Scalp Psoriasis and Transplants

/by William Rassman, M.D./1 /, ,

Does a history of scalp psoriasis (assuming it is under control with treatment) rule out using minoxidil or transplants to offset hair loss?

Psoriasis is an autoimmune disease that has a genetic preference in its victim selection. It comes in all degrees of activity. Simple dandruff may be a very low active state of psoriasis and as it becomes more severe, it takes on more of the characteristics of the disease state, where scaling of the skin and red areas in the affected area can become painful. Flaking of the skin can be easily seen when psoriasis affects the scalp. Baldness is also a genetic process but it is unrelated to psoriasis. Both processes can co-exist in the same person and both can be treated independently at the same time.

People with psoriasis often ask about transplanting the disease from one area of the scalp to another. Can, for example, skin taken from the area where psoriasis is active, move the disease to areas in the recipient area that are not showing signs of the disease? The answer here is no, as the disease seems to be localized in the area where the scaling exist and moving the hair from the scaling area does not impact the normal recipient area, assuming the recipient area is normal. Psoriasis can be aggravated in the area where the disease is active by any trauma and surgery is a trauma. Some people who tend to pick at their skin and hair can develop traction alopecia (hair loss) if they persist on picking over a prolonged period of time.

I generally tell my patients to use a topical treatment (steroids) on any active area of psoriasis prior to a hair transplant so that the scaling that occurs will be less bothersome during the transplant process. I try to get good control of any scalp psoriasis prior to a hair transplant.

With regard to minoxidil, if this medication does not produce skin side-effects, then one can use it with psoriasis. If side effects should appear or the psoriasis should become worse with minoxidil, then the medication may not be a good choice.

Photos – Day After Hair Transplants

/by William Rassman, M.D./0 /

I have thin hair in front. I am in the public eye and can not take off more than a day or two. What will I look like after a hair transplant?

To answer your question, I took some pictures of a person who is 50, who had a hair transplant (1,046 grafts) and came in for a hair wash by us the next day. He has enough hair to cover the transplants. Good washing will guarantee, as much as possible, that any scabbing is removed. With the use of medications, we can keep swelling on most people to undetectable levels. He can go out in public the day after surgery without any real detection.

The photo on the left was taken before his procedure — the photo in the middle and the photo on the right are 1 day after.





Update: Oops, I originally posted the wrong patient photos with this entry. I apologize for the confusion. The correct photos are what you see above.

Using Cover-Ups After Transplant

/by William Rassman, M.D./0 /

How soon after a transplant procedure can you resume using cover ups such as, Couvre or GLH, until your newly transplanted hair grows in?
Thank You!

The use of Couvre and other scalp coloring agents, which tend to be powdery, can be safely used after the scabbing is gone. Scabbing is gone as early as 1-2 days on the short side, and 5-9 days on the long side. The difference between the short and long side reflect two controllable variables and one non-controllable one. The controllable ones are (1) size of the wounds, the smaller the wounds the shorter the healing time, and (2) the washing technique used at the surgery, the end of the surgery and the next day or two after the surgery. Good aggressive washing gets rid of scabs (in many of our patients) in a day or two. We offer hair washes for all of our patients after the surgery and as often as they feel that they are helpful. Patients are rightfully afraid to be too aggressive with the wash, out of fear that the grafts will be washed out of their recipient site. The non-controllable variable is the patient’s individual and unique reaction to the surgery. Some patients tend to exude more ‘transudate’ from the wounds (the yellowish fluid that brings blood-coagulating elements will often form scabs) and some patients may have microscopic bleeding at the wound site after the surgery (forming clots). All of these scabs and clots can be washed off the next day with properly administered washing techniques.

After the scabs are gone, these powdery agents can be used until the new hair wipes out the need for them (usually 5-8 months after the surgery).

Child Alopecia

/by William Rassman, M.D./3 /

My Grand-daughter has been told she has alopecia she’s only 4 years old. It started at her neck line in the back, it has now started coming out in the front. She has food allegies and she is on a medication for asthma. Can anything be done to get her hair to grow back?

There are a series of genetic alopecias that show up in young children. IF she has one of these condition, she may go on to develop Alopecia Totalis, which in effect causes all of the hair to fall out. This would include eyebrows as well. She needs to be worked up by experts in this field. Your dermatologist should be able to point you to those experts, but if he can not, send me an email (found on the Contact page).

Scalp Flap Experience

/by William Rassman, M.D./0 /

I am a patient of yours and I read a previous blog question and response from you the other day where you worked the problem out with the patient. I came to you 13 years ago with a problem that others could not help me with. After I explained the problem to you (which you listened carefully) I went into my solution. Although I prefer you not to use my name, you might want to tell your audience my story. I have been forever in your debt and grateful.

I remember you very well. You came to me after having done two flap procedures where sections of your scalp were moved from the back and sides of your head to cover the front (like a banana peel). This was an operation invented by a man from Argentina (Jury Flap) that was popular amongst certain surgeons in the late 1980s. This left the patient with an unnatural hair line, hair lying in the wrong direction and a hair line that (on my particular patient in question) was located far too high. You had gaps in many areas of your frontal hairline and there was no hair behind the flaps, leaving you bald in the mid-head. The donor area was depleted of substantial amounts of good movable hair so the supply was very limited and you lost much of your native neck hair as a result of the stress of the procedure.

I remember our first conversation and what you told me. You said (out of context): “I have been thinking about this problem for a few years now. I have met with doctor after doctor and when I finally figured out a way to manage the problem, none of the doctors who I visited would do what I asked them to do.” You went on to explain that your hair had a very strong wave and character to it (Italian hair of medium weight) and that if some hair was placed in front of these flaps, far in front of the flaps, then you could style your hair with a comb-back and a pompadour (like Elvis but much more subtle) and an angled combing style would hide your problem. You told me that you used gels and blow drying to achieve your looks; and you were convinced that this solution could solve your problem if I could find enough hair to transplant. After the first surgery (which was experimental on my part) and the ensuing 12 months it took for the hair to grow out to a good styling length, the results were fantastic. Your creative styling did wonders for the 600 grafts we put into your frontal hairline area. The good news was that we performed four surgeries over the 8 years we worked on you and you got enough hair to address, not only the frontal defects, but also the balding in your neck hair, which was a complication of the flap procedure. Today, you still must spend a few minutes every morning styling your hair, but even my eye can not pick out any defect on you- you looked great when last we met for dinner at one of your restaurants! Thanks for allowing me to share your experience.

Hair Piece Blues

/by William Rassman, M.D./1 /

My earlier post about smelly hair systems generated a lot of good responses…

I loved yesterday’s question on the smelly hair system. It does not even compare to my problem. I have already found the secrets to keeping it from smelling decent, but that does not deal with the ladies when they want access to my head. I am working the internet dating scene and this problem is killing me. I find myself fearing the intimacy that I fantasize about. Now it is not fantasy, but a pending nightmare each and every time I start up a new relationship. If I do not wear the hair piece, I can not be myself. How does one deal with the no-touch zone that puts the fear of God into the rug wearer when a woman wants to run her fingers through the piece?

When a man embraces a woman, there is a tendency for the woman to want to run her fingers through her man’s hair. This is a deal breaker for hair system wearers and it puts them on-guard every time they establish a new relationship, often impacting behavoir as the wearer tenses up during intimate moments. I have spoken to many men and this is a common problem. The answer is that the rug wearer needs to keep one hand free at all times to fend off the roaming hands of the woman. It does put the kybosh on the freedoms one wants in real intimacy and it excludes such activities as bathing, swimming and the like. I have found that these problems are not addressed well in long term relationships either. I have done hair transplants on men whose wives have told me that they have never seen their husband without his wig on, not even after 30 years of marriage. I am afraid there is no real answer. Every hair system can be felt, even with the best of weaves. The only real answer to this question is a good hair transplant.

Why Did I Create This Blog?

/by William Rassman, M.D./2 /

I was wondering why you are running this baldingblog.com site rather than participating in one or more of the many chat groups on the internet?

The chat groups have a scattered agenda. Many are using it as a magnet for doctor advertising, charging doctors a fee for participation and favoring those that participate. Some of these sites have a combination of content focused on hair loss and chat activities. These sites are frequented by many of the same people who dominate the chat agenda, so it is less focused upon subject content and more focused upon selling something. With the anonimity of the internet, you can not always be sure which of the posters are honestly trying to help and which are trying to line their own pockets. Some of these sites thrive on things that go wrong. In our practice, things rarely go wrong, so a site that focused on the exceptions rather than the rule, gives a false impression of the process to the new inquirer who wants to learn about the reality of today’s modern hair transplant process. I have always liked to have free forums where new people can get answers without intimidation or salesmen hawking their every move. In my office, I started having open house events and hotel seminars 13 years ago with patient participation long before a hair transplant recipient ever came ‘out of the closet’ where he hid his hair transplants. We never used a salesmen anywhere in our business model. In those days, the ‘standard of care’ was the pluggy graft, so showing off a patient without plugs made our seminars and open house events very successful. Those who came, expected to see pluggy patients and what they saw were normal looking people where the hair transplant could not be seen. At these events, I always held an open forum, allowing interruptions as the audience fell into the tempo of the subject material and conversations. It was the audience that ran the ‘show’ not me. The BaldingBlog.com site allows the type of freedom that I have in our seminars and it put the agenda into the hands of the questioner. I am more a responsive participant as a content expert. I have had many emails that I do not put on the BaldingBlog because I am frequently responding to a follow-up question that may not have a public interest.

I have in the past experimented with participating in these chats, but many of the aggressive participants love to go after a doctor who is not paying his ‘right of way’ for immunity in the for-profit sites. Some of the comments have been tasteless. Hearsay comments dominate. If I go down in the mud with those that are hair obsessed or angry, I generally get frustrated. Arguing with an irrational person is akin to a Jerry Springer milieu rather than an educational and informative framework. The worst part of anonymous free speech is that some of these chat groups don’t care if any statement can’t be proved to be true. One can say that Dr. X is a murderer, a heartless transplant mutilator, a mercenary who is driven by the almighty dollar, and if there is no recourse to identify the person who sends out such comments, then you can not necessarily believe anything you read. I have seen people say that they have personally seen patients of Dr. X …. Or that they are a patient of Dr. X and certifies to the crime personally. Defending oneself from baseless attacks are pointless and a wasteful use of time. I would doubt that any of this audience would want to read the JerrySpringerBaldingBlog.

Body Hair Transplantation

/by William Rassman, M.D./1 /

In reply to my post titled Hirsute Men and Head Hair Loss, Duke writes…

That is fascinating but it prompts a few thoughts. Why not use body hair for transplant processes?

More research into the Red Indian genetic heritage us surely required.

And why does the balding gene only impact on the top of the head and not the sides.

This is a fun question. First, why the top of the head. Leonard Shlain’s book, “Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution,” had an interesting insight into the cause of balding. He postulates that our tribal heritage arose when man lived amongst his peers constituting 100-150 people. When looking at that the hunters (the healthy and fit men) in the light of certain qualities, there was a distribution of 4 traits that would pencil out to an 8% rule. He believed as animals learned to be afraid of man, the 8% of the hunters who were bald did not frighten the animals because they did not have the typical framed face of a hairy man, so animals would not run from them. They fulfilled the role of the spotter in the hunting party. Likewise, 8% of men were color blind and could see the animals in the bush missed by normal color visioned men, 8% were left handed and they threw the spear from the left side of the hunting group and 8% were gay so that they would stay home with the women and become more involved in their activities yet retain the strength to protect them. Fathering of children, while the heterosexual man were away hunting, was therefore not a concern.

If you take the 100-150 tribe hypothesis into the Red Indian, it would be relatively easy to see that with a small band of Indians that moved over from the Alaskan Bridge and down the Canadian countryside (they initially migrated to what would become the western American territory) it is possible that selective extermination of a sub-set (based upon the balding trait for example) of Indians over some generations during hard times, might have wiped out that genetic characteristic. This hypothesis for the Red Indian has been made by some, but without the presence of a written language or other documentation of their history, such assumptions might be a dangerous precedence to be proposed by a hair transplant surgeon.

Now, regarding body hair transplantation:

Experimentation is presently occurring on the use of body hair in some transplant centers (they just do not call it experimentation). As body hair grows in singular numbers (not follicular units of more than 1 hair each as in scalp hair) and length is not as long, and the hair cycle is possibly much shorter and the sleep cycle much longer, the use of body hair for transplantation might leave much to be desired.

When Will I Go Bald?

/by William Rassman, M.D./6 /,

i am 20 yrs old,and my dad is bald,although he started losing his hair only when he was 37 yrs old,i just have the fear that i may also get bald like my dad,so far now,my hair is ok,just that i have some dandruff .is there any specific age that i wil start balding,or how can i keep my hair healthy and ever long lasting.is it mandatory that i may also lose hair as well as i grow old

Balding almost never hits men under 18, so I have set up a model for the balding process to give some insights into men on the balding process. If you imagine that we are born with different types of baby hair that changes as we get into our first year. Then it changes again through childhood and then again around puberty (11-13). I suspect that these changes are influenced heavily by the hormone DHT. The hair undergoes another change between 18-29 years old.

The changes are two fold. The first part of the process is the advancement of the frontal hairline into the mature position. The typical juvenile hairline of the 12 year old boy is no different than the hairline of the 12 year old girl, but as men (typically 95% of Caucasians) move into a mature pattern with the central area rising about ½ – 3/4th inch above the central crease and the sides move up about 1-1½ inches, giving a slightly receded corner. A small percentage of men (Bill Clinton and Ronald Reagan) keep their 12 year old hairlines through life. Many young men mistake the mature changes in the Caucasian hairline for balding. Such changes are normal, but for the soap actors who must retain their baby face, such changes are devastating, so on rare occasions I have restored this juvenile hairline on famous actors.

Secondly, the balding process may start anytime after this change starts (about 18 years old). Since real balding starts at about 18 years old (caused by the impact of DHT on the susceptible genes associated with genetic hair loss) the faster the fall out occurs, the worse the prognosis. There is some protection against DHT that holds until 18, but when that protection is gone, the faster the fall out, the more is the indication that balding will be severe. On a visit to my office, I will put the hair of the patient on a TV, so that they can look at the hair shaft diameter variability. Normal (non-balding) hair has equal diameter while genetically impacted hair starts to become finer and finer, reducing the diameter to smaller and smaller sizes (miniaturization is the term that doctors use) until it becomes threadlike and just disappears. The drug Propecia blocks the impact of DHT on these impacted hairs, often slowing, stopping or reversing the process over time. The best way to change the course of this hair loss is to take Propecia which means that you must stay on the drug for life. Short of that medication, there is no effective proven medication or treatment. There is no doubt that the hair loss will still pick up again (even on the drug) but it will be a slower process.

Terrible Scarring from Hair Transplant

/by William Rassman, M.D./0 /, ,

Doctor; I had my 4th hair transplant last October with the same surgeon who had done the prior 3. No complaints the first 3 sessions; I had decided to do a final “touchup”, filling in the front a bit more and adding to the crown.

Big Mistake.

My donor area on the left side was totally butchered; a patch about 1 1/2X 1 1/2 inches totally barren and badly scarred. I knew something was wrong immediately after surgery. The hair was gone the next day-immense pain and tightness was in the wound and there was redness also there. On the left side, there was a scab in the middle of the patch that took 2 months to heal.

The right side was similar but not quite as bad. The hair eventually grew back on the right side around 2 1/2-3 months. Its now been over 7 months; I do not expect anything will ever grow on the left side. The sutures seemed placed extremely high above the edges of the wound, also suspicious. I was told by the surgeon that everything was fine; these things “always resolve”.

Finally a month ago, after seeing my predicament, he tepidly agreed that re-growth wasn’t in the cards. He said he would do “Scar revisions”? This did not seem right, so I sought 2 other opinions, both saying scar revision considering the circumstance was definitely the wrong way to go, and that transplanting hair into the area, in 2 small sessions, was the best way to handle it.

Do you have any advice for me?


Scars from any surgery are unavoidable. When I performed general surgery, people would judge the surgeon by the appearance of the scar after the surgery. If the scar was barely detectable, then the surgeon was great, but if the scar was stretched or obvious (for example) the surgeon was terrible. If I did 100 appendectomies, about 10 would have a widened scar and 90 would have a barely detectable scar. Was I a great surgeon 90% of the time? How did I select who got the bad surgery? The question sounds silly, but as a surgeon I am humbled all of the time that anything ever healed and I live in a constant state of awareness that there are many things that I can not control. Scarring is just one of them, but I do not abdicate on the awesome responsibility upon me to try to get perfect scars 100% of the time.

I want to know how the scar impacts your styling and your ability to function daily. Since we are talking about visible scars in most situations, we are talking about the ability for the hair around the scar to cover it adequately. The thinning of the hair in the donor area is unavoidable and as more surgeries are done, more thinning can be expected and the scarring risks rise (non-visible and visible scarring are separate issues here). Think of it as follows:

  1. the donor area has extra skin when the process is started (you can feel this if you put your hand behind your head and move the scalp up and down as it should move at least ½ inch)
  2. each time you have a procedure, some of the extra skin is removed and eventually the skin may get tighter
  3. as everyone is different, some people’ skin just gets thinner and not tighter, others get tighter and not thinner, most are a combination of the two. When the skin does not get tighter, the ‘extra’ skin probably re-grows
  4. every surgery produces more scars below the skin making the skin less mobile to some degree and the amount of this mobility (and binding of the skin to the deep structures of the scalp area) varies in each patient.

Read more

Replacing Hair System with Transplant

/by William Rassman, M.D./0 /

I read with great interest, your answer to the person who wore a hair system that stunk. Systems stink and it’s not only the smell that I am talking about. This is only one of the problems I am faced with. I don’t have a lot of money. If I did, the place where my system is serviced would take care of me as often as I want. They suggest once a week, but they want $60 for a full service. Frankly that is alot of money when you consider that I have to take off from work to have it done. In the past 10 years, I have spent over $10,000 in hair systems and the costs of replacing the one I have now will be another few thousand dollars. It really does need to be replaced. I want to know how much will a hair transplant cost me and how many transplant procedures will I have to suffer through? I am 35 years old.

Most people who are 35 have already established a mature pattern of hair loss, so first you need to find out what Class of hair loss you have. Read Assessing Hair Loss and then get back to me with photos of yourself with wet hair and dry hair, showing the full extent of the hair loss. A phone consultation with me will be specifically focused on your individual needs. Generally, the less the balding, the less expensive will be the process. A Class 3 reconstruction might run between $3000-$6000 and if your hair loss is stable, then more surgeries may not be necessary. For the very bald person, the cost can climb to range between $10,000-$15,000 (these prices are based upon our least expensive Standby program). Please see Fees and Financing for more information.

Female Hair Loss

/by William Rassman, M.D./13 /

I am 25 years old and I have thinning all over, I’ve been to two dermatologists and both of them just tugged on my head and told me to use Rogaine. I want to know how to find out what the cause is and if there might be an underlying health condition. I have never taken ANY medication including birth control but I may have some other symptoms, only slight but possible indications of something medical or hormonal. There is also no baldness in any women on either side of my family, but there are men on both sides. This is absolutely destroying me and I just want to figure out how to get some answers because Rogaine is not working, I’m running out of hope. Do you know where I can go or what I can do? Thank you for your time and consideration to my question, I would appreciate any suggestion you might have.

There is not a great deal understood about women’s hair loss. First, many women have hair loss secondary to a medical condition. You need to be check out by a competent doctor to rule out the conditions that cause hair loss. Thyroid disease, for example, seems to have hair loss associated with it. In addition to thyroid disease, hair loss can be a sign of a medical problem from anemia, connective tissue disease, gynecological conditions, polycystic ovaries and other androgen stimulating hormones. While you do not currently take any medications, some medications can cause hair loss including: oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone so at any time in the future, this awareness may have significant value to you.

The treatment of women’s hair loss with hair transplantation must be approached differently than men’s hair loss, as most women rarely develop patterned hair loss and it is much more widely distributed. In fact much of the hair remains, but the thickness of the hair shaft is smaller than normal hair and the areas that get impacted by this process can be localized or generalized. This reduction of hair thickness (miniaturization) causes the hair to appear thinner. Because a relatively large area has been subject to this thinning, for hair transplants to have any value it is important to place the hair in areas where it is cosmetically most significant and where it can augment a specifically “defined” styling plan to increase the appearance of fullness. Also, the ‘donor’ area might also be impacted so careful measurements of the donor density and distribution of miniaturization in the donor area is important before a transplant decision is made. For this reason, we generally confine the entire transplant process in women to a localized part of the scalp such as behind the “frontal hairline” or “along the part” in a plan that fits the way the woman combs her hair.

Since hair will be transplanted into a part of your scalp that is thin, but not completely bald, there is a risk that some or all of the original hair in this area may be lost. This process is called “telogen effluvium” and is usually (but not always) reversible in women. In addition, if the donor area continues to thin, then the transplanted hair will also thin over time, since it came from the same area. The progressive hair thinning may be improved by subsequent procedures, but with significant loss, there is a limit to the improvement that can be achieved. In hair transplantation, as in all surgical procedures, it is important to balance the potential gain against the possible risks when making a decision to go forward with the treatment.

Once you rule out a medical problem, then a doctor with knowledge about hair transplantation may be considered. The problem here is that too many women are so desperate for hair that any doctor wanting to offer a hair transplant to a balding women, set up a woman as an ‘easy mark’ for a sale. You must find a doctor who understands who can be helped and who can not be helped; a doctor who is honest and has a good reputation. There is an easy test to give to a doctor. Ask him/her, “What is the percentage of women patients who get hair transplants in your medical practice?”. If he reports significantly more than 5% of patients are women, you can generally assume that he is doing more transplants on women than he should be doing. Some doctors claim that half of their patients are women and that puts me on an alert that this doctor may doing more hair transplants on women than he should be doing. Women have different aesthetic challenges than men, so patient selection is critical and when a doctor elects to do a woman’s hair transplant, he/she has to fully understand the art. The thing that makes women’s hair loss different is that their donor area is frequently not healthy and the recipient area is very diffuse. Moving bad hair to another area just moves the problem around without helping, unless the goals and expectations reflect the reality of that woman’s particular problem.

Female Traction Alopecia

/by William Rassman, M.D./1 /

I have a full head of hair which is shoulder length. However due to many years of wearing a pony tail, I have developed a mild traction alopecia around the neck line and slightly behind the ears. Because of this, I am not able to wear my hair up, or side swept which limits my hairstyles. I was wondering if I may perhaps benefit from follicular hair transplant?

Tight pony tails or ‘pig-tails’ can cause traction alopecia (hair loss from constant pulling). Of interest, the ‘falls’ that women use to add fullness to hair are a frequent cause of hair loss in women who use them to make their hair appear fuller. The more the use, the thinner the hair gets and the cycle of more use to treat thinner hair produces more thin hair.

With that said, the traction alopecia may not be permanent, that is, if you stop putting the traction on it. To find out, you would need to stop using a ‘pony tail’ for at least 6-8 months. What hair does not come back is probably permanent. There is a difference in the hair at the nape of the neck (which often has a different genetic ‘permanence’) then other scalp hair. Hair in the nape of the neck is generally more fragile and can be lost with stress (like traction).

We have extensive experience with treating temple hair and hair at the nape of the neck. The neck transplants were usually secondary to scarring from flap procedures which were surgically induced. The temple hair has been done in many, many patients wanting to move the temples forward or replace them from thinning. Send some pictures to me and I would be happy to give you an opinion. My email address is on the Contact page.

High Hairline in Women

/by William Rassman, M.D./1 /

Hi I am a 24 year old blonde female. I am not experiencing hair loss, but I was born with a weak/receded hairline. Is it possible to correct something like this? I have very fine hair in two spots on either side of my hairline but you can’t see the hair unless you look closely. Let me know if there is any hope. Thanks

High hairlines in women or thin hairlines are very common. Many women who have them would like to have them fixed, but not many come to people like us who have the expertise that might apply. Without discussing which one is better, they are:

  • Moving the entire hairline forward with a surgical procedure, similar to a brow lift but with a focus to bring the hairline down. This gives a very fast result and healing is fairly fast as well.
  • Transplanting the hairline. This has great value in many cases, particularly when the hairline is weak in an identified area as you seem to be describing. This may be one of the most popular hair restoration procedures we do in women.

Send pictures in digital format to me via email and I can give you an opinion.

Hirsute Men and Head Hair Loss

/by William Rassman, M.D./5 /

As a writer focusing on men’s health issues I would be interested in your comments on two areas of my research.

  1. I have read a number of reports that suggest that hirsute men (those with a lot of body hair on chest, shoulders etc) are more prone to lose hair from their heads.
  2. I have also seen reports that the American Red Indian does not suffer from hair loss.

I do not believe these issues have been dealt with by you before.

I too have seen claims that men with heavy populations of body hair have more balding than their hairless or less hairy counterparts. I can say that in my medical practice, the balding men routinely say: “I wish you can take it from my chest or back”. But then again, I do not have the type of interchange with non-balding men to probe the same issue. There is generally a belief that DHT (the evil hormone that ‘causes’ hair loss), also brings on the body hair, the nose hair and the ear hair along with the balding on those genetically inclined balding men. I believe that in the discovery of Finasteride, the people who ingested large amounts of this drug through their dietary intake of a food stock from the rain forest, did not bald, nor do the men born with a genetic defect where they can not make the enzyme that produces DHT. I recently probed a large number of doctors asking if anyone has found evidence of a reduction of body hair, nose or ear hair with Propecia. Everyone liked the question and told me that although they believed it might just do that, there is no evidence that Propecia or Proscar actually blocks or reverses these less than ideal hair locations.

With regard to the American Red Indian, I am fully aware of this observation. His ancestors came from the Alaskan bridge and they had the balding trait, so it is strange that this particular ‘race’ (the great grandchildren of the migrating Alaskan ancestors) is unique amongst all humans as they do not have balding. Of interest, I am not aware that these people are missing any enzymes for making DHT. Could it be that a primitive people actually wiped out balding genes in their brothers in a relatively short time frame of less than a couple of thousand years?