hairline recedes quickly, this is a bad dream

[melanie]

Hello, this is an emergency!

I am 5 years post op and was on a relatively low dose of transdermal estogen for the last years. Because I had issues with estrogene deficiency I started sublingual estrogene and am taking a fairly high dose since November.

What happened during the last weeks really shocked me: my hairline on the right temple is receding rapidly. I also used estrogene gel on the hairline for 4 weeks because I thought it might be beneficial but it seems to have aggraved the situation.
Before the switch in medication I had gradual diffuse hairloss which has inproved a lot since. But losing the temples is so much worse!

I also take finasteride and minoxidil post op because I seem to be quite sensitive to androgenic hairloss.

I am getting desperate because I see it advancing within days. Bye bye female hairline! High estrogene should be beneficial for hair but it seems to make mine fall out in a male pattern for some reason.

Please help me if you have a medically sound idea what could have happened here. Thank you so much!

Best,

Melanie

[Ms Grace]

Hi, are you self medicating? I only ask because post op you shouldn't have all that much problem with testosterone leading to DHT and MPB and it seems like you are using a number of unnecessary drugs. (Not that I'm a doctor or anything.)

Testosterone isn't the only cause of major hair loss, if you have been unwell or have lost weight or been through a lot of stress it can happen rather quickly and noticeably. Perhaps consider getting a medical check up to get to the bottom of the problem ASAP before it gets any worse.

[Mariah]

Ms. Grace is right and I want to add one thing to what she said and that is putting the gel on the hairline directly could also be promoting the hair loss by clogging the pores the follicles are in. Much of my hair loss was caused by 3 things, not that DHT didn't play a role because it did, and those 3 things were stress, clogged pores, and the fact my kidney's were in such a state at one point that they were not filtering out things to the level they should which resulted in the pores taking on that stuff instead. I highly recommend getting the check up because if I had done that 5 or more years ago my kidney would be over 100 eGFR. I'm not saying is your problem, but I am saying the medical issues due play a big role sometimes and that your hair loss could just be a symptom of something bigger.
Mariah

[mfox]

Okay, don't panic!  If you're really seeing hair fall out that fast, there must be something sudden that's happened.  The papillae aren't going to become dead, vellus hair cells overnight, unless you were exposed to something drastic like radiation or a chemical.  The shed hairs should grow back once the cause is fixed.  How do you feel otherwise?

Just to add my own experience, I started to notice some hair loss on my temples before HRT, and tried using minoxidil.  It actually made it worse (notice how it says in the instructions that it's only meant to be put on the top of your head?).  I stopped it, and started taking proscar, which helped it come back.

The first thing that comes to my mind is "shock loss", but you say you only notice it in the temple area and only on one side. You should really consider seeing your doctor and get your hormone levels checked, we can only make guesses.

[melanie]

Thank you so much for your answers. I might have sounded a bit more drastic than I wanted in my post. Sorry about that. No, I am not self medicating, my endo proposed this change in medication when we were talking about problems with my former one.
I will have blood levels checked tomorrow finally. It took some time to settle this since I was moving from one country to another in the last months.

You are right that stress can play an important role. I can only say that in terms of that things were not more intense than usual. It is mysterious since I dont really notice any hair falling out but at the same time I see the hairline receding quite visibly. Next week I will see a trichologist, I hope he can shed some light on this issue.

@ mfox: minoxidil can cause initial shedding when the new hairs push the old (telogen) ones out of the follicle. This is a sign that it works. This should not last longer than three months, the duration of the telogen phase. There are recent studies showing that minoxidil also works on the temples, not only at the vertex.

[mfox]

@ mfox: minoxidil can cause initial shedding when the new hairs push the old (telogen) ones out of the follicle. This is a sign that it works. This should not last longer than three months, the duration of the telogen phase. There are recent studies showing that minoxidil also works on the temples, not only at the vertex.

Well, for me, I kept at it for 8 months but it just kept getting slightly worse.  The only hairs I think ever seemed to do anything were that the almost invisible vellus hairs got a little longer.  So I stopped and switched to Proscar, which started making a huge difference after about 3-4 months before I even began HRT. 

If you have any links/names to any studies on that I'd be really curious.

[melanie]

I cant really remenber where I saw the study on minoxidil. Sorry this was a 14 hour workday, I am not so much into research right now. Your good reaction to proscar is really interesting. It worked on the temples? Did you take one tablet a day or 1/4 of it?

[mfox]

My GP prescribed Proscar mainly because of the huge cost difference to Propecia.  But the pharmacist suggested not divide them more than 1/2 because they begin to break down in the air, and the medicine isn't uniformly distributed enough to do 1/4.  That didn't matter once it became part of HRT.  Yes it worked for me on the temples.