbrook, Illinois. My hair seems to be getting worse. I am in the process of adjusting my thyroid medication. I have low thyroid and was taking .05. Now I am trying .75 for the past week. I was also diagnosed anemic in may of 2005, and am now taking a vitamin plus iron supplement. I recently went through a very stressful family situation. Do you feel these are reasons for the further hair loss despite the action I have taken. Also, Do you have offices in Chicago where I could get a blood workup by physicians that understand hair loss in women. My doctors just seem to sluff it off. I would appreciate any suggestions you can give me.

Most of the conditions you outlined are known to cause hair loss. Add to that, genetic factors which have been present since your 30’s and you are a set-up for worsening of the hair loss. Clearly, you must get on top of the medical problems you are experiencing. The hair loss is a combination of both medical and genetic causes and there is no guarantee that it will reverse, but women often get some reversal of hair loss when the medical (disease) causes of hair loss are brought under control. A good doctor is critical to treating your process. Start off with a caring family doctor.

Eyebrow Transplants, Revisited

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

Here’s two more eyebrow transplant-related emails I’ve received…

In 2002 I cut my eye brows off. But they grew back very thin some parts did even grow back, like the ends. Only the inner part would grow but not so thick. Anyway to date they are not growing at all. My hair line has also thinned out about an inch. I do not know what is going on but I am tired of drawing it on. Please help.

Eyebrows can be successfully transplanted, if the eyebrows you had have not returned after a couple of years. The eyebrow hair is taken from the scalp hair, and as such will have to be trimmed about three times a week and cut on an angle for hair shape. I posted a blog entry recently about this: Eyebrow Transplants. You need to be evaluated for the hairline loss. Read my responses addressing female hair loss, as they do apply to you.

I am considering eyebrow hair transplantation and I have many questions. Does having permanent makeup interfere with the procedure? Should it be removed first or will it cause scarring to the follicle? Also, does the transplant have to follow the original eyebrow hairline or will it grow in any follicle (if I wanted it slightly raised for a more youthful appearance for instance)? Do eyebrow transplants yield a high success rate? I noticed you listed some special summer prices but they were specified for the strip method. What is the cost for the FOX method. Finally, I live near Riverside Ca, zip code 92313, is there an office near me?

Permanent makeup is cosmetic tattooing and is permanent by its nature. It will not impact an eyebrow hair transplant. You should be evaluated first, before any surgery is considered. Eyebrows can be angled for more lift, but it is difficult to angle them for less lift. The success of eyebrow transplants are high. NHI’s summer fees have been reduced by 10% but the FUE approach has not been discounted and still is priced at about twice the price per hair/graft as a traditional strip method of transplantation. Our closest office to you would be in the Beverly Hills area.

Itchy Scalp

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

I am a 27 year old African American woman. A few months ago I saw some bald spots in the middle of my head. I thought it was the wigs and hair weave I used to wear, but later on the bald spots started to spread down to the front of my hair line. When my hair itches I used to bang my head with my hand so that I could stop the iching. I don’t know what to do with this situation. I want to cut my hair off and start all over re-growing my hair. What do you think is best for me to do?

If you have not yet seen a physician, I suggest that you get a thorough examination to rule out any underlying medical conditions, which could be causing the balding. The physician would also be able to determine how best to treat the itching.

Female Hair Thinning

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

Hello sir,
I am an Asian female and I am 24 years old.About 3 years ago, I noticed that my hair had started thinning. That was a period of time when I was under a lot of stress and used to hav a bad diet as well. So I thougt that was the reason for my hairloss and also thought it would come back in time. I have lost hair mostly from the front region of my head.But am not loosing much hair now.My hairloss kind of reduced on its own about few months ago and I also see few hair coming.

So does that mean that I am gonna get back my lost hair? Was the damage irreparable? Should I take treatement?

My mom had lost a lot of hair at a young age,my dad is 60 years old ,but still not bald. Could you please let me know more about my hairloss and whether it will come bacK or not.I would be extremely grateful sir.I am undergoing a lot of pain because of my hair.

You are not alone. Since I started this blog, I have gotten quite a few questions from women about their hair loss problems. Here is a link to the similar questions and answers. The first thing you need to do is to see a physician who can examine you and order tests to make sure that there are no underlying medical reasons for your hair loss. Some of the reasons for female hair loss are: anemia, thyroid disease, connective tissue disease, and various gynecological conditions. These laboratory tests may be useful if underlying medical problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

If it is determined that there are no medical reasons for your hair loss, I would suggest that you visit a hair loss specialist. Since you are in New Jersey, I can highly recommend Dr. Robert Bernstein in Fort Lee- his phone number is 866-576-2400.

Menopausal Female Hair Loss

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

I am a 47 year old female, who has had thick, coarse hair all of my life. Last year, I had a few hot flashes, my gyn gave me some estradiol to take……..I felt better, discontinued it. *this was in April…I took it for a few months. I had a surgery in August…general anesthestic. In December my friend mentioned my hair looked thin. I got some Rogaine…..used for one month until my hair was falling out by the tons and I had noticable thinning in my temples/hairline. Hair looked much, much worse. Stopped using it Jan 21. Gyn gave me estradiol Feb 21st.,,after I saw him complaining of hair loss….he said I was periomenapausal. My hair shed slowed until two weeks ago and is now shedding again. I still have very thin hair in the bang area/temples….you can see my scalp in the sun or bright light. Blood work showed normal levels in all tests. I do have lots of new hair that can be seen over the back of my head…but I don’t see anything in my bang area. I am suffering anxiety and worrying constantly…which I know doesn’t help. How long does it take for hair to get back to normal if it is going to? Am I expecting results too soon? Have you ever heard of Rogaine making the problem worse and does it make it permanently worse?
I would like to consider a hair transplant if it can give me some density back. I am taking vitamins/EFA supplements….don’t smoke, ….also interestingly my once coarse hair is now soft/finer feeling which seems wierd.
thanks for any insight, help.

Your email sounds desperate and you need to be sure that there is no underlying medical condition causing your problem. Assuming that you fully check out (see female hair loss Q&A), then it sounds like much of your process is reversing. The reversal time should be less than a year. You should be evaluated by a doctor like me, who can determine your base line today, the full extent of your miniaturization and then follow your progress. A transplant can solve the ‘bang’ problem, but first let’s clear you of a medical problem.

Alopecia Conditions

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

Barring any sort of glaring injury like a burn, how easy is it for a dermatologist to tell if someone has scarring alopecia and their hair follicles have been permanently damaged?

I’m a female in my twenties and have had scalp dermatitis for several years. I tend to scratch it pretty badly in my sleep, resulting in small open spots that then scab over. Just within the last five months or so, I have developed bald patches as well as diffuse hair loss. There are other things it could be, but is scarring alopecia a possibility? Also, could the hair loss be from the dermatitis itself?

The best way to determine which alopecia condition you have, is to get a dermatologist with considerable experience in diagnosing the various alopecias to give you an opinion. You may then need to get a biopsy of the area of alopecia and get a dermatopathologist to read the biopsy if there is any doubt on cause. Most good dermatologists do this in tandem, although your history seems to suggest that your constant scratching has produced traction alopecia with possibly some scarring. Sometimes, the alopecia will reverse (Alopecia Areata for example) if you completely stop scratching it.

Clearly, the picking of your hair at night can produce trichotelomania, which is a condition where constant picking or scratching causes hair loss. The diagnosis is always clear on microscopic examination of the scalp. If it only happens in your sleep, put on mittens and sleep with them on. Get a good doctor to examine you before you startsleeping with the mittens and after a few months. If the mittens works, then the changes that we can see under magnification will demonstrate that you are on the right path. Ordinary dermatitis without picking or scratching should not cause hair loss, unless is is associated with the genetic forms of hair loss.

Female Hair Loss and Chest Pain

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

I am a 33 year old female who visited a dermatologist that specializes in hair loss because of a receding hair line, (frontal hairline thinning). Very much the same why men start receding in the front. I was diagnosed with female patterned baldness and told to take Rogaine. In the past I was told the 2% was not very effective to use the 5% but the nurse has informed me to use the 2% and it will take up to 12 months to see any results. I have used the 5% in the past and have not had any side affects though I am not completely happy with the results. Is there any other medications or options I can take other then the Rogaine? I am feeling a tightness in my chest and shortness of breath which I think is from using Rogaine, but I am not 100% sure. I have had blood work done and everything has come up normal. I take no medications other then the Rogaine. It is just so frustrating to be told to use Rogaine when there has been so many medical advancements for men.

Bells go off for me when I hear about tightness in the chest. Women with heart disease is far more common than most people realize. You must remember that Rogaine is a hypotensive medication and could induce (under certain conditions) a drop in blood pressure and chest pain from Angina. Please, see a good doctor. If you want an opinion on what to do about hair loss, please take a read through the many Female Hair Loss posts on this blog. If you are on the west coast, please come and see us.

Hair Loss in Autistic Female

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

I have an autistic 17 year old female whose normally thick and healthy hair is now thinning. I know her diet is not the best secondary to autism but she gets ample amounts of protein and loves all vegetables. There are no medidcations involved and no diet changes or home stress issues that I can pinpoint. She is not verbal so questioning her is not an option. Could you lead me to a resource for information or suggestions. Thank you for your time.

I have not read any research that indicates a higher instance of hair loss in autistic teens or adults. However, I would think that autistic people have a higher level of emotional stress, which is one of the ‘big four’ causes of hair loss. You should have a good doctor examine her and look for one of the many medical causes of hair loss. The following problems are among those that should be considered: anemia, thyroid disease, connective tissue disease, and various gynecological conditions. These laboratory tests may be useful if underlying medical problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone. Many medications, including vitamins and over the counter drugs, can also contribute to hair loss.

Genetic causes of hair loss in a 17 year old female, is unusual. Look to the family and see if anyone had such a problem at that age or if there is female genetic hair loss in any of the women in your family. It is more likely that a medical condition, rather than genes, may be the cause of the hair loss.

African American Female, Age 52

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

I am an African American female age 52. I have very long sister locks and they are beautiful. trouble is, I had a hysterectomy last summer and noticed that my hair is balding on the sides. I went to a dermatologist who said it was my locks pulling, but I clearly had to get him straight and tell him that I never had braids in that spot, only a hair line that never was long enough to incorporate into the dreads. I am a professional person and am always in the public eye. I am now wearing scarves to cover the sides. I would like to know what I can do. I did notice that before I had surgery, my scalp was itching badly on the sides and the hair at the follicle became crusty at the base, as if it was dead. Any help would be appreciated

You should be seen by an expert. With a good history like yours, I would worry about a series of localized skin conditions that should be ruled out by a good dermatologist. As you are convinced (and have convinced me) that this is not traction alopecia, then a transplant might be a good solution provided that your dermatologist has determined that there are no skin conditions that would kill off the transplants. Transplants are undetectable in most African American hair types.

Two Young Women with Hair Loss

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

I receive many questions each day, and because these two are both from young women with hair loss questions, I am posting both questions in this one entry.

I am 21 year old girl. Till now i didnt hav any hair problems . But for the past 4 to > 5 months i am losing my hair like anything. My hairline is gettin broader andn is gettin thin these days.Neither of my parents hav balding problems nor anyone in our whole family.Wat should i do so that i can get my lost hair back? Is this possible to get all the lost hair ?? Which shampoo shd i use?

I would first have a good doctor see you and look for medical causes of hair loss (there are many). The following problems are amongst those that should be considered: anemia, thyroid disease, connective tissue disease, various gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone. Many other medications can also contribute to hair loss so if you are taking any drugs of any type, then that should be looked into as well. The following laboratory tests may be useful if underlying problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

It is possible that a medical condition may be the cause of your hair loss, so before you jump to conclusions that you have genetic hair loss, I would have you checked out for these conditions. The shampoo you choose will have no impact on the hair loss so I always tell people to use what they like, what feels good, what smells good and what makes your hair look good. Also, please read my previous blog entries on Female Hair Loss.

I am a 22-yr.-old female and am experiencing thinning hair all over my scalp, with several spots void of any hair. Possibly related elements of my history include irregular periods, dermatitis and eczema (both on-scalp and elsewhere), a family history of thyroid disease, an often-unbalanced diet due to graduate school lifestyle :-), recent emotional stress, and use of 0.1% Tacrolimus ointment (one potential side effect of which is alopecia). I know you cannot diagnose me sight unseen, but I have one question I hope you can answer:

If one’s hair loss is related to use of a medication, stress, or a dietary deficiency, is the hair loss usually only temporary if the behaviors causing it are stopped?

Thank you very much for your time.

Sometimes the hair loss is temporary and sometimes not. The key is quick and accurate diagnosis and taking the proper action to go after the cause of the hair loss. The outline given to the first question above is appropriate for your medical work-up as well. If there is a genetic component, then the hair loss may be additive to the other contributing factors.

Bioidentical Hormones in Women

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

I started using bioidentical hormones in September of 2004. I started noticing hair loss and did some research and found that DHEA and Testosterone can result in hair loss. I removed these but my hair is still not growning back. I am currently taking progesterone and biest in cream form. I tried taking Selenium and thyrostin and that didn’t help either. I am at a loss of what to do, can you help me. I am devastated about this hair loss.

Bioidentical hormone replacement therapy includes such compounds as progesterone, estrogen, estriol, estradiol, testosterone, dhea, etc. I would assume from your question that you are post-menopausal. If that is correct and you have the genetic form of female hair loss without any medical cause, then it is highly likely that the trigger for the process has been ‘pulled’. Like a bullet from a gun, once the trigger is pulled, you can not call the bullet back. You need a thorough examination with a doctor skilled in quantifying miniaturization and the distribution of miniaturized hairs. Also, you will have to be evaluated with your complaint clearly outlined and understood. With that information, there might be some hope in the transplant arena, limited by the supply quality and quantity, and the size of the areas of need. You also need a good endocrinologist or gynecologist to ascertain hormone balances. I fully appreciate the traumatic impact of hair loss on women, but there is much I do not know about your unique situation. There is no substitute for a good doctor / patient relationship as a starting point. Find a good doctor and establish a trusting relationship with him/her.

Hair Loss From Brow Lift

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

I had a brow lift and and a face lift. I lost a great deal of hair in the few months after the procedure. It is now 1 year since the surgery and I have had no return of the lost hair, and I have a very weakly defined hairline. The scar shows unless I comb my hair down in bangs. I would like wear my hair pulled back and show off the new younger me, as my face lift was very successful. Can you fix this?

Hair loss is a known complication of brow lifts and face lifts. The brow lift may accelerate the aging process with thinning of the hair in front of the scar in those genetically at risk. The skin in front of the ears can be removed in a face lift, wiping out sideburns (more common in the 2nd and 3rd face lift than the first).

Hair transplants are the ideal solution for this problem. This is the most common hair restoration process I perform in women. As men do not have face lift procedures as often, I do not see as many men as women with this problem. But the same complication is still there if there is a brow lift and / or a face lift. It can be done in one procedure in most people, but it takes a great deal of transplanted grafts densly packed to get the results in a single session.