Dr Donovan Answers Reader Questions: Hair Coming out in "Clumps"

Here is a recent question from our website visitor:

I have been visiting a dermatologist for 2 months now. My hair was coming out from the root in clumps. Half my hair is gone (thank god I have lots of hair). He has been giving me the cortizone shots. First time i Went he advised me to wash hair every other day and the last time i went he told me to wash every day. Now sometimes when I go a day without washing my hair my scalp hurts a lot. I can say with washing my hair every day its falling out less but it still falls out. I took test for iron and thyroid and everything came back ok. I do dye my hair and he ruled my hair loss from that but something is just not right. I know its only been 2 months but I want my hair back...badly. Should I just give it more time or should i see someone else. Will a natural remedy help or maybe scalp massages?


Dr Donovan's response:


Thanks for the interesting question. The key question is: what diagnosis was given for your hair loss? There are 100 causes of hair loss and cortisone injections can be used in over 20 of them!!! Most likely you were diagnosed with alopecia areata because that's the most common reason that cortisone injections are given. But cortisone injections are also used for scarring alopecia and other conditions as well. Without a diagnosis, I can't comment much more.

Washing your hair everyday or every second day is fine. If you have some seborrheic dermatitis in the scalp ( a distant cousin of dandruff) or if you are using alot of topical medications (lotions, creams), then washing your hair every day will just make it feel better. Patients with alopecia areata and scarring alopecia often feel better washing their scalp everyday too. It just feels better.

If you were diagnosed with alopecia areata, there's a good chance your hair will improve with injections. But whether it comes back fully is hard to predict.  Please note that ccortisone injections do not help everyone with alopecia areata.  If you are getting injections because you were diagnosed with a scarring hair loss condition (like lichen planopilaris), you probably won't improve much at all - but hopefully the cortisone injections will prevent your hair loss condition from getting worse.  That's why we use cortisone injections for lichen planopilaris.

As you can see, the cause of your hair loss is critical to know before fully answering your question. Cortisone injections help some hair loss conditions but not all.

As for scalp massages, they have no benefit in any hair loss condition. As for natural remedies, most have not been well studied. One exception would be the use of aromatherapy for patients with alopecia areata. Check out the discussion I wrote a few years ago about this subject 



Treating hair loss can sometimes be challenging. If you trust your physician's opinion, stick with him or her. You will hear many answers for your hair loss if you "shop" around.  Make sure you ask what your diagnosis is and make sure you ask if hair regrowth is even possible in this condition.



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Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887

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