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This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
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I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
Most forms of alopecia areata are easy to diagnose, however one form is not. Alopecia areata incognito (which some pair together with so called diffuse alopecia areata) is the most difficult type of alopecia areata to diagnose.
A number of dermatoscopic features support a diagnosis including yellow dots, regrowing hairs, dystrophic hairs, exclamation hair and black dots. Unfortunately, all these features are not always present.
In my opinion, most cases of diffuse alopecia areata I see have a unique feature that I have traditionally called "wimpy hairs". These hairs are short and fine and refuse to grow straight up. They are very different than the strong thick pointy "upright regrowing hairs" seen in telogen effluvium. Rather these wimpy hairs twist and turn and flop over on the scalp. Many such hairs are seen in the photo.
Treatment includes potent topical steroids and steroid injections.
I posted an answer to a new question on Realself.com
One uncommon side effect from minoxidil is an increase in heart rate. This is not the only thing that minoxidil is doing in this situation. It's actually primary lowering blood pressure and in turn the body increases heart rate to compensate.
I'm often asked if one needs to stop. This needs to be handled on a case by case basis. Some people will say to me " my heart rate goes up when I exercise ... so what's the difference?"
During exercise both heart rate and blood pressure go up. It's a very different physiology than minoxidil. A person's heart rate also goes up (and blood pressure goes down) when hey are dehydrated and we know this is not good. A person's heart rate can go up (and blood pressure go down) with topical minoxidil. Fortunately, this does not happen to everyone. But if there are significant heart rate changes with minoxidil, I advise checking with one's physician about whether or not to stop. This is especially important for those over 65.
Hair is made up of protein. So to no surprise, my attention often shifts to the quantity and quality of protein in my patient's diets. There has been a remarkable increase in demand for organic food in the past 2 decades. There is a perception that organic farming is more sustainable, has better nutritional and health value, is kinder to animals.
Studies to date have started to show differences in the nutritional value of organic meats. Some studies have suggested organic meat is higher in beneficial omega 3 fatty acids (which may reduce the risk of cardiovascular disease). Organic meats may have lower concentrations of the saturated fatty acids myristic- and palmitic acid (which were linked to an increased risk of cardiovascular disease). Whether other vitamin, mineral and micronutrients truly differ in organic vs conventional meats is not clear. Furthermore, and perhaps, most importantly we do not yet have a clear understanding of the impact of chronic antibiotic and hormone use in conventional livestock on the health benefits of humans. More studies are needed in these areas to better understand the magnitude of effect of health issues such as obesity, insulin resistance, fertility, heart disease and cancer. While these are clearer broad issues, they have important implications for how hair loss develops and how we treat hair loss. If possible, I do recommend that many of my patients who do eat meat consider substituting organic meats where possible.
Reference
Composition differences between organic and conventional meat: a systematic literature review and meta-analysis. Średnicka-Tober D, et al. Br J Nutr. 2016.
Food safety and organic meats.
Review article. Van Loo EJ, et al. Annu Rev Food Sci Technol. 2012.
I posted an answer to a new question on Realself.com
There are many different forms of hair loss. We broadly classify hair loss into the "scarring" forms and the "non-scarring" forms. Patients with scarring forms (also called scarring alopecia) may experience hair loss accompanied by symptoms such as itching, burning or even scalp tenderness/bruising. Some patients, however are completely asymptomatic.
The hallmark of all scarring alopecias is the loss of the follicular openings or "pores" when examined up close. Rather these areas are replaced by scar tissue - as shown here in this photo of a patient with a scarring alopecia known as lichen planopilaris (LPP).
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
I posted an answer to a new question on Realself.com
