Dr Rassman,
I suffer from Trigeminal Neuralgia (all 3 divisions), as well as Occipital Neuralgia following an accident and subsequent surgery. I have been experiencing burning, stabbing and lancinating pains all over my entire scalp for the past 5 years, and my scalp is continually painful and tender to the touch.

The pain has been intense and my hair has been falling out for the past 4 years, virtually gone on the top, and thin on the sides and bace almost like diffuse hair loss of the entire scalp. In your opinion would the hair loss be as a result of Trigeminal and Occipital neuralgia? It is causing me much distress as there seems no end to the pain and hair loss continuation.

Since I suffer from severe neuralgia I would be extremely grateful for any advice about my hair loss and what could be done to ameliorate it, considering my medical condition. I am 34 years old and male.

There is no direct connection between hair loss and your condition. This is a rare and quite painful disease, and I would expect that hair loss would be worsened with the stress of your intense pain. Stress can accelerate genetic hair loss, so first I would get a diagnosis as to what is the cause of your hair loss and if it is genetic patterned hair loss, then I would certainly go on finasteride daily to slow, stop, and possibly reverse the hair loss. Talk with your doctor about this, as it is a prescription medication.

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