Tag: hair loss

Hair Loss After Surgery

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Dear Doc,

I have a friend who did surgery  for weight loss a few months ago. She keeps saying that her current hair loss is due to the surgery. Is this really possible?

 

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Sounds like the two of you have been debating the cause of her hair loss. Well, hair loss after surgery is actually not uncommon, especially after major surgery such as bariatric surgery aka gastric bypass surgery. There are several reasons she could be having hair loss after surgery.

First, the anaesthetics which put her too sleep are quite notorious for inducing hair loss. Any significant blood loss during the surgery could also trigger it. The stress the body undergoes from the surgery alone also causes hair loss. Any deficiencies that she may acquire post surgery, such as low iron, and especially after bariatric surgery, low proteins etc, can also trigger hair loss. The fact that she would have experienced rapid weight loss after the surgery is also a contributor. Hair loss often accompanies rapid weight loss.

The hair loss phenomenon she is experiencing is Telogen Effluvium, a diffuse hair loss characterised by excessive shedding of hair.  It usually occurs a few months after a stressful event, such as surgery.  Eventually, after six months it should correct itself, however, if she is worried about her hair loss, she should seek help from a dermatologist to help with controlling the hair loss after surgery. She should also make sure to follow the dietary regimen and vitamin supplements that her doctor would have prescribed for her.

5 Myths about Hair Loss in Men

From time to time during my discussions with male patients, I come across general misconceptions about hair and hair loss. Some of this information may have been gathered from the internet or derived from basic folklore that has survived the test of time. These are some of the myths about hair loss in men that I’ve encountered.

1. Hair Loss is inherited from the mother

This is not true. The genes for hair loss are quite numerous and are inherited from both parents. The severity of your hair balding has more to do with the number of genes you inherited. If you have hair loss on both sides of your family, you are more likely to suffer from hair loss than a person who has no known family member with hair loss.

2. Only older men are affected

Though Male Pattern Hair Loss is seen in more middle-aged to elderly men, young men are also capable of being affected by the condition. A lot of men start as early as in their teen or early twenties.

3. If I take testosterone pills I will grow more hair

We all know that  testosterone is the predominant androgen (male) hormone that is responsible for the sexual characteristics of men. So because of this, there is some belief that if I take more testosterone then it would make me more virile and youthful. Losing one’s hair is thought to make some men feel less youthful. Unfortunately, this myth needs to quit while it’s ahead. Testosterone is converted to the more potent Dihydrotesterone which is the hormone responsible for binding to the receptors in the hair follicle and causing the hair to miniaturise. Taking more testosterone just adds fuel to the fire.

 

4. Hard physical exercise decreases conversion of Testosterone to DHT

I’m not sure how this myth came about but this is so far from the truth. Testosterone is usually converted to the more potent Dihydrotestosterone in all men. Individuals with Male Pattern Hair Loss are more sensitive to DHT because of their genetics.  So technically speaking they may have the same level of DHT as another man, but because of their greater sensitivity of their hair follicles to the hormone DHT, they lose more hair. Yes, there have been studies indicating that extremely hard exercise may cause a decrease in testosterone and therefore should theoretically decrease DHT. However, for all the athletes who are hitting the gym for hours on end but yet are still balding, this belief should be shelved quickly. Usain Bolt anyone?

5. Men who are balding have more testosterone.

Most studies show that most men have the same levels of testosterone across the board. Its production generally slows a bit as you get older, hence why some men’s libido and energy decrease as they get older. Those men who have genetic hair loss are more susceptible to the effects of the hormone DHT than those who don’t suffer from the condition.

 

Dr. Llorenia Muir-Green is a practising dermatologist in Jamaica.  She graduated from the UWI, first obtaining a double major in Chemistry and Biochemistry. She then went on to pursue a career in Medicine. Having obtained her Medical degree from UWI, she went on to pursue postgraduate specialisation in Clinical Dermatology at Cardiff University, for which she got distinction.  She was a recipient of the 2013 Fellowship in Hair and Scalp Disorders at the University of British Columbia.  She is a member of the North American Hair Research Society, International Society of Hair Restoration Surgery,  Dermatology Association of Jamaica as well as an Associate Member of the Caribbean Dermatology Association. She currently works at the Dermatology Clinic at National Chest Hospital where she recently established a Hair Clinic.

 

November’s QOM- How can I tell if I am balding?

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Hi Doc, my girlfriend says that my hairline is receding. My hair feels different in that area but it doesn’t look like my hairline is going back like Lebron James.  How can I tell if I am balding? Help! I’m too young for this!

 

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Hi there!

I can understand you going into panic mode when your girlfriend told you that you may be balding. Truth is, no one who is young wants to acknowledge that he is losing his hair. Balding is for “old people” as I often hear my patients say. The truth is most of us do not notice our own hair loss, however persons who are around us are more likely to do so. So, if they do notice this then it is likely that you have lost a good percentage of your hair already.

The best way to tell if you’re losing your hair is to look at your old pictures. Is your hairline going more inward? Can you see the hair receding at your temples? Is there thinning noted to the crown of your scalp? Does the hair especially at the crown seem finer and soft like a baby’s hair? The latter description is often described in men with tightly coiled/kinky hair.

For  most black men, their hairline is straight across and can sometimes be low. Due to the curliness of the hair, it doesn’t become too obvious when the hair line starts to recede or the hair at the top of the scalp starts to thin out, unlike persons of other races. This is due to the styling preference of cutting the hair low. If the hair were allowed to grow out into a low afro, it would become a bit more easier to tell that the hair is thinning. Also, due to the 3-D volume created by curls, thinning is hidden well. Things start to get very obvious when the top of the scalp thins out significantly.

In your case, it is best to see a professional to get an opinion and see if there can be anything done to halt the hair loss.

 

 

 

Dr. Llorenia Muir-Green is a practising dermatologist in Jamaica. She has an avid interest in hair and scalp disorders.  She is a member of the Medical Association of Jamaica,  Dermatology Association of Jamaica and is an Associate Member of the Caribbean Dermatology Association. She was a recipient of the 2013 Fellowship in Hair and Scalp Disorders at the University of British Columbia.

 

 

 

ATHD Investigates: Biotin

Biotin is the most talked about hair growth related vitamin on the internet. It has received so much hype that you have to ask yourself, is it really worth it? Especially for what some brands are asking you to pay for it!

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Biotin is a member of the B Vitamins. It is a coenzyme i.e. it is needed for the functioning of several enzymes in the body and in general it helps maintain healthy skin, nerves and just the operation of cells in the body*.  Biotin was found to be necessary for the development of a good fur or hair coat for animals. Its deficiency in humans is extremely rare and results in a characteristic syndrome of:
1.     Hair loss
2.     Skin rash (namely around eyes, mouth and genitals)
3.     Numbness and tingling in the hands and feet
4.     Depression
 

It is abundantly available to humans in several ways. It is readily available in plenty of foods we eat.  Foods with high sources of biotin include  nuts (peanut and almond), wheat germ, whole-grain cereals, whole wheat bread, poultry, eggs, dairy products and salmon. Biotin that is absorbed into the body is actually recycled several times before it is expelled through urine or faeces. Lastly, gut bacteria actually produce a lot of biotin. So with all these sources, it is pretty hard to be biotin deficient unless you consume a lot of raw egg whites which contains a protein that binds readily to biotin thus depleting it from the body.

There are persons who may need vitamin supplementation. These include pregnant and breastfeeding women and athletes. Supplementation has been touted to be useful in persons who smoke, have diabetes or have some other nerve disorder. Biotin is useful in persons with nail diseases that make their nails quite brittle. Supplements have also been found to help strengthen hair not necessarily make it grow faster. It is worth taking if you find that your nails and hair break or split very easily.  It, however, cannot make persons with Male or Female Pattern Hair Loss regrow hair as their hair loss is from something totally different. It is also least likely to be culprit for Telogen Effluvium (excessive hair shedding). The most common cause for Telogen Effluvium in women is Iron deficiency.

Typical recommended doses for supplementation are 30-35 mcg for women. This is far lower than the mega doses seen in some of the hair vitamins on the market. Though higher doses are not necessarily bad, the exact toxic dose is not known. And yes there are times when too much of a vitamin is not a good thing.

So is it worth taking? Yes, only if you want stronger hair which will make it easier for you to retain length.

*An enzyme is a protein responsible for speeding up reactions in the body

Question of the Month – January

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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

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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