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Category Archive for Diseases


PCOS, Hair Dye, and Hair Loss

I am a female that was just diagnosed with PCOS. I would like to know if there is anything I can do to prevent hair loss in the future with my condition? Thank you

I also have a question about bleaching/dyeing. I have dyed my hair a total of 20 times (at 27 years old). I have a sensitive scalp and stopped dyeing my hair because I don’t want anything on my scalp. However, last time I got my hair highlighted, they put a color solution on my scalp. My scalp is extremely sensitive and became red and itchy after 2 minutes of this solution and I made them wash it out. Could that have caused permanent follicle damage, especially in light of my condition?

Thank you

Polycystic ovary syndrome (PCOS) often produces more androgens and can cause hair loss as a result of these hormones. For a young women, Propecia (finasteride) in contra-indicated because if pregnancy should occur while on this drug, the hormone impact on the fetus will impact the sexual development of the fetus. With this in mind, doctors may make an exception in the use of this drug in a young woman; however, such a patient must not get pregnant. For this reason, I would not prescribe finasteride in a young women.

Dying of the hair should be done by professionals who know how to test for allergies. There is a high degree of allergies with the dyes used, so what you may be experiencing are such allergies.

With regard to damage to the hair follicles, I would have to know much more than what you told here and examine you as well. Get an appointment with your doctor and ask him/her about hair damage.


Should I Not Take Finasteride If I Have a Long Family History of Cancer?

Dear Dr. Rassman,

My doctor has recommended Finasteride for my hair loss (28, Male, NW 2-3-ish, rapidly receding hairline and rampant loss). However, I recently learnt that finasteride causes breast cancer and very aggressive forms of prostate cancer which are typically beyond treatment, and various other forms of cancer.

Moreover, this is my central cause of worry: Many members of my family have expired due to cancer. My maternal grandmother, my mother’s twin sister, and my father (hodgkin’s disease). In my case, does Finasteride increase the likelihood of me developing some form of cancer? Or am I no different from regular candidates whose family history isn’t markedly carcinogenic like mine?

I understand that you are in no position to provide any subjective information pertaining to my particular case, without having see or diagnosed me, so please treat this as a general question.

In your experience, do you feel Finasteride would be extremely dangerous and significantly increase the likelihood for developing cancer in balding-folks whose family history is carcinogenic?


Step back and think about what you just asked me. Why would a doctor prescribe a “dangerous” or “cancer causing” medication to you? Finasteride does not cause cancer and is not a “dangerous” medication. There are studies that suggest that Propecia (finasteride) decreases prostate cancer. There are also confounding studies that suggest for those men who end up with prostate cancer, the cancer may be more aggressive. This does not mean it causes cancer. I’ve written about this many times before, including here, here, and here.

I do not know of any study that suggests finasteride causes breast cancer. Breast cancer in men is rare and it has been reported in men who take finasteride, but the causality is not clear.

In the end, I strongly urge you to speak to your doctor about these issues and your medical and family history.


Is There More DUPA Today or Are People Just More Aware of It?

Is there an influx in people with diffuse unpatterned alopecia nowadays or is the internet just making people more aware of this sort of hair loss?

I’ve been using the internet for the past 7 years and initially information about DUPA was scarce, in fact your website was the first place I ever saw a mention of it. and now you can find hundreds of topics from all over the web talking about DUPA.

when did you personally start noticing this type of hair loss?

When we wrote about DUPA in the medical literature back in 1995 (PDF here), the diagnosis required that the physician look at the donor area with high power magnification.

With my invention of the hair densitometer with patent issued in 1994 (U.S. Patent 5,331,472 - Method and Apparatus for Measuring Hair Density July, 1994) the ability to look at the donor area was made feasible. It took quite a few years and constant physician education by myself and Dr. Bernstein to show the importance of this diagnosis. Doctors who had hair transplant failures discovered DUPA and then began to be a big fan of doing the high powered examination to avoid tackling such patients with surgical procedures.

To answer your question, education takes time and the doctors slowly began including the diagnosis in the range of possibilities in patients. As a result, more and more emphasis of this technology was brought to the public. The internet and this site also probably helped get the word out.


In the News - Patients with Rapidly Progressive Alopecia Areata Have Good Prognosis

Snippet from the article:

Patients with rapidly progressive alopecia areata (RPAA) tend to show favorable prognosis regardless of treatment selected, according to research published online Sept. 24 in the Journal of the American Academy of Dermatology. Over a three-year period, Masaki Uchiyama, M.D., from the Tokyo Medical University, and colleagues retrospectively analyzed 1,030 patients diagnosed with AA.

The researchers found that patients with regenerated vellus hairs showed a significantly higher improvement or cure rate regardless of AA severity. Lower rates of cure and higher rates of relapse were significantly associated with early onset and lengthy duration. Regardless of treatment utilized, RPAA patients tended to show a good prognosis.

Read the rest — Rapidly progressive alopecia shows favorable prognosis

You can read the study abstract at the Journal of the American Academy of Dermatology.


In the News - Woman with Trichotillomania Pretended to Have Alopecia Areata

Snippet from the article:

A mum who has hidden behind the hair loss condition alopecia for the last 20 years has bravely revealed a secret compulsion to tear out her own hair that has tormented her since she was a child.

Zena Williams was called ’cancer face’ for wearing a wig at school and for more than two decades she has allowed anyone who noticed her bald patches to believe that she has the auto immune condition that causes her hair to fall out on its own. But in the wake of No Pulling Week, the mum-of-one has finally revealed that she has been pulling out her own hair since she was a child.

At various stages in her life, Zena has been left almost completely bald by her compulsive addiction to hair-pulling - a little understood psychological condition called trichotillomania.

Read the rest — Mum pretended to have alopecia for 20 years - in fact she was pulling all her hair out

Unfortunately, decades of pulling out her hair probably has resulted in some permanent loss. She says she has stopped pulling out her scalp hair, but still pulls out arm and leg hair. Hopefully she gets some sort of treatment for this compulsion.


Could My Hair Loss Be From Having Diabetic Ketoacidosis?

I have lost about 70% of my hair since January and am unsure if it was due to having diabetic ketoacidosis. I do have some regrowth but my hair is very thin, especially around my forehead hairline. Is this from the dka and will it grow back or should I see a dr.? I asked my endocrinologist but they said there could be a lot of reasons. I’m really concerned and don’t know if I should wait it out or seek further medical advice.

Diabetic ketoacidosis is a potentially life threatening condition. It is a major stress to your body, which could be one of the many possible reasons you are experiencing hair loss (much like what your doctor already told you). The most important point is to get your health back in shape and control the diabetes. If the hair loss is from stress, it should recover within a year.


Could My Hair Loss Be From Stopping My Thyroid Medication?

I would like to know if my hair loss sides front and back are a result of my doctor taking me off of thyroid medication. I was on 50mcgs and after he took me off of it i sustained an incredible amount of hair loss.

If your thyroid hormone levels are normal, I wouldn’t expect issues with hair loss. Usually people with high or low thyroid hormone levels experience thinning of their hair. Doctors generally monitor their patients thyroid levels and adjust the medication based on blood tests.

So stopping or starting thyroid medications is not the issue, but rather it is your own thyroid hormone levels that should be of importance.


In the News - Identical Twins, but Only One Has Alopecia Universalis

Snippet from the article:

As girls, they insisted on matching outfits, right down to the ribbons in their blonde pigtails. And as teenagers, identical twins Gwennan and Elin Thomas were inseparable, even going to the same university.

‘We were, and are, best friends,’ says Gwennan. ‘I had a freckle on my forehead as a baby – which disappeared – and that was how our parents told us apart. Looking at some childhood photos, we still argue about who is who.’ Yet, in 2002, a shocking, inexplicable event would mark the sisters apart.

That year, Gwennan, then 25, was diagnosed with alopecia, a condition that causes hair loss. She suffers from the most extreme form, alopecia universalis, and has lost all body hair, including her eyebrows and eyelashes. Ten years on, she can still remember the morning she woke to find clumps of hair on her pillow. ‘I burst into tears,’ she recalls. ‘My hair had been thinning for a while but then it started falling out in clumps pretty much overnight.’

Read the rest — One sister has alopecia and the other has a full head of hair

Identical twins… yet one has alopecia universalis and the other doesn’t. One of the leaders in alopecia research is Dr. Angela Christiano, and the rest of the article talks about how this case is causing her to rethink how this might occur in just one twin. Dr. Christiano said, “There may be something, for example reaction to stress, that causes the gene to express itself in one twin but not in the other.


Gilbert’s Syndrome and Hair Loss

Hello, I was wondering if you could help me out in explaining my blood results.

I am a 20 years old male and it seems and i am experiencing hair loss. I have Gilbert’s syndrome and i was told that it may somehow benefit to hair loss but i am unsure how. I used to have low iron in my blood and i thought that it could be an issue however i have normal levels of iron in my blood now but im still losing hair.

My blood results showed that my testosterone levels are normal however my dht levels are 3 times above normal. I recently experienced some weight loss. Could it be that my liver condition adds to the dht increase? can the dht increase be temporary due to my weight loss? what can i possibly do to slow it down?

Thank you!

I do not believe Gilbert’s syndrome (a liver condition) has any relation to genetic androgenic hair loss. The two are not related.

Gilbert’s syndrome is a hereditary condition that relates has to do with how your body metabolizes bilirubin. I am not sure how it may relate to your DHT levels or if that even has any factor in androgenic hair loss. I would recommend you consult with your doctor or an endocrinologist.


Bill Gates Criticizes That More Money is Spent on Balding Cures than Polio and Malaria Vaccines

Mr Rassman,

I have a question for you regarding Bill Gates. He’s always on TV talking about how there is less money being put into polio and malaria research than there is to balding cures. He criticizes this. I think more money should go to hair loss than polio and malaria combined. Hair loss causes so much grief and difficulty for men. I think he just doesn’t understand it and might change his tune if he were bald. What do you think?

We wrote about Bill Gates’ quote years ago here.

I am in the business of hair restoration, and even I agree that polio and malaria treatments are more important than curing balding. Hair loss, while it causes grief and stress to men and women, is not a disease, but rather a heritable pattern of hair loss. It does not cause death like polio and malaria. Some may not agree with me, but hair loss is not a disease.