proper treatment

by Francyine
(Michigan )

Hi Dr. Weaver.

How are you? I need your opinion on my hair issues. I have had hair loss towards the top center on my scalp since my last year is high school (about 8 yrs ago). I then started wearing a short hair cut, to fit the spot, at the time I was still wearing a perm. During College, over the next 4 yrs my spot would grow and shorten. In 2003 I went to dermatologist (who also treated my minor acne and skin issues) who treated me for traumatic alopecia, I had since come out of the perm and was just pressing and braiding my hair. She prescribed Loprox Shampoo, Luxiq, and Derma-Smoothe, which worked well, my hair was growing stronger and fuller, 7 months later my hair was even and healthy, I came off of the meds. 9 months later my hair began to break (over heating and curling), so I had my cut and wore a short afro/short tapper.

Fast forward December 2007, I decided to grow my hair out, I started getting it twisted 2x a month, growing all over no problems. Until last Nov of 2008. I had some health issue, and stress & didn't realize my hair was coming out it the top side, my hair dresser told me. there is Dr here is the Detroit area that specialize in skin & hair rejuvenation. I made an appt and she noticed the original spot of hair loss where their are some deaded folicales. which is fine but she didn't address the stress spots ( my dx opinion). she didn't have any FDA approved meds. she has a patented gel that’s 0.0125% retinoic acid and 0.05 hydrocortisone clear gel and what I believe to be alcohol (that I was to use nightly w a shower cap, but it dries my hair out, brittle like). she also sold me Vaidya Mishra's Herb Rich shampoo, conditioner and hair oil (hot oil treatment) which totaled the cost $187 not including the office visit. She also listed the vitamins, which were $50, but I went to health food store and found a hair, skin, nail vitamin, and upon further research found a biotin supplement. My primary doctor stated to take the biotin w my regular multivitamin, instead of the hair, skin, nail w multi due large amts of fat solubles in both.

I have no problem w integrated medicine, but I almost feel if I was swindled. My hair is growing back but I’m also massaging it, and my hair dresser said since it was not a clean spot my hair will return. My hair is chin length now (except stress spots), everyone is amazed how fast it grew w the twists. I try to eat a healthy balance diet and exercise, But I’m lost at what I should do. Do I continue treatment w the doctor who sold me items I feel I should have bought at the health food store, and have no way to validate her products and side effects ? Or back to my derm, or do I leave my hair alone w the meds, and continue my original treatment prior to last stress spots, which is wash, condition, twist, and oil ? Both of the person I saw where black and women.

I have to mention that my mom has a spot in the center of her scalp also, (like my original issue) My aunt (mom's sister) has a pattern of baldness similar to men where there is only hair on the sides and back (past her ears to the neck).

Thanks so much for your time

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Jan 23, 2009
Response About Proper Treatment
by: Seymour M. Weaver, III, M.D.


When I approach a patient such as your self, my initial area of focus is to make an accurate diagnosis. My second focus is to find relief for any symptoms or problems that are being caused by the diagnosis such as getting hair that has been lost to grow back.

I have not examined your scalp, but based upon the information you provided, one of the possible explanations for what you have been experiencing is a localized form of an eczema condition called neurodermatitis. It frequently occurs at the middle of the top of the scalp; it is very common and not a day hardly goes by that I do not see several patients affected by this condition. For some reason, most of the individuals I see with this are Black females. I don't remember seeing 10 men with this condition in the past 26 years, but I have seen thousands of women with this diagnosis.

Many of the medications that you mentioned using in the past have anti-inflammatory properties and that is what is used to correct this problem. At times the medication is given by injection and at times the medication is used topically. It depends on the severity of the symptoms and the condition of the scalp.

Since the hair that is growing in area affected by neurodermatitis is oftentimes weakened by friction or rubbing, taking hair vitamins and using products that help to strengthen the hair can contribute to the hair growth returning to normal quicker. So, using the products that you mentioned are appropriate.

If you have an issue with dissatisfaction about services you receive from any health professional, then it is best to discuss it with that individual face to face.

Whenever I have a patient who is not satisfied with any treatment that I have rendered or any encounter with anyone in there office, I prefer to be told. None of us are perfect and there is always a way to get better.

Also, stress is a contributing factor to the development of neurodermatitis so everything you can do to stay cool, calm, and collected and avoid holding things in and letting them bother you internally will help your hair and scalp return to normal as well.

This condition can improve and show up again years later when the conditions are right. So, just because it gets better does not mean that it is cured.

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