Rx for Readers

A long, hot shower or bath may sound wonderful in winter, but it will make the skin more dry and itchy as the cold air draws more moisture from the skin.

I am an 18-year-old year old male, and I think I may be balding. When I shower, I usually pull out four to eight strands of hair in the shampoo/conditioning process. At my age, the thought of balding frightens me very much. I was wondering if there is a curable skin condition associated with rapid hair loss. - M.W., Beit She'an. Dr. Julian Schamroth, a veteran Jerusalem dermatologist, replies: One's body hair has a cycle in which the hair grows, then rests and then falls out. New hairs then regrow from the same hair follicle. It is thus natural for hairs to fall out, and up to 100 hairs per day is normal. This is usually noticed when washing one's hair. Hair loss (alopecia) may be due to many factors, the commonest in an 18-year-old male is probably hereditary. This is known as male-pattern alopecia. Other causes to consider include localized diseases of the scalp, disorders of the actual hair and generalized disorders such as iron deficiency or thyroid disease. A dermatologist can readily identify the form of alopecia. It usually is clinically apparent, but it may require a blood test, or rarely, special microscopic examination of the actual hair. Regarding treatment of male-pattern alopecia, there are numerous over-the-counter preparations including vitamins, mineral supplements, special shampoos and topical applications. It is the view of this author that all these often-expensive products do not have any effect on hair growth. They are not damaging and do not worsen the condition, but they do not help. There is no scientific evidence proving that vitamins and other such products improve scalp hair growth. There are, however, two effective remedies. One is Minoxidil solution: This is applied twice daily to the scalp for a minimum of six to nine months. It is more effective on the crown than on the temples. Approximately a third of patients will achieve new hair growth, another third will show an arrest of their hair loss and the remaining third will continue to lose hair despite the treatment. If the condition improves, treatment must continue for life. The second is oral finasteride, a tablet that is taken daily for at least nine months. It is safe, with absolutely no side effects. It works in well over half of patients younger than 40. As with minoxidil solution, if the condition improves, treatment must continue for life. But both the above treatments are expensive. As a last resort, one could always consider hair transplantation. I am a healthy 32-year-old woman with a deep family history of skin cancer. (As such I am checked regularly.) I have a mole on my face from which periodically two dark hairs sprout, which I then pluck. My mother has told me not to, fearing that this may somehow aggravate the mole into becoming cancerous. Could this be true? - A.D., Jerusalem Dr. David Friedman, a Jerusalem dermatologist, expert in laser removal of hair and director of the Lase-Ohr Clinics, replies: There is no evidence to suggest the possibility nor is there a single case report in the medical literature that documents malignant transformation of a mole as the result of plucking. I am a 35-year-old woman, and I suffer from very dry skin in the winter. I have tried taking long, hot showers to moisturize my skin. But I found this doesn't help. Why? - S.T., Katzrin Dr. Erin Welch, a dermatologist at the University of Texas Southwestern Medical Center in Dallas, says: A long, hot shower or bath may sound wonderful in winter, but it will make the skin more dry and itchy as the cold air draws more moisture from the skin and the hot water can make things worse. Take warm, not hot, showers and try to keep the time spent in the shower to under five minutes. Then apply baby oil or moisturizing cream immediately to the skin after bathing. Keeping the skin well moisturized can also help prevent flare-ups of skin conditions like atopic dermatitis or eczema, as well as psoriasis, which can become more bothersome in the wintertime. Moisturizing regularly will help prevent itching and flaking, especially as aging skin becomes drier. Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to [email protected], giving your initials, age and residence.