DEAR DR. DONOHUE: My question is about female hair loss. I have heard of and read about alopecia. During a recent doctor appointment, the term “telogen effluvium” was mentioned. No explanation was given, and no treatment was suggested. Is there a treatment? Will you please comment? — M.A.

ANSWER: Hair growth involves three different stages. Hair in its growth stage is said to be in the anagen phase. This period lasts between two and six years. Women with a long anagen phase have the longest hair. Ninety percent to 95 percent of hair is in this stage at any given moment.

The catagen phase is a short, transitional stage between anagen and telogen.

The telogen phase is a resting phase, when hair growth stops. Five percent to 10 percent of hair is in this stage. In the telogen phase, the hair follicle shrinks away from the hair, and the hair falls out. About 100 hairs a day are lost — that’s normal hair loss. The telogen phase lasts two to three months, and then the lost hair is replaced by new hair.

A telogen effluvium is an abnormal number of hairs that have prematurely entered the telogen phase and fallen out. It lasts six or fewer months. Some stressful event precedes this phenomenon, and the stress can be either mental or physical. Surgery, a crash diet and the birth of a child are examples of physical stresses that usher in a telogen effluvium.

The prognosis of a telogen effluvium is good. The hair grows back without any treatment.

DEAR DR. DONOHUE: Is there anything I can do for the brown spots on the backs of my hands? — M.R.

ANSWER: Those spots are called age spots or liver spots, although the liver has nothing to do with them. Aging and sun exposure are their cause. They’re somewhat like giant freckles.

Tretinoin cream (Retin-A), mainly prescribed for acne, lightens them. Decolorizing medicines containing hydroquinone also can fade them. Solage is a liquid with both the decolorizing drug mequinol and tretinoin. Tri-Luma cream contains three active ingredients: tretinoin, hydroquinone and fluocinolone, a cortisone drug. All are prescription items. None works overnight.

Doctors can remove those brown spots by freezing them off. It’s an immediate treatment. Lasers also can get rid of them. So can dermabrasion, the sandpapering of skin, often used for acne scars.

These treatments are considered cosmetic procedures and might not be covered by insurance.

TO READERS: The booklet on stroke explains this common and tragic condition and its rehabilitation. Readers can order a copy by writing: Dr. Donohue — No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Will you please give me some information on Reglan? I would like to know what it’s used for and what side effects it has. — J.T

ANSWER: Reglan (metoclopramide) speeds the passage of food through the stomach and the first parts of the small intestine. It also enables the esophageal sphincter to close more tightly. The sphincter is an encircling muscle at the bottom of the esophagus that prevents stomach acid from squirting upward into the esophagus.

Reglan is used for GERD, gastroesophageal reflux disease (heartburn) because of its effect on the sphincter muscle. It’s also prescribed for gastroparesis, a stomach condition in which it takes an inordinately long time for food to pass through the stomach. This condition often is due to diabetes.

It also has “off-label” uses. One is to control nausea and vomiting. Another is control of Tourette’s syndrome.

Involuntary muscle contractions, facial grimacing, signs suggestive of Parkinson’s disease and grogginess are some of its possible side effects. It can raise blood pressure and have some ill effects on the liver.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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