What can a private dermatologist do that my GP hasn't already done? (Hair loss)

[zippalippa]

I'm losing my hair at 39 and I want to know if it's worth paying a private dermatologist to pinpoint the cause? I originally started thinning on top about 4 years ago, at the time the GP did blood tests and just suggested multivitamins.

The thinning paused for a while and then very rapidly sped up this year. I am now the proud owner of a big bald patch and the remaining hair is very thin and brittle. I've been using Plantur caffeine shampoo and tonic for a couple of months with no effect (although I realise it can take longer to work).

For context I've had a horrible time over the last 9 months, I'm grieving the loss of an estranged family member and I have been severely affected by it. I did wonder if stress was the cause but to be honest I've suffered some awful life events prior to this with no impact on my hair.

Just heard back from the GP that all my bloods came back normal again but my iron levels are slightly on the low end of normal so I will try and be more diligent about taking my tablets (I'm a bit forgetful).

So my questions are:

1. What can a dermatologist do to determine the cause (apart from blood tests that the GP has already done)? Is it just their best educated guess or do they have further tests?

2. Would you start minixodil in my position? I'm concerned about committing to Rogaine for the rest of my life because what if my hair comes back naturally? It's a lot of effort with potential side effects and an ongoing expense. That's why I'm so keen to know the actual cause, but then on the other hand if I delay starting treatment then perhaps I won't ever get it back.

As you can tell I'm rather an indecisive person which has been made worse by this blow to my confidence!

TIA

A trichologist will be able to tell you what is happening, and why.

Have you had Covid in the last six months? After I had it I lost a ton of hair.
also my iron is on the low side so I had an iron injection during the summer. Took 20 mins, no side effects. I have bags more energy and my hair is no longer coming out in chunks

I think the op might be sceptical of trichologists 😉

Is a trichologist medically qualified? I thought they weren't and a dermatologist who specialises in hair loss would be better.

I'd give the iron a go again. If you struggle to absorb, it's worth knowing that some foods inhibit iron absorption. Also you need to take with high dose vitamin C. As a pp said, its now thought 1 high strength tablet a day or every other day is better than 3 a day.

I started going thin after an estranged family member died nearly 7 years ago. Also anaemic (have been refused blood donations) but told by Gp levels were acceptable. It's not as bad as it was but I'm quite self conscious if it.

I've been taking iron supplements, (spatone is way too low btw) but I don't think it's really improved. I keep toying with the idea of a trichologist (Philip Kingsley maybe) but keep putting it off due to the cost.

Have a look at Nadine baggot on Instagram, she's done a few videos with JoL Jones about hair issues.

I'm the meantime I've been using a Schwarzkopf root spray which actually covers my scalp and makes me feel less self conscious.

Yes, visit at dermatologist and trichologist would be beneficial but before you book your appoitment check theirs reviews atc.

But how is your diet??
do you eat enough protein? they are essential for hair growth
Also zink,biotin and essential vitamin like d3 and other minerals ie magnesium

I have massive hair loss on one side of my head the GP has referred me to hospital dermatology who are investigating lupus ( not The systemic one) And have given me a spray to use in the meantime whilst I have investigations they are also going to take a scalp biopsy
Do you have any autoimmune conditions? I too have low iron and that probably doesn’t help.. I do wear my hair in tight ponytails as well, ( stopped now) Yours sound like it’s genetic
I don’t think a private dermatologist could make any difference if your hair loss is genetic the only solution would be to wear a wig or get a hair transplant which will probably be cheaper than paying for private doctors only to do the same tests your GP has
if Everything is fine and you don’t have an autoimmune disease Then no amount of creams or shampoo will help and I would Consider a cosmetic procedure

The hair loss started before my bout of covid and I know I didn't have an asymptomatic case prior to that because I had one of those antibody tests and it showed no antibodies from infection, just from vaccines.

Eh? I don't really know what one is, let alone have an opinion on them.

Are you vegan?

Thanks @thinend , I'll check those out

@teraculum29 my diet is pretty shit to be honest, I need to sort myself out but whenever I start a new healthy eating regime I fall off the wagon after a while. I have been taking multivitamins plus vit D to help ward off colds but I don't think it's enough to overcome my poor food choices really. I'm quite surprised that I'm not anemic because I eat zero meat and barely any green veg so I suppose the tablets are doing something!

@Banana2079 No autoimmune diseases, but they do run in the family so it could be the start of one I suppose. The GP refused to refer me to a dermatologist on the basis that it would just be cosmetic and therefore not covered by the NHS so I can only assume he is confident it's nothing like that. Mind you there's plenty of stories here of GPs missing serious stuff so who knows.

Lots of good tips here about the best way to take iron so I will definitely play around with different types and regimes to see if anything works

No, just a fussy bugger. 😂

I had similar issues and went to Phillip Kingsley in london, highly recommend

I was prescribed iron too when I had my first dc. I couldn’t tolerate them so didn’t take any for years. My hair was ok till I got to my 40s and it’s thin now.
I think that years of low iron has caused it. I take feruglobin (?) and that isn’t harsh. Bit more energy.

im tempted by iron infusion.

What’s your vit D like? I think that impacts optimum hair growth too.

If your ferritin is 29 then that’s near the bottom of the range.
Think mine was 13 and GP wouldn’t prescribe as it’s in the ‘normal range’. 70 for optimal hair growth as pp mentioned

Vitamin D should be ok as I've been taking a high dose combined with Vitamin K since the pandemic started as I read those with low levels are hit worse by COVID. But it's an interesting thought @Rummikub that my longer term iron levels might be catching up with me. I will ask about an infusion when I go private.

Alopecia just means hair loss. The dermatologist can tell you whether it’s alopecia areata, or androgenic alopecia (AGA or “female pattern”) and the treatments are different (minoxidil is for AGA).

if you have very distinct round shiny patches of loss that would be alopecia areata and I think steroid injections might be offered for this - minoxidil is not recommended - not sure as mine is AGA.

you may also have a fungal type condition that could be treated

If the hair loss is sudden and all over it could be another type of loss called telogen effluvium - hair usually recovers from this.

Don’t bother with a trichologist as they are not medically qualified, whereas a derm may be able to offer a scalp biopsy to determine which kind of alopecia or skin condition you have.

getting iron and vitamin D levels checked and eating well is a good start. There is no shampoo or hair treatment that will regrow your hair so don’t be sucked in to any expensive products till you’ve been diagnosed and know what you are dealing with.

Oh and yes stress can cause this and also do check your thyroid if it hasn’t been already

Anyone can be a trichologist, no medical qualifications required. You are definitely better off with a dermatologist as they can prescribe medication.

I went private and was diagnosed with androgenetic alopecia (which I had already sussed out myself) and had already tried Regaine for a year (5% twice a day, ignoring the 2% for women, which the dermatologist said he would have recommended anyway). I had also got my ferritin levels up really high (100+) by taking Ferrograd C every other day, which apparently is better than taking it daily. Also made zero difference to my hair but I keep it up anyway for other reasons.

Dermatologist tried me on spironolactone which slowed down the hair loss a tiny bit but made my kidneys overwork so I had to come off it again. I'm now resigned to losing lots more hair.

But regardless of my experience, you need to get a proper diagnosis and all a trichologist will do is try to sell you their products, as they can't prescribe.

The GP refused to refer me to a dermatologist on the basis that it would just be cosmetic and therefore not covered by the NHS so I can only assume he is confident it's nothing like that. Mind you there's plenty of stories here of GPs missing serious stuff so who knows.

That's horrendous. You have hair loss in your 30's. It needs investigating by an expert. Can you check out the clinical guidelines on this and challenge it?

Not surprised that a man told you it was just cosmetic! My male dr said similar to me adding that he was bald too. He's a 60 year old man and I was a female in my 30s!! Very different situations. I have never managed to get my ferritin over 18 and have lost a lot of hair. I have also spent a lot on dermatologists to no avail. It sucks.

A dermatologist can do a lot. Blood tests only tell part of the story. The problem with female pattern hair loss is that all your blood tests and hormones can look perfect on paper but if you have a sensitivity to androgens you can still lose hair.

I take spironolactone and oral minoxidil (was a non responder to topical). It hasn’t been a complete cure but my hair is no longer falling out and my part has filled in. Temples are still on the thin side but not much else I can do.

Some people have issues with spironolactone and oral minoxidil as it lowers your blood pressure and can make you dizzy but my blood pressure is a bit high if anything so no worries there 😁