Balding in Young Man and Shampoos

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

i am 21 yrs old, and am experiencing receding hairline. in no means am i bald, but i suspect i will be in a few yrs time. for now, i have been using propecia daily. i just wanted ur opinion on what products i should use for hair care-shampoo and gel. for shampoo, so far i have been using pantene pro v, and instead of gel i use coconut oil everyday. are these products ok to use, or is there something better u would suggest? also, is it ok to shampoo and style my hair daily, or is that bad for u hair? please let me know. thanks dr.

For MPB (Male Pattern Balding) Propecia is the best way to prevent or retard its progression. With regard to the various shampoos, none that I know of has proven to be a greater value than others, when it comes to hair loss. I generally tell patients to use what they like, what works for them, to experiment with many until you find the right match and to follow the recommendations of the product manufacturers for dry or oily hair. Frequent shampooing does not hurt, but aggressive massaging during shampooing and rough brushing will cause fragile hair to break easily. I personally like the smell of coconut shampoos and use them often!

Rapid Hair Loss on Propecia

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

Hi Dr Rassman
Ive been on propecia for over 6 months and in that time my hairloss espically in the front has thinned dramtically much faster than it did in the previous 2 years. Could I be having a bad reaction to propecia?..Would you recommend me quitting trying another product? Im thinking the increased testorone in my body due to the lack of dht may be cuasing me to have a faster rate of frontal loss..its much worse than it was when i started..could it still reocver on propecia? Im just very down about it and regret going on the drug as recommended by a derm i saw this past november..does propecia increase androgens?

You did not state your age, so I am assuming that you are under 28 years old or so. Assuming that you have genetic balding, you probably are seeing an acceleration of the process. If you are in the early 20s, you may be in rapid hair loss and stopping the Propecia may be the worst thing you can do. You need to see a good doctor, document the degree of miniaturization of the scalp and then lay out a plan. It is very hard for me to react to what appears to be a real crisis, without having you in front of me to ask you all types of questions and having the chance to examine you thoroughly.

Balding By Age and Race

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

I have seen documented incidences of pattern baldness, they suggest 20% suffer in their 20’s, 30% in their 30’s, 40% in 40’s, and 50% in their 50’s and so on usually with age. But it seems these calculations are taken including all races such as asians, black american indian, hispanic specifically mexican man all of which have much lower incidents of male baldness.

I am a white man and it seems to me many white man experience some loss when they hit age 40, do you have any idea what the numbers would be if it was strictly white males and not other race.

These would be my guesses if just taking into account white males :

30% suffer in their 20’s, 40% suffer in 30’s, 60% suffer in their 40’s, 65-70% suffer by they reach their 50’s. And if a man doesnt experience any male baldness when they are in their mid 50’s near 60, in most cases these are the males that die with most of their hair.

Maybe my projections are inaccurate but i rarely see a white man with a full head of hair in their 60’s, 70’s. On average, i would say by age 70 8 out of 10 men suffer MPB. WIth the remaining 20% after age 70 escaping the god awful disease we know as MPB.

What do you think?

Breakdown of racial variations by age and degree of hair loss is not well documented. There are suggestions that Caucasians may have more hair loss than non-Caucasians. As a person ages, the first appearance of hair loss lessens in severity. If you reach 40 without any evidence of hair loss, chances are you are not going to bald. With that said, actor Don Ameche had a full head of hair at 50, but he had a nearly complete Norwood Class 6 pattern balding pattern by the time he appeared in the movie “Cocoon” in his mid-70s. So, there are no hard and fast rules when it comes to balding by race. There has been interest recently in obtaining better documentation of this by geography (i.e. race) and studies may be coming in the future. Of interest, the American Indian (those that came from the Alaska migration) do not have balding at all. This makes the American Indian unique for racial groups. There is no explanation of this.

Propecia vs Hair Transplants

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

thanks so much for your reply i really appreciate it. i dont mind taking all the medication for the hair loss but i would rather prefer to get the hair transplant because it will last forever and then i dont need to worry about taking a tablet or putting minoxidil on twice a day. i would rather just get it over and done with so i dont have to worry about it anymore and it will also be good for my self esteem and confidence. what do you recommend?

Here, my age and experience come into place for value. If you are not going to get really bald because your final hair loss pattern is a simple Class 3, 3A or 4A, then you can take the view you discussed. If however, you eventually bald to a Class 6 or 7 pattern (advanced balding), then you will run out of donor hair before the process is complete, unless you are unusually blessed with very high densities. None of us have a crystal ball into our future. The question you should have is, “How bald will I become?” Hair loss is progressive, so chasing hair loss can be a losing proposition for some men. For that reason, I strongly suggest the use of Propecia because there is almost no down side to it, and it will slow down or stop the hair loss for some reasonable time so that you can enjoy your hair. Getting hooked on having expensive hair transplants surgeries on a yearly basis to keep up with progressive hair loss, until you run out of money or donor hair is not what you need.

Propecia is a simple, safe way to make sense of this entire genetic hair loss process.