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I went to see a dermatologist in Raleigh NC. After he learned that my hair loss started 15 years ago, then got excessive in the last 3 months since I am a breast feeding mom, he came to the conclusion that I have the genetic type of hair loss and I have 2 choices if I am not going to have more kids - propecia or rogaine.

I mentioned that my scalp is irritated and I have a lot of pain. His response was that this may not be related to hair loss. Bottom line he said that he wished that he was a hero and could fix my hair but he is not and he asked me to look at his bald hair. He basically said there is no cure yet and just deal with it. This experience was so hard because I had hope that I will get some kind of help, instead I had to hear just deal with it and use rogaine.

it has been 2 days since then and still asking myself if I went to see a very honest dermatologist that happened to be a rude doctor or if there was some test and other practices that he should’ve proceeded with but would not or could not do.

I wish I was a hero too, but I am merely a doctor who has to inform you that there is no medical cure for hair loss in either men or women. Maybe your doctor was too blunt or was not sensitive to such a delicate issue, but I think your doctor was being honest.

In general, the only hope for women that want to treat hair loss (after excluding any medical reasons for the loss) is topical minoxidil, also sold as Rogaine. Propecia (finasteride) does not really work for women unless there is a clear diagnosis of androgenic alopecia and it should never be prescribed to any woman who might get pregnant. And since you’re a breastfeeding mother, it should be pointed out that it is unknown if the medication can be passed through breast milk. Besides that, even if you have androgenic alopecia, Propecia is generally not recommended for women since we do not know the potential side effects (including cancer). The cancer part may be very rare, but since there have been no large scale studies it might just be a worst case scenario that has been theorized.

The final option may be hair transplant surgery, but this is also a limited solution for women who generally have diffuse thinning. And since you were curious about tests for possible causes of female hair loss, they are listed here.

Hello Dr.

I am a 21yr old female. I am 5′5″ and 85kgs overweight girl. My TSH level is 7.49mg/dl. So I have hypothyroidism. I had started hair loss since the age of 12yrs. But I didn’t really notice it then. The hair loss then worsened gradually until at the age of 16yrs I developed a bald patch on the left lateral aspect of my scalp which slowly spread to my right lateral aspect also. This had affected my psychologically and socially. I am a MBBS student.

I had read that if there is excess Oestrogen levels then it gets converted into testosterone which causes hirudism and baldness. My question is this: does obesity cause baldness in any way? I am taking treatment for hypothyroidism and also am taking multi vitamin supplements. Still there is no improvement. In fact… My baldness is increasing. Kindly help me out please. Thank you

While obesity itself doesn’t cause female hair loss, stress and poor diet can certainly contribute. I’ve written the same thing before here.

Hypothyroid, polycystic ovary syndrome (PCOS), and many other medical issues can potentially cause hair loss. The goal is to treat the medical issues and the hair loss should slow down. You need to be followed by your physician. That is the best help I can offer.

(female)
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.

(female)
I am currently receiving chemotherapy for my synovial sarcoma. I have 2 more rounds of Ifosfamide to go (Cisplatin/Adriamycin in my previous rounds). I will have 6 total rounds of chemo. I’ve read everywhere that permanent hair loss can occur if there has been very high doses of chemo given. What counts as “high dosage?” Do you think 6 cycles of my chemo will cause permanent hair loss? I just want my hair back!! Thank you.

The reason for hair loss with chemotherapy is because these drugs kill cells that are fast growing, and hair cells fall into that category. We may not know immediately if the hair loss is permanent or temporary, because some of the women who have had such treatments may also have genetic hair loss that is triggered by the drugs. Only time will tell.

Within a year, there is enough time to survey the hair loss. Doing bulk measurements on the newly grown out hair and then repeating such measurements over time will tell much about how the hair may or may not be recovering.

I suggest that you finish your course of chemotherapy and after 6-12 months, you might consider being evaluated by someone like me if you are in the Los Angeles area. At one year out, call me and send me photos so we can start a dialogue.

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.”

I have lost more then 40% of my hair. My dermatologist said I am still actively shedding. I had hormone replacement. I was told in October of 2011 that my level was a 4. I have had a hysterectomy and am menopausal.

A pellet of testosterone was inserted sub-subcutaneously I February. I developed severe cystic acne, shortly after. My testosterone levels were three times the norm from my age (in the high 200s almost 300) and sex. My dermatologist advised me to not get implanted again- then three months later my hair began to fall out. My dermatologist said this also was a result of the drastic swing in my testosterone levels- they are still quite high.

The men in my family start to experience hair loss around age 20. I’ve never seen a female in my family lose hair,- they have it in their 90s. Shouldn’t women be warned that Hormone replacement therapy can cause hair loss? I have no other health issues, had no disease or took other medications that cause hair loss.

I realize you are experiencing hair loss, but I cannot say if hormone replacement itself is the cause or if there should be a mandatory warning label associated with the therapy. Menopause itself could be the cause or there may be other medical issues, as well. I believe you are under the care of a physician and communications between patient and doctor is the most important element. My point is, before you start any medical treatment, side effects and treatment issues should always be explored.

I am 26 years old, and I recently gave birth to my 2nd child (4 months old), and noticed a significant increase in hair loss. We are talking handfuls come out in the shower, or even just brushing my hair. In addition, my scalp has become incredibly itchy. Is it the stress? Are they related? What is causing it?

Some women complain of hair loss after child birth. It may be due to hormonal changes your body goes through, but it is not well understood. There is no cure for this phenomenon, but the hair grows back usually after about one year.

Hello

I am a 30 year old woman and I have been experiencing hair thinning especially in the front. I did a hormonal test a couple of years back and it came ok. Last year a dermatologist in Atlanta did a Hair and I was diagnosed with TE. He did nothing but to prescribe vitamins. My hair loss has not stopped. What shall I do? can you suggest a doctor or a treatment?

You should perhaps consider seeing another doctor for a second opinion, though I don’t have any personal recommendations in the Atlanta area.

In general, there is no definitive cure for women’s hair loss once other medical causes have been ruled out (anemia, thyroid conditions, etc). If you do have telogen effluvium, hair generally grows back after about one year.

A previous post from a few months back talked about a way to prevent hair loss when a patient is going through chemotherapy by using Cold Cap Therapy. Chemo is used for treating many types of cancer, and many of these treatments cause hair loss.

I am happy to report that the patient discussed in May has just finished her chemotherapy, and she sent this email to me with permission to post it on this site:

Wow – it is good to be looking at the end of the chemo cycle (six treatments in an outpatient facility). I am finally seeing my energy beginning to come back. This cycle had more general fatigue and much more muscle fatigue which is slowly waning. I am thinking that I should be 90% to my normal state by the weekend. I can report that my hair is holding – we sent back the cold-caps with a fond farewell.

Overall I’ve had about 20% hair loss over the therapy course and my hair is growing normally. I may have lost 20% (my estimate) of my original hair and the new hair is already growing back. I want to put the word out that if you know anyone who is looking at chemotherapy and wants to avoid hair loss that they should contact me [note: BaldingBlog will make the connection to this patient].

I have put together a guide to using cold-caps based on my experience which I think will be helpful. It is only hair but it makes a difference to know I look healthy and when I looked in the mirror through this period of chemo, having my hair kept my spirits up. Please tell others to contact me.

If you’d like to contact her, send us a message via the Contact page and we’ll make sure the email gets to the right place.

Some women develop changes in their hairlines as they age that make them look more masculine due to receding corners. These defects are very evident in women with very dark hair and light skin (like the Asian patient below), more so than in women with blonde hair and white skin or brown hair with olive skin tones.

These changes occur with many women who undergo plastic surgery, as their hairlines are often negatively impacted by face lifts and brow lifts. The changes tend to become noticeable rapidly after their plastic surgery is done, while others who did not have any such cosmetic procedure will barely notice the changes as they occur very slowly over the years. There are many women who show miniaturization in the corners of the hairline that may eventually lead to the type of changes shown here.

We love doing these surgeries as the patients are most grateful.

The before photo is below on the left, the after photo is on the right. This was done in a single procedure of 1800 grafts, mostly in the corners with some work in the frontal hairline. The after photo was taken about 18 months after her surgery. Click to enlarge.