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Facing hair fall issue with patching just above forehead. What can be done?

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Dermatologist
Practicing since : 1996
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I am facing hairfall issue. There is patching just above the foreahead.
i will upload my recent blood test report by monday, after which Doctor can work on the same.
Posted Sun, 19 May 2013 in Skin Hair and Nails
 
 
Answered by Dr. Bharat Chawda 24 hours later
Hi!,

Thank you for posting your query,

It is certain from your question that you are loosing hair ,but the pattern of hair loss is not very clear.I would like to know further from you regarding the same.
My questions are as follows :
1) Is there a diffuse hair loss from all parts of the scalp?
2) Do you observe any coin shaped hair loss patches on scalp ?
3) Are you married & has your hair loss started after after delivery ?
4) Are your menstural periods regular?
5) Any other hormonal problems or thyroid problem ?

Answer to these questions would help me understand your problem better.Even a close up picture of the lesion would help me further. So if you can send me a picture of the lesion on nose ,I would appreciate.
You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.You can also email the same to YYYY@YYYY with “ATTN: ” in the subject line.

In females the most common cause of hair loss is –iron deficiency, hormonal imbalance, thyroid problem, stress, lack of sleep, familial ,or use of chemical on scalp ,procedures like perming or straightening etc. Other rare causes are zinc & copper deficiency . One has to find the exact cause of hair loss and treat.

In females there are various patterns of hair loss,which can be judged clinically by a dermatologist.If you are losing hair only from the front of the scalp then it is known as Androgenetic alopecia(AGA). In such a case you should get your hormonal level checked along with an ultra sound if necessary to rule out PCOD (polycystic ovarian disease).Such patients are usually obese & have irregular periods. This can be diagnosed by a ultrasound and simple blood tests.
The second most common type of hair loss seen in females is Telogen Effluvium (TE).In this we observe diffuse hair loss from all over the scalp .There is also thinning of hair in this pattern.

In Alopecia Areata one looses hair in coin shaped patches .This is a auto immune condition and requires inject-able treatment.

These patterns can be diagnosed by proper physical examination and blood tests.

Other simple test which we do are hair pull test and trichogram to diagnose which type of hair loss is there.

After proper diagnosis you can start with topical preparations like Minoxidil 2%-5% applied twice daily on scalp along with tab biotin once daily.Other hormonal medicines are also available if needed.These medicines can only be prescribed by a qualified dermatologist after proper examination .

Improve your diet with green leafy veg, fresh fruits, plenty of water, sprouts ,pulses, high protein diet,more of milk , ghee & dry fruits .
Avoid items with high sugar content like sweets & chocolates, Chinese foods, pizza & burgers . Good sleep also has a important role to play . In case nothing helps and if baldness sets in then we do hair transplantation for those needed.

I thank you for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.Answer to my above questions & your blood reports would help me further understand your problem and guide you better.

Please accept my answer in case you do not have further queries.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Facing hair fall issue with patching just above forehead. What can be done? 4 days later
I have uploaded my blood report. I will upload my photo by wednesday, you may revert post that.
Answers to your question:
1) Is there a diffuse hair loss from all parts of the scalp? Yes, its spread across and thining of hair is all over.
2) Do you observe any coin shaped hair loss patches on scalp ? Yes, its just above the foreahead, rest of the places its just thining and not patch.
3) Are you married & has your hair loss started after after delivery ? Yes, i am married and the hair loss exist prior to my marriage but itis now very visible.
4) Are your menstural periods regular? Yes, it is very regular.
5) Any other hormonal problems or thyroid problem ? I have attached my blood report for your reference.

Let me know incase i need to start any medicine
 
 
Answered by Dr. Bharat Chawda 46 hours later
Hi!,

Thank you for writing back & reports.

I was actually waiting for the picture which you were planning to send .That would have been very helpful,but anyway,I would answer your query according to the reports.

All your reports are normal except serum iron level which is on the lower side.I would like you to add iron tablets in your prescription apart from the other medicines which we have discussed earlier.

As you mentioned in text that you have a patch of bald area on the front area of scalp.I was very keen to see that patch if you can send a picture of the same.I just want to rule out a condition known as Alopecia areata in your case in which we observe a coin shaped bald patch on scalp.

Rest of the medicines would remain same like Minoxidil (2% to 5%) for local application twice a day .Tablet Biotin can be taken once a day for long.

I don't see any hormonal problem in you case as far as the reports are concerned.

Since these are prescription based medicines I would advice you to consult a dermatologist for proper prescription.

Hope I've answered your query.

Should you have additional concern regarding the same ,I would be happy to address it.

Please accept my answer in case you do not have further queries.
Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Facing hair fall issue with patching just above forehead. What can be done? 5 days later
I have sent the photograhs for better understanding. You may prescribe the correct medicine.
Let me know the name of the medicine and duration
 
 
Answered by Dr. Bharat Chawda 8 hours later
Hi!,
.
Thank you for the pictures you had sent.

What I understand from these pictures and the blood report is that you have a diffuse hair loss which is known as Telogen Effluvium(TE).

This is also seen when serum Iron level is low(as in your case).

I would repeat the medicines for you as I had disused earlier.You need to apply Minoxidil solution (5%) initially for a month and then later on shift to minoxidil 2% solution .This solution is applied twice a day on the roots of scalp.This can be used morning after bath and in the night before you go to bed.This should be used for about 6 to 10 months and later tapered.

You should also take iron tablets on daily basis.You can also supplement yourself with tablet Biotin once a day along with zinc.These too should be taken for 6-10 months.

Since these are prescription based drugs and not an OTC ,I would advice you to consult a dermatologist for proper prescription and follow up.Diet as discussed earlier should also be followed routinely.

Hope I've answered your query.

Should you have additional concern regarding the same ,I would be happy to address it.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
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