Expert: Melanie Vonzabuesnig - 6/24/2009

Question
In September of 08' I noticed some subtle thinning of hair from the front of my scalp back about a 1/2 and inch.  This was occuring where I have parted my hair for many years.  When I first noticed the thinning I thought it was related to my constant playing with my hair in that spot.  I pull my hair up (sounds weird, but kind of pet it and pull at it until I've messed it up) and then take it back down and pull it back up and start the process over.  Sometimes I didn't notice I was doing this until my arms started to ache (generally while watching tv or reading or on the computer).  Also, I have PCOS and at the time I noticed the thinning I had been on BCP (ortho-cyclen)for about nine months as well as Metformin 1500mg in the evening, and Allegra 80mg in the evening.  I also use a Albuterol inhaler for asthma at times.  I've had pcos since I was 17 yrs old (I am now 32) and have never had significant trouble with hair loss, only with hair growth elsewhere on my body.  About 7 yrs ago I remember noticing a generalized thinning when I lost about 75 pounds in 6 months, but it all grew back.  About 3 months ago I switched BCP to Yaz and I noticed the hair loss got worse.  The only significant thinning I can see is still in that spot but it is now about and inch and a half from the part to the middle of my scalp.  My left side seems affected but not my right side.  The derm that I saw me was very brief and basically said that I have pattern baldness and to start using Rogaine.  I was in shock and didn't even tell her about the damage I could have caused myself by messing with it all the time.  I am hoping someone cne can give me some insite.  I am scared.  My thinning hair in that spot is kinky and the rest of my hair is wavy.  Could it be something other than MPB.  My lab results were, of course normal.  Hormone levels fine, iron fine.  I will be seeing another derm in July, but that seems like forever.  Please help!!

Answer
Hello Lucy: If the hair is thinning only in the area in which you are pulling and rubbing, it is highly possible that this is the cause of the thinning and hair texture change. Trichotillomania is a condition in which people obsessively pluck, pull, twist or rub their hair. Some people are aware of what they are doing. Others are not as consciously aware. The pulling is often done when relaxed and involved with activities such as while watching TV.
If you have hair loss or thinning in other areas you may have another hair loss condition. Androgenetic alopecia (female pattern baldness) will cause hairs in certain areas (bang, top, crown)to become thinner and weaker. Birth control medication is a common trigger for hair loss. The new pill you are on seems to be highly associated with hair loss.  Extreme dieting and weight loss is known to trigger telogen effluvium (excessive shedding) as you seem to have experienced 7 years ago. It seems as if your hair grew back normally as your body adjusted to the weight loss.
Hopefully you will be able to have a thorough exam with the new dermatologist, discussing all these issues. It is important to see a dermatologist who is highly experienced in hair loss matters. Be sure to research Rogaine before making a decision to use it.
I used essential oil scalp massage treatments very effectively for my own hair loss condition. They are natural but very potent and they do not come with the adverse side effects of synthetic topical treatments. You can read my story and also learn about female hair loss at my website. I will provide a few links:

My Personal Experience Female Hair Loss
http://www.vzbotanicals.com/mystory.html
Understanding Female Hair Loss
http://www.vzbotanicals.com/overcomefemalehairloss.html