When Does Hair Loss Stop?

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

Dr.
I am an African American male who is 37 years old and started noticing my hairline receding at the age of 27. My hair loss at this point is not bad (probably class II). At the moment, I have no balding in the crown area but as I said earlier, my hairline is receding. My mom side of the house (brothers have full heads of hair) and my dad still had his hair before he passed at the age of 43. I have a few questions

1. At what point if any does your hair loss (receding)stops?
2. I decided a few years ago to take propecia after I started taking some other DHT blockers (procerin, kevis, follicure etc…). I even visited the hair club for men. Is there anything right now that I can do (laser therapy) that will continue to reduce hair loss.
3. Has avodart been approved for hair loss yet and would you recommended it?
4. Are there any good Dr’s you could recommend from my area (Hampton Roads are of Va)

  1. Most people start their balding process in their early 20s, some like you in the late 20s and a few after 30. The general rule is that for those who have hair loss in their 20s, most of it will slow down by the mid 30s and by the time the person reaches 40-45, it should slow down even further. There are no real rules other than what you see. You can anticipate it by mapping out your hair for miniaturization to see what the future may hold for you.
  2. There is only one FDA approved, proven DHT blocker, however with that said, many products claim DHT blocking effects without the science behind those claims. You must, of course, make your own decisions. I’ve written about laser treatments quite a bit — see Low Laser Light Theraphy and the general “laser” keyword search.
  3. I do not prescribe Avodart, because it is not FDA approved to treat hair loss. It is doubtful that the drug company which produces it (GlaxoSmithKline) will seek FDA approval for hair loss.
  4. For doctors in your area, I would intervew those who are on the ISHRS.org website, for at least they are interested in education for themselves.
Tags: hairloss, hair loss, avodart, laser, fda, dht, ishrs

Why Am I Experiencing Hair Loss Months After Surgery?

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

Hi
I’m 18 year old male. I had surgery about 4 months ago. 2 months after I noticed my long hair has been falling out in clumps of 15-20 hairs in one pull or when I brushed it. It has been going on now for 2 months and my hair got very thin very fast. I have noticed a bunch of new tiny hairs growing in front of my hair line but after reaching 1 cm in lenght they had stopped growing and some of them are falling out as well.

I would be greatful to hear your answer.

Am I to assume that your surgery 4 months ago was not a hair transplant? Hair transplantation at 18 years old is very unusual and in most situations, not appropriate. Hair transplants can accelerate hair loss in an 18 year old and that is one reason this is rarely done. If you have genetic balding and are not on the drug Propecia, I would suspect that you have an extremely high chance of acceleration of your hair loss. If your miniaturiation is high, then that makes hair loss in an 18 year old almost a sure bet. The amount of hair loss and the distribution of the hair loss will reflect your genetic pattern. This sounds like shock hair loss with the acceleration of your patterned balding and may be permanent.

If you are not on Propecia, it may not be too late to start it and try to hold on to what you still have. I would like to know who did your hair transplant (if that was the surgery you meant)?

Tags: hairloss, hair loss, surgery, hair transplant, teen

Does Minoxidil Strengthen Existing Hair?

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

Hi Dr., I know minoxidil does not block DHT but I was wondering if minoxidil strengthens existing hair, or if it just regrows a bit of new hair. Thanks for helping out so many people with your site!

I believe that it does strengthen the hair on some people. Minoxidil is not, however, a reliable drug for either strengthening or regrowing hair in the majority of patients that take it.

Tags: minoxidil, rogaine, hairloss, hair loss

Doctor Advised Against FUE Due to Healing Dangers

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

Hi Doctor,

I have been adviced by a hair transplant surgeon against FUE, instead he suggested FUT.

The reason he gave was – the scars of FUE, which are generally left open to heal are very dangerous in weather condition like south asia. The scars are prone to get infected. Also he mentioned about various types of sealing but he also added that it doesnt help much.

He advocated FUT over FUE for- its less prone to infection, it takes less time, its costing much less and the it suitable for large number of grafts (I need around 2000 grafts on frontal area).

I am confused as I dont want the scar involved in FUT, but want a safer procedure.

So is FUT more safer/better suited alternative than FUE for my condition?

First, if you are clean and wash your hair regularly, FUE is not a problem even in wet or warm climates.

I agree with your doctor otherwise. The FUT is less expensive, easier to get larger sessions, and probably in his hands, safer than FUE. I personally try to tell my patients that scarring above 3mm occurs in less than 5% of patients. The use of a trichophytic incision and fascial closures as discussed in this blog, should address the scarring risks in most patients.

Tags: fue, hair transplant, hairloss, hair loss

GNC Men’s Mega Men and Hair Loss, Follow-Up

/by William Rassman, M.D./10 /,

Doctor,
You recently mentioned (GNC Men’s Mega Men and Hair Loss) that a certain GNC multivitamin contains DHEA, which can produce hair loss as a side effect. I use the GNC mega men multivitamin, and I can’t find any mention of DHEA –or the full name of Dehydroepiandrosterone– in the ingredients. Does it go by a different name? I suspect one or more of the following ingredients: L-Arginine, L-Carnitine, L-Glutamine, L-Taurine, L-Valine, L-Leucine, L-Isoleucine.

I also take a protein shake that contains much larger quantities of L-Isoleucine, L-Leucine, L-Valine, and L-Glutamine. In addition, I take a creatine supplement with L-Glutamine, Taurine, Glycine, K-Arginine, and L-Methionine.

Ironically, I usually take these supplements alongside of a DHT blocker (first propecia, more recently Avodart) because I was experiencing thinning hair a while back. I’m under the impression some of these may increase DHT production in the body.

I would appreciate it if you could tell me which, if any, of these ingredients produce hair-loss, or increase DHT, as a side-effect.The good news is that I haven’t noticed any additional hair loss, but I would like to cease use of these products ASAP if they accelerate the hair loss process.

Thank you very much.

My comments that reflected the presence of DHEA in the product GNC Men’s Mega Men come from the GNC.com website, where it states “Features DHEA, one of the most abundant hormones produced in the body and is a precursor to other hormones.. ”

DHEA can cause hair loss and that is all I have said about it. I am not against this product, just looking for things that cause hair loss and reporting what I learn to this audience.

With regard to the other listed nutrient supplements that you asked about, clearly a deficiency of any essential dietary elements in your diet can, by themselves produce hair loss.

L-Glutamine: There is a suggestion that high amount of this can cause increases in growth hormone, which could therefore produce hair loss if that association bares out.

Taurine, Glycine, K-Arginine, and L-Methionine : There is no direct association that I know of between taking amino acids supplement and hair loss. Any deficiency in these however, will produce hair loss. Good diets should alone produce adequate amounts of these essential nutritionals.

Tags: gnc, mega men, vitamin, hairloss, hair loss, dhea

Combat Itching from Hair Systems

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

I wear a hair system and I would like to know how to combat itching

Itching may be caused by the inability to get a good wash. Can you remove the system and wash your scalp regularly? After a wash, are there abnormalities in the skin of the scalp? As you will note, I am starting to ask questions that require observations. Other than basic cleanliness, I would have to examine you before rendering an opinion.

Tags: hair system, hair piece, hairpiece, hairsystem, wig, itch

FUE with a 0.75mm Instrument

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

Hi Doc,

Quick question regarding your “FUE Scars” response on May 30th. Are any tools under research or developement (at NHI or anywhere else) that will leave wounds in the 0.75 mm or less range? Or does “impractical” mean “impossible?”

Thanks!

CommandentsThere are some doctors using a 0.75mm sharp punch for FUE which is smaller by a factor of 30% from the 0.9mm punch. The follicular holocaust is very large. If it were reliable, I would be using it. Some doctors are telling their audience of patients that they CAN do this successfully with a 0.75 mm sharp punch. I am just a mortal and will not delude the public into believing what they may want to hear, or selling them a ‘bill of goods’ that I believe promotes the business at the patient’s expense.

If the technique can be perfected (we are trying to do just that), then it would be superior to what we do now with a 0.9mm instrument, because the wound would be much smaller, faster healing (now it heals in 5 days), create a smaller scar (now the scars are 0.9 mm round) and possibly would allow more harvested follicles. But alas, the technology is where it is now, that is, except in those doctors who promote their godly likeness.

Tags: fue, hairloss, hair loss, hair transplant

Bulimia and Hair Loss

/by William Rassman, M.D./4 /,

hi.. about 2 years ago, due to break up of a relationship and some family problems,i began abusing laxatives (bulimia) ( during this time i was on dianette to treat my polycystic ovaries, i stopped takin diannette 10 months after my laxative abuse started).. i abused laxatives for about a year and half where then i got help and stopped. however during this abuse period, i suffered alot of hair loss.. and now my hair is about 50 % of what it was.. i cannot tell you what this has done to me mentally.. firstly because i was well known for my beautiful thick and glossy hair and secondly because by profession i work on tv.. i went to see a dermatologist who insisted i take 600mg of ferrous sulphate a day.. i did this for a bit but it gave me tummy cramps and constipation. he says the injection is big and painful, but i dont really mind. what i want are results.. its been almost 7 months and even though im eating healthily , and not taxing laxatives, i cant see any new hair growth. and i have this awful feeling my hair is still thinning.. i got myself some hair extentions to give myself a bit of confidence.. and it was successful to give me some confidence if only for a while.. i will have the extentions removed within a couple of weeks, which i would find tolerable if i knew my thick luscious hair will grow back.. but as i said i cant even see any new hair growing.. i feel my dermatologist isnt taking full action to combat my problem, im willing to undergo and try anything.. do you know of any top dermatologists in london with specialty in hair loss or its research? do you also mind giving me your opinion on what i should do.. really appreciate it. thank you

You have many things that precipitated the hair loss and if the hair thinning has not reversed in a year or so, it will probably be your new normal status. Bulimia, diet problems, and general intestinal problems most probably contributed to your situation. The presence of Polycystic Ovaries in itself produces enough endocrine abnormalities to explain the persistence of your situation. You are correct to locate a good dermatologist, but I am not familiar with London’s doctors. Ask other doctors who they would use for their own family.

Tags: bulimia, hairloss, hair loss, women, woman, female

Taking Propecia When There Is No Hair Loss

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

To Dr. Rassman:

I am 19 years old, and my hairline has receded slightly. My mother insists that I am paranoid, and that my sense of paranoia is only exacerbated by my reading too many Philip Roth novels. But a few jokes here and there about my thinning hair from friends who don’t know about my “paranoia” has only confirmed me in my judgment.

I want to start taking Propecia. My question is, in the unlikely event that I’m completely wrong and am not balding at all and that my mother is actually correct but I go on Propecia anyway…are there any side effects from taking Propecia when it’s not “needed,” besides the ones reported (decreased libido, etc.) by those who do “need” it? On a side note, (forgive my naivete), are proscriptions of Propecia difficult to obtain? Thanks very much for your time and help.

There is no point to blindly commit yourself to a lifetime of drug without a diagnosis. Be smart and get your hair mapped out for miniaturization to find out what is really happening. Many 19 year olds are developing a maturing hairline, not balding. Get a good doctor to tell you what is happening to you. Friends, at your age, can be cruel even if it is not intentional.

Tags: propecia, finasteride, hairloss, hair loss

Using Rogaine When It Is Not Needed

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

i saw a dermatologist yesterday and she recommended that i take b complex and biotin. she also said that rogaine is not harmful. can rogaine cause hairloss if i dont need it and am using it.

thanks

I think that you know the answer to that question. Rogaine has many side effect including skin irritation, dizziness and skin dryness to name a few. No one should take any medication that they do not need.

Tags: minoxidil, female, women, woman, hairloss, hair loss, rogaine

Very Thin Hairs on My Comb

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

Recently I’ve noticed short hairs that are also extremely and unusually thin appearing on my comb after I comb my hair. I only see them on occasion (small minority of my hairs), but nontheless they are there. Does this indicate that the miniturization process has started to some extent, or do normal hairs sometimes go through thin/short phases only to return to normal eventually?

I would want to know if you are male or female and if you are having signs of balding present. What is your age?

People with miniaturized hair will find the hair to be more fragile and easier to be pulled out with combing and brushing. Large-toothed brushes are probably worth using as they do not place the full power of the ‘pull’ on each hair. If you are concerned about miniaturization, get your scalp mapped out for it and you will know for sure.

Tags: hairloss, hair loss

Hair Transplant, 10 Days After (with Photos)

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

I am constantly asked how long it will take for a typical patient to be able to go back to work. This patient is 10 days post-surgery and went back to work in 4 days. He had 1,677 grafts transplanted and is a class 3A on the Norwood scale. He has the advantage of a blonde hair so that the beard of transplanted hair is also blonde. There is a small beard if you look carefully. The skin of the transplant is still slightly swollen with a fine pink hue (he is sandy blonde with white skin, known for showing a pink hue) and this will subside over the next week or so. The hair he has presently covers these changes so that it had not been seen in either his work or in any social setting. Click photos to enlarge.




Tags: hairloss, hair loss, hair transplant, photos

Using Minoxidil When Pregnant

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

is minoxidil safe in pregnancy?

Any medication that you take on the skin will go through the skin and into the body. If the baby gets exposed to this drug by absorption through the skin, there’d be at least one report of babies with more hair than normal. Unfortunately, good studies are not available to answer this question. This may be an issue of benefits vs risks, so I would suggest that you ask your OB doctor and see if that causes him/her concern.

Tags: minoxidil, pregnancy, obgyn, female, women, woman, hairloss, hair loss

Folligen Spray, Dutasteride, and Sex Drive

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

I’m 25 and I used finasteride for more than 3 years now, with no sucess at all. I also had a lot of problems with dandruff and irritation on my face and scalp. I was really worried about this, than I decided to take dutasteride. I’m also taking now minoxidil 2%, and using folligen spray and revivogen shampoo. I noticed some very little hairs in my left temple. Not too many. But I also felt a difference in my sex drive, and some shedding. My dandruff desapired, I think because anf the folligen, it really resolved my irritation in the first week. Do you think I should keep this treatment? Should I worry about the shedding and libido, or this could be a transitional state?

thanks a bunch!

Finasteride may be working by preventing hair loss progression, but just not growing new hair. I gather that the dutasteride has reduced your libido, which is not a surprise at all. Folligen spray contains copper peptides which have had some unsubstantialed scientific claims for hair re-growth. I am happy to hear of your positive response to the dandruff with the routine you are using. Hair shedding and libido having appeared brings you to a decision: Is the benefits (or proposed benefits) worth the price? How do you rate your sex drive balanced against having hair?

Tags: hairloss, hair loss, finasteride, dandruff, folligen, libido, dutasteride

Hair Loss and the Immune System

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

I recently read a posting on baldingblog where a women suggested the use of Visine to stop hairloss. I’ve heard of using visine to help sooth razorburn an ingrown hair as I assume it has antiflammatory medication.

I’ve read other places that some people think hairloss is a type of immune response of our body, where DHT causes the structure of the hair follicle to change. At some point our own immune systems reject the changed follicle and attack it, ultimately causing the phenomenon we see as balding. Somewhere else I read that in cases, such as people getting transplants take immune suppressing drugs such as Cyclocsporine, to stop organ rejection, actually noticed hair regrowth.

Going back to the woman who earlier spoke of the Visine treatment that she heard, this woman said that her hairloss got worse after she moved. Speaking from my own experience, I have noticed that certain immune responses happen when one changes environment. For instance, I grew up in New Jersey and never suffered any real allergies or medical problems. When I moved out to California when I was 16, notice an increase in my hyper-histamine.. or histamine positive response. I believe thats what you called it. In particular, I developed an allergic reaction to heat.

Anyhow, its interesting to think that environment may have a small role in a complex immune response that results in hair loss.

Is hairloss a more modern occurrence? I mean, does hairloss occur more in modern society? I remember reading an article recently in Wired that said that when comparing lab mice with sewer rats, the sewer rats had “better” immune systems because of their dirty environment. The immune systems of the lab rats tended to overreact to stimuli. On the other hand, the sewer rats immune systems better defended against real threats while not overreacting to things such as allergens. ( https://www.wired.com/news/wireservice/0,71185-0.html)

Anyway, thx for your blog, Dr Rassman. It’s always interesting and entertaining!

I agree with you that although hair loss is caused by genes, it can be influenced by the environment where chemical products, drugs, malnutrition, and stress can induce the expression of balding genes. Hair loss is not a modern society occurrence. Men have been bald since the beginning of recorded time. Hats and wigs have been around since the earliest records in the history of civilization.

Are we more self conscious with hair loss today? Somehow I doubt that, but we do have better communication (like this blog and the internet in general) to share what is happening to us with others. We do know that autoimmune diseases can cause hair loss by creating antibodies attacking the hair follicles, but that may not mean that hair loss is always an immune modulated disorder. A famous doctor told me once that sooner or later (he predicts) that we will learn that every disease entity will arise from either infection or genetics. At this point though, who really knows?

Tags: hairloss, hair loss, modern, immune, infection, genetics, genes