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Dermatology (Expert Forum)
Hair loss second opinion
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
Hair loss second opinion
by JohnAK, Jun 14, 2008 01:24AM
I am a 23 year old male and noticed approximately 4-5 weeks ago that I have been losing quite a bit of hair. Not in large clumps but when I run a wet hand through my hair, a good 10-20 hairs are stuck to it. If I keep running my hand through more and more keeps coming out. Although it is worst in the front it appears to be rapidly thinning everywhere. I have very thick hair so this may have been going on for longer and I may have just not realized it.
Having done some research on my own, I 'thought' I knew what I had. Every single hair has a white root which from what I've read means it is in the telogen phase. Further, the hairs are very thin, fine, and sometime very very short. There appears to be no scarring or scalp irritation. My grandmother on my moms side is the only relative who has experienced hair loss. Finally, it appears to thinning everywhere (though much worse in the temple area) and no chunks are missing. From this, I had pretty much concluded I had telogen effluvium.
Now, I have already seen a dermatologist for this. In the space of a 5-10 minute appointment, the physician's assistant pretty much ruled out telogen effluvium, told me it was androgentic alopecia, and wrote me a prescription for Propecia. I almost wish I had not went to this appointment as I now have to decide between what this PA concluded and what seems like common sense.
Does this seem like a correct diagnosis or should I get a second opinion? I just moved here and this was practically the only dermatologist office in the state (Alaska) so I am debating whether to fly home to Denver to consult another dermatologist. I don't want to just start taking the Propecia as if the hair does grow back, I will never know which syndrome caused the hair loss and could be potentially be paying $600-700 a year that does nothing for me. Advice on how to approach this would be appreciated.
Having done some research on my own, I 'thought' I knew what I had. Every single hair has a white root which from what I've read means it is in the telogen phase. Further, the hairs are very thin, fine, and sometime very very short. There appears to be no scarring or scalp irritation. My grandmother on my moms side is the only relative who has experienced hair loss. Finally, it appears to thinning everywhere (though much worse in the temple area) and no chunks are missing. From this, I had pretty much concluded I had telogen effluvium.
Now, I have already seen a dermatologist for this. In the space of a 5-10 minute appointment, the physician's assistant pretty much ruled out telogen effluvium, told me it was androgentic alopecia, and wrote me a prescription for Propecia. I almost wish I had not went to this appointment as I now have to decide between what this PA concluded and what seems like common sense.
Does this seem like a correct diagnosis or should I get a second opinion? I just moved here and this was practically the only dermatologist office in the state (Alaska) so I am debating whether to fly home to Denver to consult another dermatologist. I don't want to just start taking the Propecia as if the hair does grow back, I will never know which syndrome caused the hair loss and could be potentially be paying $600-700 a year that does nothing for me. Advice on how to approach this would be appreciated.
Doctor's Answer
by Alan Rockoff, MD, Jun 15, 2008 05:25AM
, Jun 15, 2008 05:25AMTo: JohnAK
Getting 10-20 hairs every time you run your fingers through it is a pretty good indication of telogen effluvium. In general, people with ordinary male-pattern hair loss (androgenetic alopecia) do not see increased hair fall of this type. If you had some event 3-4 months ago that induced a "shock" to your health (high fever, surgery, etc.), that would provide further circumstantial evidence that you do indeed have telogen effluvium. Since telogen effluvium is reversible and self-limiting, I think you should hold off on the Propecia for 3 months and see what happens. If the hair is falling out a lot less, then I would continue to wait for the hair to re-grow from its telogen loss. You don't really have anything to lose--male-pattern hair loss wouldn't leave you substantially balder in 3 months anyway, and you can always reconsider the use of Propecia then.
Take care.
Dr. Rockoff
Take care.
Dr. Rockoff
I'm on propecia...however, my doctor (being pretty cool), prescribed me 5mg Finasteride (i.e. Propecia). I split the pills in half, which is pretty close to the dosage for Propecia. The bottle lasts me two months, and costs me $5 because finasteride is covered on my insurance. I'm 28 years old, soooo....the insurance company DID need my doctor to verify the prescription. But like I said, he is cool :) See if your doc will hook you up the same!