The Hair Doc, Author at

Does my child have scalp ringworm?

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Hello,

I have been taking my son to a new barber for the past month. I am now noticing he is having small dry patches throughout the top of his scalp. After washing his scalp with shampoo his head becomes very irritated( head and shoulders shampoo) and you can open the skin on top of his head. What should I do? Also, he had ringworm on the back of his neck after sharing a helmet with a teammate year around this time. Could this bacteria re-surfaced ? Thanks for any assistance!

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Dear J,

Unfortunately, it sounds as if he contracted scalp ringworm (fungus) again, and may have become infected/irritated, as indicated by the description you gave. He will certainly need to see a doctor to get treatment. He should get both topical antifungal creams and oral antifungal medication, as well as an antifungal shampoo. The oral medication should be taken for 4-6 weeks, otherwise the scalp ringworm can return. Using a shampoo alone will not cure him. During the treatment, he is to not share any hats, combs, brushes, towels etc. Anything that goes on his head must be washed on a weekly basis. He is also to avoid going to the barber at this time.

Treatment of Male Pattern Hair Loss

Treatment options for Male Pattern Hair Loss are quite limited. With more men seeking treatment, and plenty start suffering from hair loss at quite young ages, more research is being placed on reversing or slowing this frustrating condition.

Treatment of Male Pattern Hair Loss are mainly divided in to three: Topical, Oral, and Surgical

Topical Treatment of Male pattern Hair Loss

Topical Minoxidil

This is the mainstay of treatment for Male Pattern Hair Loss. Studies have shown that 5% Minoxidil prolongs the anagen phase and thickens the hair fibre. The exact mechanism by which it does this is still unknown. It takes 4-6 months before results can be seen. It is up to 60-70 % effective in the crown and 30-40% effective in the front of the scalp. The brand is Rogaine and it comes in 2 forms- solution and foam. There are many generic brands available and quite a few countries that provide it OTC.

In Europe, OTC caffeine based products are available in shampoo and lotion form. Caffeine has been shown to increase the anagen phase. The studies have been found to be encouraging.

Oral Treatment of Male Pattern Hair Loss

The two main medications used are Finasteride and Dutasteride. Both are used off-label from their intended use, which is for the treatment of Benign Prostatic Hypertension.

Finasteride (Propecia or Proscar) help to stop the conversion of Testosterone to Dihydrotestosterone by the enzyme 5 alpha reductase. Fiansteride takes up 4 months before results can also be seen. It has a slightly greater efficacy compared to Rogaine. Together with Minoxidil, there is increased benefit to the patient. Most persons can start off with Minoxidil and Finasteride added to see if there is any more improvement.

Dutasteride (Avodart) is a more potent form of Finasteride because it acts on the many forms of the enzyme. It is 95% effective compared to the 50-70% seen with Finasteride. However, it has 5 times more the effects of side effects compared to Finasteride. The main concerns for both Finasteride and Dutasteride include: decreased libido, decreased power of orgasm/ejaculation, erectile dysfunction, and depression. For Finasteride, this is quite low, but much higher in Avodart. The side effects usually go away after cessation of the medication, however, it should note that many men who start this medication are already at risk of having these issues.

Surgical Treatment of Male Pattern Hair Loss

The ultimate treatment of this condition is Hair Transplantation. It involves permanent removal of hair from the back of the scalp, which is less likely to be affected by the condition. These are then transplanted to the front of the scalp and will take and grow keeping their inherent properties from where they are coming from. There are two main types: Follicular Transplant (strip harvesting that leaves a visible scar) and Follicular Unit Extraction (individual harvesting of hair follicles). Hair growth is not immediate. It takes about 4-6 for the transplanted hairs to start growing, and up to a year for it to be noticeable.

Surgical treatment is limited to how much hair is present in the donor site. There are many factors that can cause decreased hair growth. However, up to 99% of the hairs transplanted usually grow.

Treatment of Male Pattern Hair Loss is limited but promising as there are many new treatment therapies such as Stem Cell Therapy are actively being investigated.

July QoM

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Can you reverse relaxers?

I feel like this is a long shot. But, I’ve been asking around and even googling questions trying to figure out what I can do to get my daughters tight kinky curly afro back. My daughter mixed (African-American and white), I of course learned as much as I could about her hair and may have even received false advice for her hair from peers. Last summer I chose to relax her hair with a product (Just for me), I thought it would make it easier for me to manage her hair. And well, at the time, it did. But now I want those beautiful curls back. I keep her hair moisturized and I never brush, only comb. She now has wavy to loose curls. What can I do to get those natural bouncy curls back? Did I ruin her hair? I’m willing to spend a pretty penny on any good, working, product to bring back those curls. Any advice would be greatly appreciated.

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Hi there, I’m sorry you were led down the wrong path. The Just for Me product is a chemical relaxer which permanently straightens the hair. The only way to allow her hair to go back to its regular curls is to have them grow out and cut off the straight ends gradually. This is called “Transitioning”. Or you could just cut off all her hair and let it grow out. This is called “Big Chop”. There is no easier or faster way to get back her curls. Unfortunately, you cannot reverse relaxers or have them washed out, wear out, or sweated out, despite what people say.

For the future, you may consider using newer products on the market that straighten the hair without permanently keeping the hair straight. One such product is African Pride Dream Kids Texture Manageability Maintenance. I have tried products marketed to adults. They do work. They help to keep the hair straight for up to 6 weeks and wear out each time you wash the hair. I just wanted to keep my hair straight for a few days, instead of it reverting within hours. Do not depend on these to keep the hair straight permanently because they require application of high heat on a regular basis. Otherwise, a regular flatiron will have to do and those will revert within a few days when you next wash her hair.

June QOM

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Dear Doc,

I recently flatironed my natural hair. After I washed it out, some sections of my hair remained straight. Is there anything that I could do to restore them?

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The short answer to that is no. Unfortunately, when hair is subjected to high temperatures, especially without a heat protectant, the proteins are permanently changed. The only way to restore the hair, is to have it cut off.

There are reports of persons who have tried to revive their heat damaged hair with intense deep conditioning about twice a week. That may help IF the hair wasn’t completely burnt straight. However, there is absolutely no guarantee.

Having had this happen to me in the past, it was quite frustrating to have to cut sections of my hair, but in the end it did grow back.

Male Pattern Hair Loss

Male Pattern Hair Loss or Androgenetic Alopecia is the most common type of hair loss found in men. Up to 80% of men will experience some level of hair loss by their 70s. Most will discover their hair loss in their 30s and 40s however, quite a number may start long before in their teens.

So what causes Male Pattern Hair Loss?

Male Pattern Hair Loss is due to the activity of a hormone Dihydrotestosterone, a potent androgen (male hormone). The hair follicle in affected men is more sensitive to this hormone. There are several genes responsible for the condition and they can be inherited from either the mother, father, or both. This hormone is made from Testosterone under the action of the enzyme, 5-alpha reductase. Dihydrotestosterone latches onto the receptors in the hair follicle and causes a decreased anagen (hair growth) along with reduction in the size of the hair follicle. The hairs become progressively thinner and more vellus-like.

Stages of Male Pattern Hair Loss

There are several stages of Male Pattern Hair Loss. The main staging system used is the Norwood Hamilton Scale for Hair Loss in men.

norwood-hamilton

Which stage do you fall under?

Next month: Treatment options