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Hello Doctor

I know many people with hair loss that use ketoconazole 2% shampoo times a week, thinking it fights seb derm. Others use salycylic acid shampoos 4 - 5 times a week thinking it thickens the hair shaft

My question is: Could overusing active medicated shampoos for long periods, contrary to official recommendations lead to permanent hair loss?

Thank you

I don’t think shampoos will cause permanent hair loss per se, but you should not be using medications of any sort in ways they are not prescribed or recommended.

Ketoconazole shampoo (also known as Nizoral, among other names) does work in treating seborrhoeic dermatitis, but you should follow your doctor’s recommendation for dosing.

Used Propecia 6+ yrs ago and still experiencing the sexual side effects… From loss of libido, shrinkage in penis and testicles, wrinkled skin, crazy amount of numbness, loss of sensitivity, pre-mature ejac., ALL started with use of Propecia (used for 3 mos.) and over 6 years later, I almost feel like the side effects are getting worse and I haven’t touched the stuff since then. I sometimes feel like I want to smash my penis with a hammer just to feel something down there.

Also some random stumbling over words and thoughts but not sure if that is tied to it.

This has pretty much ruined 2 very important relationships and has made me a very depressed human being. Is there any way to fix this?

If you have thoughts of hammering your penis and you are depressed to the degree you describe, I would strongly recommend that you see doctor or a psychiatrist. There is help.

Hi,

I’m a 22 year old male, for the last 6-7 years I have been losing a lot of hair per day. For example, when I go in the bath it’s absolutely filled with hair 400-600+ strands when I get out, same in the bed every morning. It’s much more than the “50-150″ people estimate as normal loss.

I’ve always had a receded hairline but overall it doesn’t look any thinner or more receded than it did when I was a child (even pictures when I was 6-7 it looks the same as it does now). My hair started greying when I was 12 and I’ve been dying it every few months for the last 9 years.

Once hair loss speeds up to a rate I’ve been experiencing is it likely to ever slow down again, either naturally by itself or any medication? It’s rather embarrassing staying over at somebodies house and waking up with their bed covered in my hair. I’ve been to a dermatologist twice, the only advice they offered was to stop dying my hair for a year (which I did and it made no difference) and that they wouldn’t recommend I take propecia. Any advice would be appreciated, thanks in advance.

I can’t give you any advice, because I do not know what is going on with your hair loss. You need a good physical examination and a diagnosis. Miniaturization studies and bulk measurements at different areas around your scalp may shed some light.

You’ve already been under the treatment of a physician, so I’m not sure what I could offer. Why wouldn’t your doctor recommend Propecia? If you’re a young man with hair loss, Propecia might be your best shot. With respect to greying, I do not believe it has any association with hair loss.

You can not lose 400-600 hairs per day without becoming bald quickly. Just do the math. The average man has 100,000 hairs on the scalp… so that means that you would lose every hair on your head in 167 days if you have an average hair density.

I have had in the past scalp reduction and hair transplants which has left me severely scarred and with and unnatural look. It has also caused my hair to start falling out and thinning rapidly as I am now 51. My scalp is often irritable, hot and prickly.

My life is more than ruined as I am in a senior management role and frequently have to deal with people who are too embarrassed to look at me. I am at the point where I may have to leave a company that I helped build and find a job where I can wear a hat. My last chance would be to disguise the scars and create throughout my scalp and cut my hair shorter with perhaps your method of SMP?

Could you please be discreet when returning my email as this is my work computer, although nobody actually uses it, however you never know. I hope that you can restore some normality back to my life!!

In general terms, Scalp MicroPigmentation (SMP) is a great method to disguise scarring from previous surgeries on the scalp, but you would need to keep your hair shaved. Another option would be a hair transplant to disguise the scars.

A consultation would be best at this point so we can see what you’re dealing with and come up with some treatment options. If you would like a consultation please contact us at (800) NEW-HAIR or use our consult form.

Hi Dr Rassman.

I would like to know if a hair transplant can be done on a balding area previosly treated for aktinic keratosis.

Thanks!

Actinic keratosis is a precancerous growth on the skin caused by sun exposure. A hair transplant to the scarred area where the actinic keratosis is removed may work. Hairs transplanted to the scar in general do not grow as well, so you may need another touch up. You must also consider being more vigilant on the area when the hairs are transplanted.

Worried about “shiny” scalp.

I have very very fine, wispy dirty blonde hair. However, in the sunlight, very often when I walk past a window I feel like I see so much scalp. I have an intact frontal hairline with a low-dipping widow’s peak and lose next to no hair in my brush or in the shower. The distribution of hair *feels* the same all over.

Does this just sound like paranoia? (I won’t go into the genetics question as that’s impossible to answer).

Yes, it sounds like paranoia. Many thin haired blonds have a see-through appearance where almost anyone can see their scalp in bright sunlight… especially if your hair is wet or is very fine and wispy as you describe.

We’re taking a long weekend to celebrate Independence Day. We hope everyone has a happy and safe July 4th!

Happy birthday, USA! We’ll be back here tomorrow.

My question is in regards to my daughter. I have an 11 year old daughter who about 3 weeks ago started experiencing hair loss (none before then). She’s always had a full head of hair, but now I can feel the difference.

I noticed her hair started falling out after I brought her in for her physical. She was given two immunization Tdap and Menactra. Could hair loss be a side effect to any of these immunizations? I brought her back this week and her doctor ran additional blood tests, which he said came back normal. I asked for a referral to see a dermatologist because I’m concerned with the hair loss. Can you shed some light on this problem or can you advise as to what I should be asking the dermatologist when we see him?

Thank you for your help.

I doubt immunization caused her hair loss. Menactra is a meningitis vaccine and Tdap is tetanus, diphtheria and pertussis vaccines. I am unable to find any cases referenced that mention hair loss from those.

While vaccines in general don’t cause hair loss, there’s a small study published in 1997 that links temporary hair loss and the hepatitis B vaccine in very rare cases, though most children in the world receive standard immunizations and they do fine. I realize the topic of immunization in children has been in the media in recent years due to a report connecting those shots as a cause of autism, but that turned out to be false.

With respect to your daughter’s hair loss, I really cannot say. I would defer to the doctor who will be examining her. Sometimes hair shedding may be just temporary and you may be overreacting.

Hi Doctor,
I’m 22 yo man and I have a weird experience from dutasteride and wanna know your opinion about this. After a month of daily use of 0.5mg dutasteride my hairs started to shed very fast! and it continued for at least 3 months. now shedding became slower but it’s not halted or regrown! also I think my hairs become a bit slacker and thinner! I think (just think) I have some new growth, little hairs on my hands. I have no decreased or increased in libido or any sexual side effects.

after 4 months on the drug I took a blood test that showed my T=430ng/dl and FreeT=14pg/ml but LH was low and it was 0.91(from 1.1-7).

So doc, what does these results means? If I become hyperandrogenic so why T and FreeT are normal and LH is too Low. and if I have hypogonadism why my hairs sheds and body growth some new?

I cannot interpret your laboratory test results for you. This is something you need to discuss with your doctor that is treating you. It isn’t because I do not want to interpret the test results, but rather I do not know how to correlate the values with what you are experiencing. More importantly, I would want to know what the values were BEFORE you started taking dutasteride.

I do not recommend dutasteride to treat androgenic alopecia and I do not know what the correlation it has with rapid hair loss. This may be a temporary shedding which would reverse in 2-3 months.

Hi Dr. Rassman,

I am 24 years old and in May 2006 i fell off from the 2nd floor. I managed to hit my head on the 5 inch water pipe on the 1st floor and then fell directly on my head on the ground floor. I had a skull fracture and multiple fractures on the plate below the skull. I was operated 3 times and the surgeon gave a cut 2mm above the hairline just above my forehead. Now there is a 6-7 inches scar where people say the hair follicles are dead and you will never get a hair growth in that area.

Dr. please help me and provide me with a solution that can cause hair growth in that area. I oil my hair on a regular basis and also apply dry coconut but I see no results.

Hair loss from neurosurgery or a craniotomy can be easily addressed with a hair transplant directly on to the scar. We have many patients in your situation. Generally you will need more than one surgery to adequately cover your scar, but this mainly depends on how short you keep your hair. See here for more.

Dry coconut won’t regrow hair, but I’m sure your scalp will smell nice.