30 yo female - can anyone help read my scalp biopsy results?

[labellavita1985]

Hey guys,

as I have talked about before, I have been experiencing fluctuating, high sheds since February 2015. This has resulted in a diffuse loss of approximately 40% of my hair. I was significantly iron deficient and had a slight hormonal imbalance (elevated total testosterone.) I have been supplementing iron, and although my total iron, hemoglobin, and hematocrit counts have increased and now seem to be in range, I'm still red blood cell deficient. I've also been on birth control pills and Spironolactone (for the hormonal imbalance, also hoping it would help with my hair) since late July. Still shedding heavily, no improvement at all. I finally had a scalp biopsy consisting of one 4mm punch. I would really appreciate any feedback. I know many of you know much more about hair loss than I do. Thanks.

Ignore the first image.

 

[labellavita1985]

:/

Bump

 

[Soviet Youth]

Well I can't really help you except maybe explain the scalp biopsy a little bit better for you. The results of the scalp biopsy are most likely androgenic alopecia, meaning hair loss caused by the androgens (testosterone, dht, etc), sadly there is no cure for this condition and it is progressive. However, the analysis of the scalp biopsy also mentions that it is possible that there is a slight chance that it is telogen effluvium instead, which essentially means hair loss due to heavy physical stress (major illness, surgery, severe nutritional deficiencies, etc), luckilly this type of hair loss goes away on its own after a period of time, roughly six months to a year. However, I will say this, since you do not know what type of hair loss it is the longer you wait to do something about it (if it is Androgenetic Alopecia) the harder it will be to regain the hair that you have lost.

 

[Pequod]

I think most of your hair loss was because you are anemic and had low iron. You must have had obvious menstrual bleeding that caused it (or possibly something else as well?) and never caught back up on iron. This may be that you were low for a long time and your hair finally said enough and shed. The scalp biopsy diagnosis I don't believe is accurate, but this is only my opinion and i could be wrong.

Did they do blood tests to see if the Spironolactone is working? If it is androgenic alopecia that might help.

 

[Saurabhaj]

Did you suffered from something like typhoid 3 months backs?

 

[Joan]

Hi, labella. My scalp biopsy results (over two years ago) had the same wording as yours re: Androgenetic Alopecia and a Telogen Effluvium component. I once read that everyone has some degree of hair miniaturization and that certain deficiencies can cause it as well, so maybe it's not Androgenetic Alopecia after all. Although you've raised your total iron, hemoglobin, and hematocrit counts, are they in range? I'm asking because you said you're still red blood cell deficient. Maybe that's part of your problem. I'm sorry to hear that things haven't improved for you--but there's still hope.

 

[labellavita1985]

Thanks everybody.

Joan,

thank you for your encouragement. I really appreciate it. Things have gotten much worse. Actually, I don't think my hair looks much worse but shedding has increased 4-5 fold. My hemoglobin, hematocrit, and total iron appear to be in range now (ferritin wasn't screened in my latest bloods,) but I'm still RBC deficient. I don't understand why that would happen or how it happens. Any ideas?

How are you doing? Did you start on spironolactone?

 

[Joan]

Maybe someone with a medical background can answer your question regarding your deficiency. You say they appear to be in range, but maybe they're at the low end or borderline and need to be even higher?? Also, it sounds like you do have some Telogen Effluvium going on, since you're shedding more. I find that I go through months and months of major shedding (I'm talking 300 hairs a day just after washing and styling, plus hair falling out all day long), and then it lets up for a couple of months (maybe 200 hairs per day with not so much falling out throughout the day), only to start up again.

My hair is still thinning, sad to say. I'm still on 25 mgs, of spironolactone, which gradually will be increased. I think I have one more refill, and then I'll ask my internist to increase the dosage to 50 mgs. I've been using Rogaine (men's foam) for 20 months. I'm not seeing any benefit from it, though. I'll try the liquid next as one last attempt. I might be able to apply it easier, since the foam sticks to my hair. Who knows--maybe things would be worse without it. Thank you for asking!