HRT Hair Loss - will I need a transplant?

Question

I started HRT pellet therapy a little over a year ago for 6 months. Since then, I started losing hair all over but especially at the crown and temples. I had switched to estrogen and testosterone cream in February. However, the hair loss continues. I stopped taking the testosterone a few days ago. Will my hair come back or will I need a transplant?

Christine M. Shaver, MD · Answer

You should wait at least 1 year after stopping hormonal treatments to see if the hair returns on its own. Hormonal drugs can result in telogen effluvium (a stress-related shed) and the hair will return about 1-2 years after the drugs have been stopped without any intervention. I would not approach hair transplant as a solution until after the resolution of TE has occurred.

Vincent Gardner, MD · Answer

Hi pioneering92927,Based on your post, I assume you are female because you mentioned estrogen. Hair loss in women is complicated. It can be attributed to many factors&hellip;. Too much or too little thyroid, stress, chronic, inflammation, genetics, hormones, etc. The testosterone can definitely have an effect, but it’s not actually the testosterone. It is the DHT, which is one of the byproducts of testosterone. You could consider using finasteride&hellip;.it blocks the conversion of testosterone to DHT. Finasteride should not be taken by any one who is still of childbearing age because it can cause birth defects. You should also be on a good hair vitamin, have your thyroid evaluated and consider other options such as spironolactone, which decreases the skin sensitivity to testosterone receptors. I would find a good BHRT provider and consult with them. Hopefully your hair will improve over time. Hair Transplant could be an option down the road. Good luck!

Kulakarn Amonpattana, MD · Answer

Hello I'm Dr. Wipawan Vathananai, a co-worker of Dr. Kulakarn Amonpattana, from BHI Clinic, Bangkok, Thailand.
Is it possible for you to provide more photos regarding your concern for better evaluation? May I also ask why you had to use HRT?
Thank you

Matt Tahsini, MD · Answer

Hello and thank you for your question. It's difficult for me to answer this question without knowing a lot about your medical history. I recommend you see a qualified dermatologist in order to determine what is best for you. Best of luck to you.
Dr. T

Jeff Donovan, MD, PhD · Answer

We diagnose hair loss based on complete stories and complete up close examination ls. Neither of these are possible here. So be sure to see a dermatologist who specializes in complex hair issues. For some women, HRT can cause hair loss and HRT protocols with testosterone dramatically accelerate thinning for some women. Again, I don’t know if this is what’s going on in your case as I would need the answers to 50-60 more questions and to see the scalp up close. Be sure to see an expert. A hair transplant is possible only under strict criteria. Rapid ongoing hair loss would disqualify a person but yes- if hair loss stabilizes and a clear diagnosis is present it sometimes is possible. You’ll need many blood tests as well including hormone levels.

HRT Hair Loss - will I need a transplant?

Answers (5)

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