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Dear Dr Rassman:

I’m a 27 year old who has long suffered from Fibrous Dysplasia (I’m not sure if you are familiar with this disease). Due to my ailment, I have incurred over 30 medical surgeries over my lifetime. My hair was thick up untl high school, and then it really began to thin. The only ancestors of mine that have been bald were only two of my great-grandfathers. I was wondering if all of the major surgery I have had would have caused my hair loss. Also, I have been on propecia since November of last year and am having some back surgery next week. Would the shock of surgery or the medications used cause my hair loss to increase? Also, because I may be missing a couple of days of propecia doses would this affect the progress of the drug in combating my hair loss?

I’m familiar with fibrous dysplasia (it is a very rare bone disease), but I do not know what surgery you have had or what medications you take. Your question is very general and it is not something I can give you an answer to in this format. You need to see a physician and have a complete history and examination.

In most cases, hair loss in men is caused by genetics. If you have an autoimmune disease like a form of a scarring alopecia, surgery done in these conditions can be dangerous and produce failures of the grafts and further scarring of the scalp. Any medical illness or surgery that is a stress to your body can cause hair loss (sometimes permanent). But to distinguish that from genetic causes is something that only a thorough examination with a physician can provide. You are looking for a cause and effect type of relationship and I really cannot help you with the limited information I have.

Snippet from the press release:

“Up to 85 per cent of people with SLE develop skin involvement at some point,” explains Dr. Pineau. “Our study shows that the risk of skin damage such as permanent hair loss and scarring from skin inflammation is significantly increased in smokers. So is the rate of active lupus rash.”

Read the full text: Smokers With Common Autoimmune Disorder At Higher Risk For Skin Damage

The information comes from a study published in the Journal of Rheumatology, and “has clearly linked skin damage and rashes to smoking in people with systemic lupus erythematosus (SLE).” The great majority of those with SLE are women, and could be something else doctors consider when looking into a cause for female hair loss.

I have had the strangest hair loss from about the age of 15 or 16. I am now 18 going on 19. There was hairloss on the crown which I thought was MPB but over the last 2 or 3 years I have had small but noticable regrowth at times which is uncommon with MPB as I took no minoxidil or propecia. One doctor told me I had folliculitis decalvans after some examination but I have read that this occurs after adolesence into adult hood where as my hairloss has been around since I was about 15 so I don’t know if this could be true. Also I have no pain, swelling or crusting often associated with the disease just some itching on and off or maybe a button or pustule on a rare ocassion. Please help.

If your hair is regrowing and you’re experiencing no pain and no crusting, how can I help? Let it grow! This is a good thing!

If you are not comfortable with what you were told about folliculitis decalvans, get a second opinion. It is a rare condition that is generally seen in adults, but it could occur in young men at your age.

Hi:
I was on Propecia for roughly six years between 2000 through 2006. I had decent results, kept the hair on the top of the head, however the temples were receeding a bit. The hairline in the front was thin as well. In 2007 I was diagnosed with stage 1 testicular cancer. It was localized to my left testicle and I was lucky to catch it early as it did not spread anywhere else. I had surgery to remove the affected testicle and undergo preventive tests on a quarterly basis.

My questions are: Could the cancer be caused by the Propecia? I would like to start taking the Propecia again to re-gain what I lost as I am starting to get the dredded “hair ring” around the head. I am 38 and was wondering about fertility since I only have one “factory” left?

Thanks!!

I would ask this question to your oncologist. I highly doubt testicular cancer is caused by Propecia. There are many men who get testicular cancer who are not on Propecia. Most of the time you cannot establish a causal relationship.

With respect to your fertility, I am not the doctor to ask this question to (as I am not a fertility doctor).

Snippet from the article:

In the early ’80s, Robin Kettlewell had a thing for punk rock and a haircut that showed it: purple, with three stripes shaved into one side of her head.

So when she faced losing her hair during chemotherapy for breast cancer this summer, she knew what to do. First she had her long golden brown hair cut off for Locks of Love. That soon became a brush cut that she dyed pink. A few days later, that turned into a pink Mohawk.

Now though, 11 weeks into chemotherapy, she goes proudly and completely bald. Shopping. At restaurants. In her Saturn Sky convertible. But when riding on either of her two Harley-Davidson motorcycles, she always wears a helmet - always. She’s not going to do anything stupid, after all.

Read the full article: Breast cancer patient faces the disease “head first and no looking back”

Robin is taking back control of her life and is showing the world that even cancer can’t keep her down. She’s able to spread breast cancer awareness by being so brave. Check out the blog Robin created to share her journey.

We wish her the best of luck!

Hi,
I have celieac disease and I (unknowingly) used a hair color product that contained wheat. It blistered my scalp and my hair fell out. it has been about two months and very fine peach fuzz hair is growing in the spots but its very thin. will my hair ever grow back in the right texture and density? Female, 45

I know, as I’m sure you do, that those with celiac disease shouldn’t have foods, beverages, or medications that contain wheat, barley, rye, and oats. What I do not know, however, is how the disease impacts hair loss after using hair dye with wheat in it. I would assume your hair should grow back, but it would take many months, possibly up to a year to find out. This doesn’t seem like it would be a permanent loss, but you should be followed by a good doctor that can provide you with an examination (perhaps even the doctor you’re already seeing for your celiac disease).

Dear Dr. Rassman,
I’m a 55 year old male in good health with the exception of being a type 1 diabetic. I have been using propecia and rogaine for 10 years with very good results and have maintained almost all of what I started with.

Here’s my question. My hair is thin at the nape of my neck. I can pull on it and 5 or 10 hairs will come out each time. I don’t think I have DUPA because I cannot see any change in my crown,vertex or hairline. I have read on your site that this type of loss is genetic. I know you prefer not to diagnose online but could the diabetes have anything to do with it? my A1c is 7.5 to 8.0 which I know is an the high side - Thanks

I doubt that the diabetes is causing your neck hair loss. I have seen men over the years (in airports, on the streets, in shopping centers, etc) who have lost just their neck hair and not their scalp hair, so I believe that this is a genetic trait in these men. I suspect that the number of hair cycles your neck hair has is limited and those hairs develop apoptosis (meaning that they have reached the end of their lifetime); if this is the case, there’s not much you can do. Perhaps applying minoxidil to the area will cause new hair growth? Also, I agree with you — it doesn’t sound like it is DUPA if it is limited to the nape.

(female) i have bulimia, i used to smoke weed and be very depressed. during that time, i had a v8 moment and suddenly realized my hair was soo much thinner than it used to be. i looked around and realized both of my older sisters, have extremly thin hair, balding hair i guess could describe it more. they have been smoking for tens of years, i have stopped, unfortuantely i have picked up another habit. i guess i want to know what everyone else here wants to know, will or could it grow back? also, i am only 15, im still growing, is there hope?

I would have to see you and understand what you are actually referring to as thinning. I would map out your scalp for miniaturization, perform a hair pull test, and then render an opinion. Obviously without seeing you, I can not really understand what your situation is and where you are in this cycle.

Bulimics often have hair loss from stress and unhealthy weight loss, so I would like to know more about your overall nutrition. I wouldn’t rule out that your hair could regrow at some point, but I doubt it will until you get your eating disorder under control. Hopefully it is a temporary telogen effluvium, but I have no way to know that over the web and without some more medical history.

I am recently diagnosed with ckd (kidney disease) stage 2 (mild one). i was on topical minoxidil for almost 4 years but i stopped after my knowing about my ckd. is it possible that minoxidil cause ckd within this 4 years? And can i use minoxidil 5% again or it is dangerous for progression of my kidney problem ?? does minoxidil worsen kidney problems?? I also take propecia for almost 2 years.

A precaution in the literature for minoxidil states, “Tell your doctor your medical history, especially of: heart problems, kidney problems, liver problems, other scalp conditions, allergies (especially drug allergies).” This is a question you need to discuss with the doctor treating your kidney disease.

Minoxidil is an antihypertensive medication, which means it can reduce your blood pressure when given orally or when absorbed through your skin in substantial doses. Generally, lowering high blood pressure helps to prevent kidney problems, but that connection between blood pressure and kidney function is what you need to discuss with your doctor.

Snippet from the article:

Like any 12-year-old getting ready for her first school disco, Aimee Blinkhorn wanted her hair to look perfect. But as her mother put it up into pretty curls, she noticed a small bald patch at the back of her daughter’s head, about the size of a 50p piece.

‘Neither of us was particularly alarmed,’ says Aimee, now 26 and living in Manchester. ‘I just presumed some hair had come out when I pulled out a hair tie.’

But over the next few months, more bald patches appeared. Soon there were six of them - and twice the size of the first.

Read the full article at UK’s Daily Mail.

This is a great story about a courageous young woman that has been living with alopecia universalis. I applaud her for bringing her story to the public, and I hope she inspires others with this condition. If you want to know more about the disease, please see the National Alopecia Areata Foundation.