Colby Evans, MD (retired)

Hair loss can have many causes and hormonal causes are common. Women who have excess testosterone (the male hormone) can develop male-pattern type hair loss (as well as other symptoms like deepening of the voice or hair growth on the chin and face).

Consult a board-certified dermatologist if you have hair loss as there are many potential causes and treatments. Blood tests can easily check levels of male and female hormones. If there are hormonal abnormalities, you may need to see an endocrinologist or OB/GYN who specializes in this area to look for the cause.

Hormonal hair loss can sometimes be treated with spironolactone in women and finasteride in men. These both have potential side effects and should be used only under the supervision of your doctor. Minoxidil (Rogaine) does not address the hormonal causes of hair loss, but may still be useful is stopping hair loss or regrowing hair.

A lipoma is a collection of fat under the skin. They are very common. Although lipomas are generally not dangerous, they are often removed if they are growing, painful, or unsightly.

Consult a board-certified dermatologist for any lumps in the skin since there are certainly other things that can cause this symptom, some of them potentially dangerous. Most lipomas can be diagnosed by a dermatologist simply by looking at and pressing on the lesion. If there is any doubt, a biopsy or surgical removal can confirm the diagnosis.

Keloids are thick scars that form after injury or trauma, but can also occur on their own. They can happen anywhere on the body but are common on the earlobes and trunk (especially the chest and upper back). Any form of injury to the skin, including surgery, ear/body piercing, accidental injury, or a tattoo can cause a keloid.

You should consult a board-certified dermatologist to discuss the treatment options. Steroid injections are often helpful for small keloids or to prevent keloids after surgery. These usually need to be repeated monthly for 3-4 months.

Surgery is also often used on the earlobe to debulk or remove the keloid. The recurrence rate can be high, so it is important to inject the keloid monthly after surgery.

There are other rarer or more experimental treatments like radiation therapy or imiquimod cream that are sometimes used for severe or difficult to treat keloids. These should only be considered in consultation with a dermatologist or plastic surgeon who is familiar with keloid treatment.

As we get older, time and cumulative sun exposure lead to the signs of skin aging, which include fine lines, color change, and rougher texture. Retin-A is a synthetic Vitamin A cream that can help (slowly) with all of these signs over time.

Adults of any age can potentially use Retin-A for aging (although it should be avoided in women who are or might be pregnant). As we get older, we often get deeper lines and wrinkles, which Retin-A will not help very much. Even so, it can still help with skin coloration and texture. There is no upper limit to the age at which Retin-A can be useful. Consult a board-certified dermatologist to discuss Retin-A alone or in conjunction with other treatments for the signs of aging.

Yes, hydroquinone can damage the skin and cause more darkening (called exogenous ochronosis) if used too long or in too high concentrations. Hydroquinone concentrations vary with different products (over the counter products usually contain 2%, most prescription creams have 4%, and compound formulations may have 6, 8, or even 12%). Those with higher concentrations or when used for long periods (greater than 6-8 weeks) are more likely to cause this (otherwise rare) problem.

You should consult a board-certified dermatologist and remain under his/her care for monitoring while using hydroquinone.