Hair Loss/Possible CTE
QUESTION: Hello Dr. Vonzabuesnig,
I had my first bout of TE about 18 years ago during a stressful period in my live (divorce). I started seeing a trichologist in Los Angeles, which proved helpful at the time and the shedding began to taper off and eventually stopped. I continued on the regime that the trichologist recommended to keep my hair in good shape.
Fast forward to about 6 years ago when I switched to a low estrogen birth control pill, and the shedding began again. I decided to go back to the regular estrogen pill I had been taking, but that did not help stop the shedding. I finally decided to stop birth control completely almost 2 years ago. My problem is that the TE never corrected itself and I have had problems with shedding for the past 6 years. I am sure that now I have CTE. I have lost over 2/3 of my hair in these past 6 years. It has caused me severe depression and I have tried most everything possible to find the solution and stop the problem.
I have had so many blood tests, all have come back in normal range and I recently had my ferratin levels tested and they were above 90. My overall iron levels were within range as well. I have been to doctors who practice both western medicine and Chinese medicine. Been to naturopaths, chiropractors, trichologists and dermatologists. Nobody can pin down exactly what is causing the shedding to continue. Currently, I shed approximately 60-70 hairs on a GOOD day. The bad days are well over 150 hairs. And it's constant, there is no break in the cycle. I have cut my hair to a short bob and have noticed that now, not only does it shed, but it will not grow past a certain length. I fear that soon I will need to wear a wig if this shedding does not stop. I do have regrowth, but it never stays long enough to catch up to the rest of my hair, or it does not grow to any noticeable length.
I apologize for this long message, but I want to try to give you as much information as possible. I am a lacto-ovo vegetarian and have been for 20 years. I am 44 years old and have never had children. I currently take 30mg of Zinc daily, a hair & nails supplement, DIM Detox, Vitamin D, Biotin and fiber supplements. Please let me know if you need name brands or dosages. I have tried essential oils for the scalp (rosemary & lavender, separately and with coconut oil as the carrier oil) but the problem I find is that I shed A LOT of hair when oiling and it makes me very stressed and nervous.
I would really appreciate any advice you can give me. It is incredibly generous of you to give your time and share your expertise with people. I know the reason you do it is that you have suffered as well and know the fear and loneliness that women feel with hair loss. I wish I had a dime for every time a doctor has told me not to worry and to be grateful that something isn't really wrong with me! Not very compassionate of them. Thankfully, there are doctors like you!!!
ANSWER: Hello Kaie: It is often difficult to pinpoint the exact cause of chronic telogen effluvium. Often there are multiple contributing factors. When the cause is unknown it is important to look at entire picture of physical and emotional health and well-being. How do you feel overall? Do you have energy and vitality? Are you happy? Do you exercise, get fresh air, etc. Do you have any health conditions?
You are taking a lot of supplements. Is that due to deficiencies, recommendations, or due to the fact that you are lacto-ovo vegetarian and want to cover your bases? What does your normal diet include? If you are eating ample vegetables and fruits you may not need extra fiber. 30mg of zinc a day on a continual basis may be high unless you have a known deficiency. Your hair and nail supplement most likely contains zinc also, so you would be getting more than 30mg per day if this was the case. Too much zinc can inhibit copper absorption, causing a copper deficiency. Although copper deficiency is rare, copper is necessary for healthy hair growth. Excess copper can cause hair loss and other problems as well. Nutrients must be intricately balanced.
What type of treatment were you using after your first bout of TE?
Essential oils can help stimulate hair growth. They do not cause hair loss. The reason you saw more shedding while using them is because the manipulation of hair caused the loosened hairs that were already in the telogen stage to come out. Those hairs would have fallen out anyway, the fallen strands just would not have been as noticeable.
There is no reason to fear wearing a wig. I often recommend it to women who are very depressed and fearful about their hair loss. Wigs do not carry the stigma that they used too. Many women are wearing them just for fun. If you wear a wig and feel better about how you look you can relax enough to allow your body to heal better. Please send me more information so I may help you further.
Sincerely, Melanie Vonzabuesnig
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QUESTION: Thank you for your response. I appreciate you taking the time to ask me some follow up questions.
How I feel overall varies day to day...I often feel quite depressed about the hair loss and have tried taking anti-depressants, but then find myself worrying that they are contributing to the problem. My energy and vitality are also varied. I go through periods of low energy quite often. I feel like I should be over the moon happy because everything else in my life is wonderful. I have an amazing fiance who I am marrying this July. I have a great job, a nice home and a terrific family! What more could a person ask for, right? But the hair loss seems to dominate my mood and occupy my thoughts almost all the time.
I exercise but not consistently and have no known health conditions. I have noticed over the past several months that I have a very itchy scalp and that when it flairs up, the hair loss increases. I've tried topical medication from the dermatologist, but it burns my scalp and that makes me nervous...it can't be a good thing! My diet could be much better, I'm sure, and most of my bad eating habits stem from depression and comfort eating.
The treatment I used the first time I had TE was given to me by a trichologist in Los Angeles. It was vials of topical treatment that were applied to the scalp and then washed out the next day. It did work for me at first, many years ago before the hormones became part of the reason for the hair loss. Now, the treatments don't work and since they are very expensive, I have discontinued using them.
I would love any suggestions you might have to help improve my situation. My hair at this point is not growing at all. It doesn't seem possible, but it seems to be getting shorter every day. I know that must be because of the loss of longer strands. My impending wedding makes me so nervous, but not for the normal reasons. I become tearful just thinking about how I'm going to deal with my hair issue for the wedding. I'm considering going to Follea in Beverly Hills and having a consultation for a wig.
I did start adding Rosemary essential oil to my shampoo, which was a suggestion from my homeopathic doctor. And I began taking Evening Primrose Oil. Do you think I should stop taking the Zinc?
Thank you again!!!!
Thank you for the additional information. For several reasons, I do think it's a good idea to purchase a nice natural looking wig for now--while you are working on regrowth and repair of hair. You say that the condition of your hair dominates your mind and your mood. I totally understand this. But I also know that it can be much more difficult to heal a condition when there is intense worry, anxiety and depression involved. The body can heal more easily, and find appropriate solutions when it is in a relaxed state and not so focused on the problem. Wearing a beautiful, natural looking wig can help relieve some stress and help you focus more on wonderful things in your life like the upcoming wedding to your amazing fiancÚ.
While you are wearing the wig you can treat the hair loss without worrying how fast it is/or is not working. I think this will provide you with some much needed freedom. Secondly, Your wedding is n July--about 4 or 5 months away. Even if you got your hair to start growing and stop falling very quickly, it still takes time for the cells at the base of the follicle to form a strand of hair with the follicle. Once the newly growing strand permeates the scalp it will grow approximately one half inch per month. It will take some time for new growth to add to the volume of your existing hair.
Many women who don't even have a hair loss problem will wear some type of extension, add-on or wig for a special occasion such as a wedding. If you start wearing the wig soon, you will be used to it by the time of your wedding and you will not feel self-conscious. Once you feel better you may also start taking better care of yourself. This will be very helpful in your overall well-being and can also help your hair, as the condition of hair is intimately connected to overall health and well-being.
When a person cannot pinpoint the cause of telogen effluvium, I suggest implementing anything that may better their overall health and well-being. Any positive changes are helpful, even small changes.
That said, I would like to know more about the scalp flare-ups that cause itching. Is this in one area or the entire scalp? Did the dermatologist who prescribed the burning medication say what the condition is? Do you have any scaling, flakes, dermatitis, inflammation etc? Can you also tell me what the root end of your fallen hairs look like? Do you see or feel a clear (or pigmented) little bulb at the end? Do you have any bald patches? Is the hair loss fairly uniform throughout the scalp or is it more prominent in certain areas?
You mention your hair loss is partly due to hormones. Have you been diagnosed with hormonal imbalances?
Rosemary in shampoo is fine but just adding it to shampoo may not be enough to initiate regrowth. Using it in a scalp massage formula that is left on scalp for more than a few minutes (as in shampoo) may be more effective.
Sincerely, Melanie Vonzabuesnig