AboutPeter J. Panagotacos, <B>M.D.</B> Expertise I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified
in Dermatology and Hair Restoration Surgery.
Experience I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified
in Dermatology and Hair Restoration Surgery.
More information can be found at my website
www.hairdoc.com
I am a 38 years old female from Europe. I am not sure when my hair loss started. I used to have extremely thick, curly hair, and as long as I can remember there was a lot of hair behind me in the shower, but I only thought it was natural, with this incredible mane that I had.
After the birth of my second child, five years ago, I noticed that I was shedding even more than usual, but I still had so much hair that it took me almost 4 years to realize that I was actually losing it. The first doctors I saw only gave me vitamins, even though I had already lost about a half of my hair.
During these 5 years of excessive shedding, I often had low ferritin level - last year only 14 - and I changed my BCP twice. I now only have about 1/3 of my hair, and since February, the scalp is getting more and more visible on the top of my head, around the part.
I am taking iron supplement, so my ferritin is now at 60. I am also taking vitamin B and zinc. Three months ago I started with Diane 35, but now the shedding has even increased. I lose about 50 hairs a day, when I don’t wash it; when I do, twice a week, I lose 300-400. About a half of these hairs are short (1,5-2 inches).
I don’t have any scalp problem, it’s just a bit greasy. My hair has always been very dry. On a blood test 3 months ago my testosterone was at 0,70 ng/ml, and my oestradiol at 407 pg/ml (during the ovulation).
I would like to ask you the following questions:
1. When can I expect some results with Diane and iron? How come there are no positive changes yet?
2. Does the fact that I am shedding a lot of short hair mean that this is an AGA? Most of these hairs are normally thick.
3. How much hair can grow back with minoxidil, in case it works? (I haven’t started yet.) Is it “real”, long hair?
4. Could you please tell me how often you see women in my condition growing back at least some of their hair? Can a hair loss really stop if it has lasted for years?
5. Is there anything more that I can do?
Thank you in advance for your patience and advices!
Sincerely, Ivana
Answer Dear Ivana,
You did not mention whether your father was bald or your mother had thin hair but I would guess that you have inherited some bald genes from one or both parents. It is normal to lose 50 to 100 hairs daily. Over 150 hairs lost daily is a sign something is stressing the hairs and forcing them to change their cycles prematurely. I would suggest you use Neutrogena Daily Control shampoo daily or every other day and Minoxidil 5% only once a day in the morning as the last thing you do before combing your hair for the day. It usually takes six months to see changes due to therapy from Diane or Minoxidil. The fact it is still shedding excessively is a problem. Your serum ferriin should be over 60 -- some doctors use 70 as the low limit- so I would suggest continuing the supplemental iron. You are doing most everything correctly and the only other thing I would suggest is 50 mg spironolactone to block the DHT from getting to the hairs. If you do not improve soon on this treatment you may want to consider Yasmin instead of Diane. Yasmin has Canrenone in the equivalent of 25 mg of spironolactone. None of the other oral contraceptive pills have Canrenone.
The massive loss after having a baby is called a post partum telogen effluvium and it can cause you to lose half of your hair over a six month period. Dermatologists see this fairly often. The hairs which were lost in the past two years may start to regrow once your serum ferritin is over 60 or 70 for a full six months and with the spironolactone and minoxidil added to what you are doing now you should see some results by the end of the year.
