What should I ask my Dermatologist about hair loss?

[MermaidGirl]

Has anyone been to see a Dermatologist about increasing hair loss/shed/fall? If so, what was your experience like (if you care to divulge), and what can (or should) I expect from my office visit?

I first started noticing a bit of hair loss about 3-4 years ago, and it is getting increasingly worse. I'm sure a lot of it is hormonal and/or attributable to getting older. But the increase lately may be attributed in part to stress as I have had two major anxiety episodes this year, one at the end of February, and one mid-to late July when my father died. However, my hair has been coming out for a long time prior to these two stress episodes, so I know that stress not the main cause of this problem.

My mom, who I only see about once a year or so, noticed it, and my hair stylist also has noticed it. I am having what appears to be definitely receding areas above my temples on both sides, and the areas on both sides above my ears to the temples and back a couple inches in my hair line is noticeably thinner, as is the area at the nape of my neck. I think I also having diffuse thinning throughout -- I have a ton of what are either new growth hairs or breakage throughout.

I'm wondering what I should have the dermo do? I'm wondering what blood tests I should absolutely request be done? What should I expect in the way of a scalp/hair examination? Would a scalp biopsy be expected or is that only reserved for extreme cases?

Any suggestion that anyone can give me would be most appreciated! Thank you in advance!

[ambychelle]

I haven't been, but I have read a LOT about others experiences on http://www.womenshairlossproject.com/ and heralopecia.com and I decided not to go because it seems like a waste of money for the little help I've seen offered to most women who have gone.

The first thing I did was have my thyroid checked, checked for lupus markers, and for low iron because those are fairly common causes of hairloss. If you haven't done this, there's no point in going to a dermatologist right now becuase they will need that info before they even bother to do a scalp exam.

As far as the scalp exam goes, it really varies on your doctor. Some doctors simply take a quick look and talk to you about what's going on. Others will want to do a biopsy. Sometimes they'll do a hair pull test.

What it came down to for me, because my bloodwork was negative, was --

If it's TE, there's nothing a doctor can do at all. I don't think mine is TE at all, but IF it is, they can't help me. And truth be told, they can't even diagnose TE unless they know you've had major surger or been in a tramatic accident etc. Even then, they'll often tell you that it's "likely" TE but could still be AGA.

If it's AGA, the only thing they'll do is recommend Rogain. I can do that on my own without paying a doctor hundreds of dollars to tell me to do it. As for getting an AGA diagnosis, the most common story I read is that if their bloodwork came back negative for thyroid or anemia, the doctor would automatically assume it was AGA.

If you have patchy bald spots, sometimes there are injections (cortizone?) that can help regrow hair in those specific areas, but there are very few options out there for diffused thinning or receding hair lines.

I hate to sound discouraging but I'd also hate for you to spend hundreds of dollars to walk away without any help from a dermatologist.

Be sure to go to your regular doctor and get some bloodwork done to check for thyroid issues. You *might* want to think about an anti anxiety medication. I tried one a few months ago and all it did was make me sleepy which just isn't helpful when I have children to take care of. But for some people, they are a huge help. But do ask if hair loss is a side effect of the drug if you decide to try one.


Do check out http://www.womenshairlossproject.com/
There are many fantastic stories there and lots of support. And, they make you feel like there IS hope and that getting something like a topper or wig is an option and sometimes it's just nice to know you aren't alone.

[maaria]

I went to a doctor this spring beacuse my hairloss, she (the doctor) took bloodtests and after a two weeks i got answer, i had lack of zink in my blood. Now I eat zink 2 times a day (Solvezink) and slowely my hair is coming back:joy: so good luck!

[plainjanegirl]

I haven't been, but I have read a LOT about others experiences on http://www.womenshairlossproject.com/ and heralopecia.com and I decided not to go because it seems like a waste of money for the little help I've seen offered to most women who have gone.

The first thing I did was have my thyroid checked, checked for lupus markers, and for low iron because those are fairly common causes of hairloss. If you haven't done this, there's no point in going to a dermatologist right now becuase they will need that info before they even bother to do a scalp exam.

As far as the scalp exam goes, it really varies on your doctor. Some doctors simply take a quick look and talk to you about what's going on. Others will want to do a biopsy. Sometimes they'll do a hair pull test.

What it came down to for me, because my bloodwork was negative, was --

If it's TE, there's nothing a doctor can do at all. I don't think mine is TE at all, but IF it is, they can't help me. And truth be told, they can't even diagnose TE unless they know you've had major surger or been in a tramatic accident etc. Even then, they'll often tell you that it's "likely" TE but could still be AGA.

If it's AGA, the only thing they'll do is recommend Rogain. I can do that on my own without paying a doctor hundreds of dollars to tell me to do it. As for getting an AGA diagnosis, the most common story I read is that if their bloodwork came back negative for thyroid or anemia, the doctor would automatically assume it was AGA.

If you have patchy bald spots, sometimes there are injections (cortizone?) that can help regrow hair in those specific areas, but there are very few options out there for diffused thinning or receding hair lines.

I hate to sound discouraging but I'd also hate for you to spend hundreds of dollars to walk away without any help from a dermatologist.

Be sure to go to your regular doctor and get some bloodwork done to check for thyroid issues. You *might* want to think about an anti anxiety medication. I tried one a few months ago and all it did was make me sleepy which just isn't helpful when I have children to take care of. But for some people, they are a huge help. But do ask if hair loss is a side effect of the drug if you decide to try one.


Do check out http://www.womenshairlossproject.com/
There are many fantastic stories there and lots of support. And, they make you feel like there IS hope and that getting something like a topper or wig is an option and sometimes it's just nice to know you aren't alone.




have you tried rogaine nd had any results from it? I thought about trying it but then you hve to use it forever or if you stop then any hair that grew from it will fall back out.

[ambychelle]

have you tried rogaine nd had any results from it? I thought about trying it but then you hve to use it forever or if you stop then any hair that grew from it will fall back out.


I'm way too terrified to try it for that very reason.

I did read that if it's AGA, sometimes doctors will prescribe Spironolactone but according to one of the women on womenshairlossproject.com --


Spironolactone is commonly prescribed as a treatment for women’s hair loss. From what I’ve read it is a mild anti-androgen. It’s real use is as a blood pressure pill and diuretic, but somewhere along the way someone took note of it’s anti-androgenic properties. So on the upside you’ll never be bloated again http://www.womenshairlossproject.com/wp-includes/images/smilies/icon_smile.gif I’m just joking, but it does diuretic properties as a lot of blood pressure pills do. The side effects listed in the PDR:
—-More common side effects may include:

Abdominal cramps, breast development in males, change in potassium levels (leading to such symptoms as dry mouth, excessive thirst, weak or irregular heartbeat, and muscle pain or cramps), deepening of voice, diarrhea, drowsiness, excessive hairiness, fever, headache, hives, irregular menstruation, kidney problems, lack of coordination, lethargy, liver problems, mental confusion, postmenopausal bleeding, severe allergic reaction, sexual dysfunction, skin eruptions, stomach bleeding, stomach inflammation, ulcers, vomiting



Seems like there's no easy answer if your bloodwork comes back clean.

[Heidi_234]

I did, he was very dismissive though. My doctor sent me to a comprehensive blood test that showed no abnormalities. I took the results to the dermatologist, he asked me for how long I have been experiencing hair loss, when I said few years, he took one look at my part and said I don't have hair loss. He said that if I did my hair would have been much much thinner than it is.

[MermaidGirl]

Thank you everyone for your responses. Wow, does this issue sound discouraging though! I looked at the hairloss websites and they also sound somewhat discouraging as far as dealing with doctors. I am going to go anyhow, and will prepare a list of questions and a list of tests I want done, and will see how it goes. At least by reading what I have and seeing how discouraging this issue can be, I will not have my hopes and expectations up that I will actually get an answer, but will feel lucky if I do.

Thanks again.

[ambychelle]

Please do keep us updated. Even though I know it's probably futile, I keep thinking about going. My family doctor says there is nothing else he can do for me since bloodwork came back clean. It just seems like there has to be a CAUSE, and therefore a cure right?

[susiemw]

When I went the dermatologist told me "I was getting old and it's normal" and sent me on my way. Not a blood test. Nada.


Thanks for not diagnosing my underactive thyroid!

She really made me angry.

Susan

[Amara]

I don't have any other advice to offer but I wanted to send you a *hug* and say good luck!

[mamaherrera]

I have been to so many dermatologists too and they give me varied bluff answers, sometimes they tell me nothing. Other times they barely look at my head. Other times, my ferritin came back low and they still said it was fine. So many of them are stupid. My only complaint is also my temple area, that has thinned a bit and the area above my ears. I had a four year shed, if I knew it 's just a matter of time, I'd be more patient, but with these other things going in my head, . . AGA, , mpb, etc. it's scary.

[jocelyn anne]

I think it will best to ask if there is a permanent solution for your hair loss and of course how much will it cost.