Why The Diffuse Hair Thinning And Loss And Receding?

[sar06]

Hello......I am a 34 y/o female experiencing diffuse hair loss, diffuse hair thinning (follicular miniaturization?), and a noticeably receding hairline at the temples, widow's peak and back of my hairline (nape of neck and above ears). I used to have a lot of peach fuzz on my face, especially my forehead -- that's disappeared and the tops of my eyebrows seem to be also "receding" slightly.....almost like the hair loss is creeping down my face. Even light fuzz I had on my neck, surrounding my hairline in back, is gone and the skin feels as though I've waxed the hair off. I don't seem to be losing at my crown, but my part seems to be widening.

I've brought the hair loss up multiple times with my PCP and dermatologist and feel somewhat brushed off by both. PCP sent me for blood tests -- all labs came back normal, although I noticed ferritin is 28 (I've read optimal is 60-70). T3 was the only thyroid test not included in labs but I have an appointment with an endocrinologist in about 3 weeks. Dermatologist plucked a hair out and said it's "probably androgenetic alopecia" and told me to try minoxidil.

My question is -- why all the DIFFERENT symptoms??? If it's androgenetic, is receding normal for females (especially at temples and widow's peak)? And what about balding on my face and neck??? If it's thyroid or diet related, can these cause receding hairline and miniaturization? Could it be CTE and does miniaturization occur with this? I'm particularly worried about Frontal Fibrosing Alopecia, with the receding I'm experiencing, since I know this diagnoses requires fast action...but what about the diffuse loss and follicular miniaturization? Can those also occur with FFA?

A few other details:

I have sebborheic dermatitis - could inflammation be contributing? For about 6+ years, my scalp has gotten progressively more tender, almost like a bruised/sore feeling. Selsun and T-gel are the only shampoos that keep the dandruff and oiliness in check. A few months back, I started trying Nioxin instead (as this supposedly helps hair loss) and my scalp became so greasy (even same day washing), my hair looked wet and my scalp became extremely painful and inflamed. After stopping Nioxin and restarting the Selsun/T-gel routine, my scalp was still very tender with red, inflamed areas, so my derm prescribed steroid drops which seems to have helped.

I felt in my 20s that my hairline might be receding and, for most of my adult life, it's been the norm for globs of hair to come out in the shower. I was never sure, though, in my 20s if I was only imagining hair loss/receding. I've been using 2% minoxidil daily for a couple months now and tried it before on/off in my 20s.

I started my own business 2 years ago and have been INSANELY stressed at times. I'm sure this is not helping, but could it be causing it? If stress is controlled can it be reversed? Or have I now kicked off something that's irreversible?

A few other things -- I'm a vegetarian, but eat eggs, fish and dairy. I take methylphenidate everyday for ADD (not sure if this could also be contributing). My mom has hypothyroidism and so did her mom.

Sorry for such a long post. I just feel hopeless and helpless and unsure where to go beyond the doctors I've already seen. I'm working on diet and lifestyle changes, but this still feels like a "wait and see" approach and I'm so worried I'll permanently lose more in the meantime if I'm not seeking the right solutions. Has anyone experienced the types of hair loss I'm having or have experience with any of this?

Thanks so much in advance!!

 

[hairblues]

Im sorry you are going through this.

Can you post pics of hair (crop face out) ?

 

[sar06]

Thanks for your reply! I attached images, hopefully it worked...

The first 2 images show the receding "M" at temples and also the thinned out widows peak. The image where my hair is damp looks the most dramatic, but the part doesn't look quite as severe when my hair is dry (post-showering is when I do most of my crying). On my back hairline, there is visible white at the edge where hair used to fill in that area and, excluding the longer, fuzzy outlying hairs, my neck feels smooth where there used to be peach fuzz. I actually noticed my neck felt weird to the touch and I felt more chilled above the collar when wearing jackets, before I realized hair was missing. Same with my forehead, above the eyebrows....weird to the touch...and then I realized.

It's hard to capture the thinning of the actual hairs and diffuse loss, but all of the strands falling out are significantly thinned from what they used to be.

I apologize for the photo quality -- hopefully these are somewhat helpful. Thanks again!

 

[hairblues]

Thanks for your reply! I attached images, hopefully it worked...

The first 2 images show the receding "M" at temples and also the thinned out widows peak. The image where my hair is damp looks the most dramatic, but the part doesn't look quite as severe when my hair is dry (post-showering is when I do most of my crying). On my back hairline, there is visible white at the edge where hair used to fill in that area and, excluding the longer, fuzzy outlying hairs, my neck feels smooth where there used to be peach fuzz. I actually noticed my neck felt weird to the touch and I felt more chilled above the collar when wearing jackets, before I realized hair was missing. Same with my forehead, above the eyebrows....weird to the touch...and then I realized.

It's hard to capture the thinning of the actual hairs and diffuse loss, but all of the strands falling out are significantly thinned from what they used to be.

I apologize for the photo quality -- hopefully these are somewhat helpful. Thanks again!

I dont know what would cause recession in nape..there are some types of scarring alopecia that effect the front hair line...you probably seen some older women that hair line is ver recessed..thats different then regular Angrogenci alopecia or aerate...so i am not saying yo have this but i don't know.

I think you should find a dermatologist who specializes in alopecia and get a hair biopsy--the PROPER way to get a hair biopsy is they take 2 to 3 samples so the derma pathologist can compare samples because not always conclusive with just one sample ( I was misdiagnosed from one, they had to do a 2nd and compare then gave me properly diagnosis--this is VERY common).

You have to be a bit strong and brave and call around to insist what you are looking for which i know may not even be possible depending on where you live...but try and find dermatologist who specializes in hair loss who lives near you...are you close to a major city? I live in biggest city so i take some things for granted.

I know with my hair loss i was at one point shedding the 'baby' hairs that frame the face but once i started minoxidil these came back strong.

My diagnoses is andgrogenci alopecia 'early' (does not feel early) and ferritin anemia--my ferritin was around 10 for several years at least..i gotten it up to around 60 after many months of supplementing and monitoring but they still want me to get it up over 70 (70-90) and keep it there..kind of hard to do.
Ferritin won't CURE hair loss but can make hair loss worse or happen prematurely...so its good to get ferritin up no matter what other treatment you do--makes it more efficient. Hair needs ferritin to grow and if the hair is already weakened from DHT it makes sense that lack of ferritin makes it worse.


but you need a proper diagnosis by an experienced dermatologist for alopecia.

If you need more help and guidance (which you do) try also on Facebook 'alopecia areta' group..its a private group so it won't show up on your profile but they are more knowledgable about other types of hair loss and you may be able to get some recommendations of Dr were you live on that page...its not just ARETA they all have various types of hair loss although Areta is most common there.

 

[sar06]

Thank you so much for your response! I spent a couple days calling around and found a dermatologist specializing in hair loss available next week. I'll be sure to ask for a scalp biopsy and ask questions about how it's done to be sure it will be conclusive. Hopefully I'm not brushed aside and I'll update here for anyone else going through my weird combination of symptoms.

I'm trying to eat more protein and have been working at cutting out sugar and dairy. I'm still in the "normal" range for ferritin, but wonder if it's not still too low at 28. I seem to find mixed info on ferritin......either that it has no impact unless it's WAY below normal....OR that anything under 60-70 is low enough to cause/accelerate hair loss. I plan on getting iron supplements....in moderation, I'm sure it can't hurt to try.

With thyroid disorder, I know there's diffuse loss, but is there ever loss at the temples too and would there be follicular miniaturization? If it's FPB and not thyroid or another cause, I just don't get why the receding too. It's such a confusing blend of symptoms.

I've been considering all other contributors as well....hard water? Endocrine disruptors (plastics, fabric softeners, etc.)? Lack of exercise (I need to work on this!)? Inflammation from seborrheic dermatitis? Wearing my hair up all the time? (The last one seems like a stretch...again, because of the miniaturization).

Thank you again....I'll update on derm appointment next week and endo in a few more weeks...

 

[hairblues]

Thank you so much for your response! I spent a couple days calling around and found a dermatologist specializing in hair loss available next week. I'll be sure to ask for a scalp biopsy and ask questions about how it's done to be sure it will be conclusive. Hopefully I'm not brushed aside and I'll update here for anyone else going through my weird combination of symptoms.

I'm trying to eat more protein and have been working at cutting out sugar and dairy. I'm still in the "normal" range for ferritin, but wonder if it's not still too low at 28. I seem to find mixed info on ferritin......either that it has no impact unless it's WAY below normal....OR that anything under 60-70 is low enough to cause/accelerate hair loss. I plan on getting iron supplements....in moderation, I'm sure it can't hurt to try.

With thyroid disorder, I know there's diffuse loss, but is there ever loss at the temples too and would there be follicular miniaturization? If it's FPB and not thyroid or another cause, I just don't get why the receding too. It's such a confusing blend of symptoms.

I've been considering all other contributors as well....hard water? Endocrine disruptors (plastics, fabric softeners, etc.)? Lack of exercise (I need to work on this!)? Inflammation from seborrheic dermatitis? Wearing my hair up all the time? (The last one seems like a stretch...again, because of the miniaturization).

Thank you again....I'll update on derm appointment next week and endo in a few more weeks...

I highlighted stuff i am going to comment on

1. I would suggest you tell him/her something like
"i would like to do a biopsy where two sections are taken instead of 1 so they can compare--i hear a lot of women get misdiagnosed when they only have one biopsy"

2. Try to find the study from Dr George Costarellis...he published in a dermatology journal many years ago--it is the study everyone quotes and often misquotes for articles about iron...I cant look for it right now but i would suggest try to find the actual Study---i found it once online in the journal back log.

What he found in the study was in many women with hair loss--regardless of type of hair loss--women had low to low normal ferritin levels...

in the women who were treated with iron to get the ferritin up to optimal number (over 70-90 ) those women responded better to hair treatments (minoxidil, hormone blockers etc) then the women who did not raise the ferritin)

So the treamtmets are more effective IF ferritin is over 70 then those who its low/low normal.

IF you start to supplement it is very important you do this with a DR supervision so they can periodically monitor your blood work ever 6 to 8 weeks to make sure you are not overdosing---Also they can adjust how much you take according to how quickly your ferritin raises.

IF you have trouble absorbing Iron pills--you can take on an empty stomach with orange juice or vitamin C tablet...taking with food (some foods more than others you can look up about this) make it difficult to absorb iron. Calcium is a big blocker of iron absorption when taken together.

3 I dont know aobut thyroid except that eyebrows usually thin and it think body hair is also effected...but i dont know...

make sure you don't have PCOS either.

The receding hairline may have to do with estrogen. Lack of or if you are taking any estrogen blocker.

here is a quote from Bernstein medical about women and hair loss vs men. I highlighted what i am talking about with estrogen and hairlines---I dont KNOW but if i were you i would ask about it with Dr maybe print it out.

https://www.bernsteinmedical.com/hair-loss/women/causes/

In both men and women, 5-a reductase reacts with testosterone to produce DHT, the hormone responsible for the miniaturization (shrinking) and gradual disappearance of affected hair follicles. This explains why both men and women lose their hair. But one of the reasons why women seldom have the conspicuous bald areas that men do is because women naturally have only half the amount of 5-a reductase compared to men.

Adding to this complexity, in women, the enzyme aromatase is responsible for the formation of the female hormones, estrone and estradiol, counteract the action of DHT. Women have higher levels of aromatase than men, especially at the frontal hairline. It is this presence of aromatase which may help explain why hair loss in women looks so different than in men, particularly with respect to the preservation of the frontal hairline. It may also explain why women have a poor response to the drug finasteride (Propecia), a medication widely used to treat hair loss in men that works by blocking the formation of DHT.


4--all that stuff i Don't know about so i cant help you but i wouldnt feed into it too much..its probably rare (not impossible) any of that stuff causes or contributes to hair loss or effects hormones in such a way to effect hair loss...but keep it in back of head IF your tests have no cause.

but honestly if your parents one of both had hair loss then you just inherited the gene for it and other factors may be making it worse.

 

[Alexia]

Hello sar06, news biopsy????

 

[Roxxy]

Hi sar06. My hair loss is similar to yours, and I have sebderm too. Were you able to get any answers? I hope things are going well.

QUOTE="sar06, post: 1445806, member: 129952"]Hello......I am a 34 y/o female experiencing diffuse hair loss, diffuse hair thinning (follicular miniaturization?), and a noticeably receding hairline at the temples, widow's peak and back of my hairline (nape of neck and above ears). I used to have a lot of peach fuzz on my face, especially my forehead -- that's disappeared and the tops of my eyebrows seem to be also "receding" slightly.....almost like the hair loss is creeping down my face. Even light fuzz I had on my neck, surrounding my hairline in back, is gone and the skin feels as though I've waxed the hair off. I don't seem to be losing at my crown, but my part seems to be widening.

I've brought the hair loss up multiple times with my PCP and dermatologist and feel somewhat brushed off by both. PCP sent me for blood tests -- all labs came back normal, although I noticed ferritin is 28 (I've read optimal is 60-70). T3 was the only thyroid test not included in labs but I have an appointment with an endocrinologist in about 3 weeks. Dermatologist plucked a hair out and said it's "probably androgenetic alopecia" and told me to try minoxidil.

My question is -- why all the DIFFERENT symptoms??? If it's androgenetic, is receding normal for females (especially at temples and widow's peak)? And what about balding on my face and neck??? If it's thyroid or diet related, can these cause receding hairline and miniaturization? Could it be CTE and does miniaturization occur with this? I'm particularly worried about Frontal Fibrosing Alopecia, with the receding I'm experiencing, since I know this diagnoses requires fast action...but what about the diffuse loss and follicular miniaturization? Can those also occur with FFA?

A few other details:

I have sebborheic dermatitis - could inflammation be contributing? For about 6+ years, my scalp has gotten progressively more tender, almost like a bruised/sore feeling. Selsun and T-gel are the only shampoos that keep the dandruff and oiliness in check. A few months back, I started trying Nioxin instead (as this supposedly helps hair loss) and my scalp became so greasy (even same day washing), my hair looked wet and my scalp became extremely painful and inflamed. After stopping Nioxin and restarting the Selsun/T-gel routine, my scalp was still very tender with red, inflamed areas, so my derm prescribed steroid drops which seems to have helped.

I felt in my 20s that my hairline might be receding and, for most of my adult life, it's been the norm for globs of hair to come out in the shower. I was never sure, though, in my 20s if I was only imagining hair loss/receding. I've been using 2% minoxidil daily for a couple months now and tried it before on/off in my 20s.

I started my own business 2 years ago and have been INSANELY stressed at times. I'm sure this is not helping, but could it be causing it? If stress is controlled can it be reversed? Or have I now kicked off something that's irreversible?

A few other things -- I'm a vegetarian, but eat eggs, fish and dairy. I take methylphenidate everyday for ADD (not sure if this could also be contributing). My mom has hypothyroidism and so did her mom.

Sorry for such a long post. I just feel hopeless and helpless and unsure where to go beyond the doctors I've already seen. I'm working on diet and lifestyle changes, but this still feels like a "wait and see" approach and I'm so worried I'll permanently lose more in the meantime if I'm not seeking the right solutions. Has anyone experienced the types of hair loss I'm having or have experience with any of this?

Thanks so much in advance!![/QUOTE]

 

[Inkymalinky]

Hi sar06. My hair loss is similar to yours, and I have sebderm too. Were you able to get any answers? I hope things are going well.

Hey Roxxy, did you ever find out what kind of hair loss you have? Mine also sounds similar.

 

[Inkymalinky]

Hey Sars06, I know this is an old post, but did you ever get answers?

 

[Jhair123]

I've been dealing with hair loss for awhile now too, and feel your pain. I found this girls videos and they've helped me so much. She just posted one that shows a good way to style hair when thin, and I'm excited to try it so i thought i'd share! Good luck to you all.