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Hair Loss/miniaturized hairs androgenetic or low iron?

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Question
Dear Dr.Panagotacos,  Would you kindly let me know your opinion regarding my possible Androgenic hairloss? I'm a 56 year old woman and to look at me, you'd never guess I have hair loss--my hair looks very dense, thick and long.  But in the temple area, I have some recession and "baby hairs," and lots of 4 to 6-inch-long hairs sticking out on the top of my head. This just started about 9 months ago. If this were androgenic alopecia, would there not have been some sign of this prior to age 56? I did see a dermatologist who said the hairs were miniaturized, but her assistant said they looked more like they were growing back.  So how can one tell if they are "coming or going?!"  I've heard miniaturized hairs look like "peach fuzz." My supposedly miniaturized hairs look as thick in diameter as the rest--they just have remained shorter than normal for about 9 months. So, short of a biopsy, how can I tell if they are indeed miniaturized? Do miniaturized hair follicles always die eventually?  The dermatologist I saw also said he thought progesterone is an androgen precursor, and could aggravate androgenic alopecia--if that's what I have.   Could I turn this around with more estrogen, Iron, vitamin D and C?  My ferritin has been stubbornly around 20-30 for years, and my vit D around 28. However, my endocrinologist said new studies show iron supplements cause health problems--even in small doses. So I'm very confused now. Have you heard of any problems with iron supplementation if taken correctly?  My endocrinologist also said I could crush up estrogen pills and put them in my shampoo, to counteract androgens at the scalp---have you ever heard of this? Does Propecia or Latisse work for women in the temple area?  I'd rather wear a wig than use minoxidil! Sorry for so many question--but I am confused and scared.  Thanks so much for any information you would provide.  Best,
 Kate

Answer
It is very difficult to be sure what the loss is that you are describing without photos or a hair exam, but it is possible that you may have damaged theses short hairs with a curling iron or hair drier which causes bubbles in the hairs when they get too hot and later break off at the site of damage while combing the hair. This is also seen in people who have the nervous habit of twirling their hair through their fingers leading to short broken hairs which is what these hairs seem to be. Miniaturized hairs are fine and wispy and usually less than and inch long. Miniaturized hairs are those going into their last life cycle and then they get scarred and die. This may take a few years.  If these are normal but shorter hairs then they may have been broken off. A biopsy may help but that is usually reserved for more serious conditions and yours seems to be one that will resolve itself. Ferrous Sulfate 325 mg taken with Vitamin C 500 mg daily is considered a safe supplement and is available at most drug stores. Propecia does not work well for women as it works primarily in the prostate and not the skin and hair. You may want to ask your doctor if you could take Avodart (dutasteride 0.5mg) which does block DHT production very well in women. Latisse does work to stimulate hairs in much the same way as minoxidil does. Crushed up estrogen pills in a shampoo not part of a treatment I would use.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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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

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