QoM Archives - Page 5 of 5 -

Question of the Month- February

questiontext

Hi Doc,

My dad is pretty bald. Will I be as bald as him?

Concerned Teen

answertext

Dear Concerned Teen,

You may not necessarily become as bald as your dad. The exact mechanism of inheritance for balding/thinning is not entirely known. However, it is generally believed that persons inherit several genes and the number and type determines how bald a person gets. For the most part, persons who have a father who is balding is more likely to start balding before age 30. Also, if the person’s father is really bald, the chances of becoming bald like his dad is pretty high. However, you might have inherited your mom’s non balding genes. I do hope that there is no thinning on your mother’s side of the family. But don’t despair new technologies are being worked on to tackle hair loss. These will be available in the near future.

Question of the Month – January

questiontext

Dear Doc,

I just had a baby boy and I got the same hair loss that I had after my first pregnancy. I expected that, but this time I noticed that my hair did not grow back the same way. It looks thinner in the front. What’s up with that? What can I do to stop this?

Concerned Mama

answertext

Dear Concerned Mama,

Congrats on your second child!

Yes you have experienced the typical Postpartum hair shedding also known as Telogen Effluvium. During your pregnancy almost all of your hairs are in the anagen (growing) stage of hair growth. This is due to the high levels of the hormone oestrogen in the body which is known to keep the hair in the growing stage longer. As soon as your hormone levels go back to normal after delivering your baby boy, your hair follicles converted back to the regular 90% anagen :10% telogen. The telogen stage is the resting stage, the stage right before the hair falls out. What happens in some women is that this shedding can reveal latent or hidden Female Pattern Hair Loss (1) resulting in decreased density in their hair at the front of your scalp right behind their hairline. Some of their hairs have grown back in smaller, finer and thinner. Their parts look much bigger than usual and they see more scalp. Look at your family members. Do all the men have hair? Do the women have thin hair as well? If so, this is unfortunately showing up in you as well.

So what can you do about this? If you’re not breastfeeding, you can try topical 2% or 5% Minoxidil (Rogaine is a brand) twice a day. It is available over the counter in a lot of countries. If after four to six months you do not see an improvement you may need to visit a doctor to see whether or not you may need oral medication to help slow down your hair loss.

(1) Birch, M. P., Lalla, S. C. and Messenger, A. G. (2002), Female pattern hair loss. Clinical and Experimental Dermatology, 27: 383–388. doi: 10.1046/j.1365-2230.2002.01085.x

Question of the Month

questiontext

I am using Rogaine for my hair loss, but I noticed that it makes my hair quite dry and keeps stripping my hair colour. What can I do?

answertext

This is a common question that is asked by many many women who have Female Pattern Hair Loss and are using topical 5% Minoxidil (whether Rogaine brand or otherwise). It’s a catch 22 situation. On the one hand, it is helping keep or grow their hair but, on the other, it is wreaking havoc on the hair itself.

The solution more than the foam is the usual culprit. It contains a high concentration of (denatured) alcohol in which the minoxidil is dissolved. Alcohol, is notorious for drying out skin and hair. It does so, because it is a small volatile molecule. This aids in rapid drying of the product, but because alcohol can dissolve natural oils, it can take with it much needed oils when it evaporates from the scalp and hair. The alcohol can also dissolve the hair dye, thus making the colour disappear rather quickly, much to everyone’s annoyance.

So what can be done?

Use the Foam preparation. It doesn’t have denatured alcohol present in the ingredients. It is less likely to dry out the hair.
Use a Temporary Colour. These include hair rinses, mascaras, colour mousses, crayons or sprays. These will coat the hair shaft and will not penetrate. They will last up to 3 days or longer depending on how often you wash your hair. This will help to extend your hair colour.
Use Sulphate Free shampoos. These are the new “it” products in the cosmetic industry. They are less stripping than the regular shampoos. They will make your hair clean but not squeaky clean thus reducing the any contribution from the shampoo stripping the hair of the hair dye.
Use Deep Treatments. Rinse out conditioners do not deposit enough replacement oils, fatty acids, proteins etc to decrease the effects of the dye on the hair. Deep treatments tend to be thicker, and are filled with potent ingredients. For dry coloured hair, they should be left on the hair for 30 minutes to an hour on a weekly basis or used every other week.

Question of the Month

Good day, I’ve realized that I have immense breakage in my crown area as it is about 1/4 of an inch long in most areas (the rest of my hair is about 4-5″) and also the thinnest part of my hair even though the rest of my hair is very thick. I give it extra TLC everyday since my big chop in January to go back natural. I massage with castor and peppermint oil and do the LOC method along with taking vitamins and wearing my hair in protective twists (no hair added) which I take down weekly to shampoo and deep condition with natural products. I have ruled out it being genetic because no one else in my family has this problem and I have no fungal infection. I have no idea as to what else to do as I am at a loss and I am really hoping you can help.

Dear Crown Problem,

It is quite possible that you may be suffering from an early presentation of a hair disease called Central Centrifugal Cicatricial Alopecia. It is quite common in women who relax their hair or used to relax their hair, and it is suspected to be due to the relaxer setting up an inflammatory process resulting in that type of hair loss. Most times persons present with a shiny scalp in the area that you described, but there have been case series (1) on patients presenting with an early form where the centre of the scalp has markedly shorter hair and that portion of the scalp is extremely itchy.

It is best that you go to a dermatologist to get a proper examination. It would also be good to get a scalp biopsy, (where they take a piece of the skin under local anaesthetic), in order to definitively arrive at a diagnosis.You may be placed on injected and topical anti-inflammatory agents (such as a cortisone) and oral antibiotics which help to reduce the inflammation. The sooner you get this sorted, the better it will be for you. This is because the condition has a tendency to continue despite stopping relaxers.

1. Callendar V. et al. Hair Breakage as a presenting of Early or Occult Central Centrifugal Cicatricial Alopecia. Arch Dermatol 2012;148(9):1047-1052.

Question of the Month

I have Seborrhoeic Dermatitis and I was prescribed by the doctor a shampoo. It works but I find that it dries out my hair. Is there something I could use to minimise this? This is the only shampoo that seems to help me.

Dena*

Hi Dena,

Most of the shampoos, both prescribed and Over the Counter, available for dandruff and Seborrhoeic Dermatitis are very drying to the hair. It is best to wash your hair with a regular moisturising shampoo first, then apply the medicated shampoo to your scalp only. You may have to part your hair to do this. Leave on the shampoo for ten minutes, and then rinse as usual. You must follow with a conditioner for the hair. If that doesn’t help, then ask your doctor for a different brand. Some brands have less drying formulations and won’t affect the hair as much.

*Not real name