Hair Loss Information at Balding Blog

Your hair loss questions, answered daily.


I’m 20 year old male from the England and I have rapid thinning hair loss on the top of my head and slightly on the back. It’s all happened over the past two months, I spotted a slight gap in my hairline and was getting a little scared about it. I started counting the hair after washing to see if I was losing it. It was only about 20-30 and rapidly its been increasing to 50 then 100 and now for the last 5 weeks its 150 to 200 everyday. It itches a lot through the day, I’m starting to get dandruff (which I’ve never had before) and my scalp is becoming clearly visible, especially under bright lights. When I comb my hair I lose about 10 per area of my head including the sides and back. I went to see my doctor 4 weeks back and he said there is nothing any of us can do to stop it. I started Propecia a week ago in fear that if I don’t do something now I will lose it forever, the hair loss is still around 150-200 a day though. I know its no miracle worker but if my hair loss doesn’t stop now I fear it will be gone in two months. Its totally destroying my life and its making me completely depressed. I would provide photos but I think I’m the only 20 year old who doesn’t have a camera

Thanks for the great blog and I hope to hear from you soon, Thanks

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Wow !!!
That is something !!!
You must be the only 20 year old without a camera (even on a phone) !!!

On a serious note, you should think about getting a camera.

With respect to hair loss you may be experiencing, I am glad you were able to see a doctor and you have a treatment plan. The doctor should perform a ‘HAIRCHECK’ on you for measuring your hair bulk. This is the most accurate test available to follow changes in your hair and hair loss across the board. Aside from that, I really cannot help you much other that give you a generalized fact that genetic male pattern balding starts in your 20’s, even in teens as early as 14.
There are medications such as Rogain and Propecia to help. There are also procedures like SMP and hair transplant surgeries which can help but there is not one thing along that will solve your hair loss problem. A good Master Plan is important, especially if you are in your teens or 20s as the wrong approach can be disastrous. There are too many horror stories about young men who took actions too early, like hair transplants in your teens or early 20s.


I have questions about hair loss. We know that hair loss can be the cause of stress, poor diet, Hair products, and other various known symptoms, especially most heredity (MPB) in men as people say.

Considering male hair loss which actually is hereditary, the scientist have evidence that heredity hair loss in men caused by most Skull expansion (bone growth), anything that it say that the skull develops and shapes, ie, bone grows on our heads, and then slowly approaching scalp tissue, slowing the small capillaries and strangling the blood supply needed to grow hair.

It doesn’t interpreted as someone with a big skull will lose hair and some with a small skull not. Skull expansion simply means that, for those with certain skull shapes, their skull bones will grow and change shape (to be somewhat larger in the process). These include parietal bones and frontal bones aside with DHT.

It is DHT that is responsible and encourage bone formation, not just in our heads but also in our body as we age.

That is how DHT Hormone do, it stimulate hair growth, muscle growth and bone growth, not hair loss.

This is recognized as a true genetic traits.

It is clear why your MPB regions feels tight, hard and bony.

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I am amazed at the questions we receive at times.
How does one come up with these things? Late night watching Star Trek?


Hair loss in men that is androgenic alopecia (genetic male pattern balding) is due to the genes. Not the shape of one’s skull or growth of skull shape. You can have a big head or a small head and if you have the genes for hair loss, you will have hair loss. If you don’t have the genes for hair loss then you can have a giant head and still have hair!

The person you referenced that came up with this hypothesis is trying to sell a book for $29.95. Everyone wants to make a buck.

Skull shapes do not have an impact on DHT.


I had a hair transplant done over a year ago (3500 grafts) and all in all I’m very please with the results. Definitely looks better than it did. However, one side came in much thicker and fuller than the other side. But when I now run my fingers through my hair on the lesser filled in side I can feel this stubble growth sticking through that’s about 1/8 to 1/4″ in length. The thing is, its been over 13 months since I had the procedure done but its been at least 8 months feeling this same stubble length on that one side. It just doesn’t seem to want to grow any longer than it is now. So my questions is… is it normal for some of the implanted grafts to not necessarily fall out and not grow at all but they’ll never really take and grow past this stubble phase? If so, what would be some of the reasons for this dilemma? I’ve been taking the prescribed Propecia (finasteride) but is there something else I can do or try or something you might recommended trying to somehow kick start the growth again on my thinner side so my overall hair growth will look more even?

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I always advocate that if you had surgery and you are having issues, that you should always follow up with your surgeon. They are the best equipped to answer any issues arising from surgery since every surgery is different and not all results are the same.

In general if you are still feeling the same stubble a year after the surgery those may be just old hairs left in your scalp that are not growing. Think of it like a foreign body. If you gently pull on them it may just slide right out. I cannot say if the surgery was a success or if hairs will grow from that spot. Only your doctor can best explain this to you. Final note: I am just guessing all of this based on generality. If one side is fuller than the other, and the same number of grafts were place on both sides of the head and if both sides were equally bald, the a HAIRCHECK measurement may tell you if there is a difference in bulk/ growth.

As far as what I would recommend is deferred to your doctor who you have a relationship with. They should be better equipped than me to answer that question because they have examined your and know your specific situation.


This is a review of a SMP procedure performed at New Hair Institute Medical Group. This is a female patient who had traction alopecia from wearing her hair pulled back too tight. She also had a component of triangle alopecia. SMP diminished the contrast between skin and hair. Note: patient also colored her hair on the after photo.

SMP to traction alopecia

SMP to traction alopecia

Tags: traction alopecia, triangle apolecia, smp alopecia repair


Dear Dr Rassman

I have been using Minoxidil once per day since November 2013 on the temples and hairline (as well as finasteride)

I haven’t ever experienced a noticeable shed, or any regrowth. My hair has continued to get slowly worse. I have continued using Minoxidil as I thought that maybe it could at least be contributing to help slow down the MPB process – but I am unsure if this is the case

The Rogaine website states that treatment should be stopped if no results (i.e. regrowth) are seen within one year. My questions are therefore

1) Is it best that I quit using minoxidil?
2) Is there a risk that healthy hair would have become dependent on minoxidil, and fall out if minoxidil is stopped?

I look forward to hearing from you.


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If you hair loss is just the frontal hairline and the temple peaks, I would not expect to see hair regrowth in thise locations. The maturing hairline does not respond to minoxidil or finasteride. If you are sure that there was no benefit from the use of minoxidil, then stopping it should not make a difference; however, if there was some benefit, stopping it might cause loss in those hairs that benefited (something I doubt). So it really is important to be sure.

Tags: hairloss, hair loss, minoxidil, rogaine


I’ve been taking Propecia for many years (generic over the last year), and my hairline has remained stable ever since. I just noticed a nickel-sized bald spot on my crown. I thought Propecia worked better on the crown than on the hairline, so what gives?

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Propecia is a medication for the treatment of genetic male pattern balding also known as androgenic alopecia. It works best for treating the thinning / balding on the top and crown areas of your scalp. It does not work as well for the front hair line. Propecia is not a cure and its response is different in each individual. You may still have thinning or continue to lose hair. The point is that it should slow down the hair loss. There is no cure for genetic balding.

You should see your doctor. A bald spot the size of a nickel could be the result of other causes like alopecia areata. A clearly defined bald spot is not a presentation of genetic male pattern balding so you must be assessed by your doctor.

Tags: generic propecia, propecia androgenic alopecia, propecia alopecia


I always have thin hair when I was young. However, I noticed that the vertex of my head is really sparse. I am only 20 this year. Asian.

The thing is my family has NO HISTORY of balding. Both paternal and maternal side. However, my mom and dad hair are thin probably due to age.

Will I go bald eventually?

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Genetic balding in men happens after the puberty years in their 20’s and 30’s. Most hair loss falls into one of the Norwood hair loss patterns. Not everyone who goes bald will fit into one of the many patterns. Of note only 7 to 8% of men go completely bald.

You do not need to have family history of balding to inherit the genes for balding as mutations or gene expressions can cause this to show up. It can skip generations and the exact inheritance pattern is not well defined. If you think you are balding, you can see a doctor for an examination. Some doctors can do the Bulk test of even Miniaturization studies. There is no way to predict if you will go bald. We are not fortune/misfortune tellers.


I started to lose my hair at 19 due to MPB. After a year or so, my hair texture started to change rapidly and my hair changed from normal hair which you can style to pubic-like hair.

It looks horrible.

My question therefore is: what can you do about acquired progressive kinking. I am already taking finasteride which seems to do little against it.

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Generally when you lose hair from genetic balding, your hair thins out (miniaturize) and fall out. It generally does not change in texture to a point it starts to kink. Maybe you should see a dermatologist as there may be a series of genetic hair diseases that can cause kinking.


I am a 33 year old male. I had been using Propecia for 3 years and switched to Dutasteride approximately 6 months ago. Since switching to Dutasteride, I am experiencing less sexual side effects than Propecia, even at 1.0mg daily dose (twice the dose which is recommended in treating BPH) – I am also experiencing more hair regrowth than Propecia. I am wondering how and where you draw the inference that Dutasteride has the potential to cause sterility. Any firm evidence, clinically?

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Just like your positive hair growth experience with dutasteride there are others who have negative experience with sterility and sexual side effects.

I cannot find a study or firm evidence, but I always try to balance risks and benefits. If you are never planning to have children, then it may not matter but if you are, why would you want to risk it? In addition dutasteride is not approved for the treatment of genetic balding and there is also no clear evidence it is much better than Propecia (despite your personal experience). If you want to know if you now have a problem, your doctor can order a sperm count which will show a problem if there is one.


I know dr.rassman has mentioned a few times that if a person is genetically balding their hair has a certain lifetime (example 5 or 10 years) , with or without the use of finasteride, before it completely dies. If that is the case, what is the point of taking finasteride if the hair is going die anyways within 5 or 10 years? Could finasteride prolong the hair from falling out early?

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The point is you have the extra 5 to 10 years or possibly more of good hair. Imagine being 20 years old in your prime and you notice thinning. Imagine taking a drug that can postpone this until you’re 30 or 40. To some this may be worth while.


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