I lost all my pubic hair after cancer radiation therapy. I am hirsute guy with hairy chest, legs, arms. The blank spot now looks terrible and I’m embarrassed in the gym shower etc. Is there anything I can do?
Transplants should work well. Head hair may grow in curly, so it is worth a try. Underarm hair may also work, but the yield may be less due to the shorter growth cycle. Beard hair works very well. In older men, that would be my first choice. What is your age?
Male, 28 yrs. old. I have been losing hair diffusely through out the top part of my scalp for about 2 months now. It really really itches in the same area my hair is thinning… is this just a coincidence? What do you recommend as a treatment plan?
When there is hair loss or hair thinning, there is both a greater chance of skin drying and more sun damage. Both can cause itching. I recommend that you get your hair mapped out for miniaturization, learn what it happening to you, get a good doctor who can develop a Master Plan for your hair loss which is customized to your situation, and then act upon that plan if you are comfortable with the plan and the doctor. Stick to whatever you decide and follow-through.
I am 23 years old and I want to tell you my story. I was worried sick as I saw my hairline starting to climb. I went to a doctor in Toronto who said that I was going to go bald and needed to take swift action to prevent it. After listening to him, I went into a panic, took out most of the money I saved to go to graduate school and got transplanted with 2700 grafts. The doctor lowered my hairline also (about 1/4 inch) as well and transplanted the entire front, top and back of my head. I did some comparative shopping when I was investigating who to see about my problem and found that the price he was charging me was very competitive at slightly under $4/graft Canadian ($10,000 in cash). After the transplant was done, I found my hair falling out faster than before. The doctor told me that the new hair will replace far more than I lost and that I was lucky to get to him before the the hair had fallen out. It is now 10 months since my surgery and I am worse off now than before the surgery. I have less hair and a hairline that is nothing like the pictures the doctor showed me when I was shopping. I am very depressed, so much so that I feel that what I did to myself has created a monster. I needed to tell someone about this, but I am not sure what I am asking of you. What would you advise your son to do if he screwed up like this?
This is a tragic story, one that is hopefully not common today. To be blunt, you got taken advantage of. To do 2700 grafts on a 23 year old with little or no balding and only a receding hairline is not only malpractice, but (in my opinion) it is criminal. You got scammed and fleeced. The doctor who preyed upon you took advantage of his position, breached the Hippocratic Oath and probably violated the law.
I speak over and over again on the importance of commanding this process. You need to meet patients directly, one on one, and see the results for yourself. You need to examine the practice of the doctor you are intending to do the surgery to find out about his/her ethics. Their patients will tell you what you want to know. I can remember an unethical, scummy medical facility from many years ago that gave out a list of patients to call for references. I knew that these doctors were crooks, so when I got the list, I called down the list of patients. What each and every person on the list told me was that they would never recommend their doctor, that they were deformed by that doctor and that they felt cheated, raped, and ripped off. What I also learned from the patient victim that gave me the list is that he never called the patients on that list, because he assumed that these people were 500 good references for the doctor — clearly not the case.
What you should have learned here is that you must protect yourself from the unethical doctors out there. I would certainly notify the governmental agency that controls the doctor’s license. In America, you can file suit and clean up if this was the criminal process that it sounds like. Elective cosmetic surgery is a Buyer Beware business. There are good doctors out there who do practice ethical medicine. So for our audience of readers, I hope that you learn from this young man’s mistake — learn that it is your job to research your doctor before you buy.
I feel empathy for you. If you would like to talk with me, please set up a conference with me at 800-NEW-HAIR.
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I am 25 and afraid that my hair has been falling out for several months now. I notice that my fallen hairs are much thinner near the root than at the top. I have read that a miniaturization process is common in hair loss, but I thought that the ENTIRE hair would shrink before it falls out, not just at the bottom. Am I experiencing something weird or was I wrong about how hair miniaturize?? Also, I am debating whether or not to take Propecia to help this. I was wondering if Propecia works, would the thickness of thin hair increase OR do you think a the thin hair will still fall out and a new thick hair could possibly grow in its place?
The decision for the use of Propecia must be a lifetime decision, so it’s better to find out what the diagnosis is and to form a Master plan for your hair loss before you embark on that path.
With regard to miniaturization and hair loss, some people miniaturize progressively as they bald. These are the people who benefit the most from Propecia, as this drug in young men can reverse the miniaturization process. Some people do not go through the miniaturization stage and this is most common in the frontal region as it recedes from a youthful to a mature hairline.
I am a 33 year old female who has been using 5% minoxidil for the last 2.5 years. The minoxidil has helped hair to grow in the thin/bald areas of my head and has been very sucessful.
I want to try and have a baby this year. I know it is not advisable to take minoxidil during pregnancy but my question is to when do I need to stop. Is it OK to be using it while I am trying to conceive and to stop as soon as I know I am pregnant? I’m worried that if I stop now and don’t conceive for a long period then I am going to have to suffer the bald patches again.
Thank you
Topical minoxidil has small absorption from skin that can potentially affect the baby during pregnancy. There is not enough information on humans for the use of minoxidil during pregnancy, but animal studies showed some side effects on babies. To be on the safe side you should not use topical minoxidil during pregnancy. Of course, stopping the drug may cause reversal of the benefits in a short 3 month timeframe. Using minoxidil during lactation is thought to be safe. The good news is that your hormonal balance during pregnancy is toward protecting hair growth and strengthening hair via a surge of estrogen. Your hair loss may be affected adversely after pregnancy (telogen effluvium) and during this period you can restart taking topical minoxidil.
I’ve been monitoring your blog since I was diagnosed with AGA. I find it extremely comforting to have a reliable source of information on this matter.
I’ve been on Minioxidil for 4 months. At first the results seemed to be good (saw new hairs growing on the vertex and forehead) but a couple of weeks ago I noticed an increased rate of hair loss. My question is: how can I determine if minoxidil is (and it’s going to continue being) effective? Is variable hair loss rate normal?
I honestly do not know the answer to your question. I would want to know what the miniaturization of the area was prior to treating it and after the 4 months. I would want to know if what you saw was new hair of just increasing bulk of the miniaturized hairs. Without a good baseline metric, I really have no way to tell.
Variable hair loss is part of the AGA process, as hair loss occurs in waves of time. Again, I do not have direct access to your head to make judgments.
I have been experiencing hair loss on the top of my head since taking nexium 40mg. Please advise if the hair growth will be returning after discontinuing use or if a drop to 20mg will stop the accelerated hair loss.
I wrote about Nexium and hair loss before. I do not know if reducing the dose of the drug will reduce the hair loss side effect. As this side effect is not common, I really do not know where to find good scientific knowledge on this question. I can be sure, however, that if you cut the dose on Nexium, it will be less effective. Please use your doctor to alter medication doses, do not do it yourself or through an internet advisor like me.
hey,
why is it that propecia and minoxidil aren’t (as) effective in the temple regions? i happen to be thinning in the temple largely, and have been on propecia for approximately 2 months. should i continue and hope that there is regrowth in the temples or continue for posterity’s sake?
At two months, you can not draw any conclusions about the effectiveness of Propecia. You need 8-12 months. I only report what the drug company submitted to the FDA as the basis of my knowledge on this drug and the areas of effectiveness. When you talk about ‘temples’, many people believe that the temples are what I might call the corners of the frontal hairline. You need to either send me a photo and show what area you are calling the temples, or see me in person to give you an appropriate opinion.
Dear Dr. Rassman,
I just would like to know if it is better to wash my hair every day or not so much – e.g. twice a week. Skin on my head seems to produce lot of sebum (hope it is the right word), so I think it is better to wash it more often but I read some articles stating it is quite unhealthy.
So I would like to know your skilled opinion.
Regards
When your scalp makes a great deal of sebum, the oily feel and appearance of the scalp can be managed with daily hair washes using a shampoo made for oily hair. I wash my hair daily.
I’m an 19 year old male and I think that I am starting to have early stages of balding, similar to that of broadcaster steve hartman but at a smaller alot smaller level. Is my hair going to continue to bald until it looks like steve hartman’s or is there a chance that it will stop? Also whats steps can I take at this young age?
You need to have a diagnosis, so get your hair mapped out for miniaturization to determine if that is what is happening to you. Why play guessing games? You need a Master Plan for your long term management and a good doctor to do it for you. I just can’t stress these things enough. My apologies to the regular readers that think I’m sounding like a broken record, but there’s just so little I can do to help via the internet without examining your hair loss, so I must keep recommending the same things over and over.
The staff at NHI have hijacked the blog for just a moment to post this special message to Dr Rassman…
Have a great birthday this Sunday, doc!
HI! Doctor. I have been reading many blogs and I need to ask you one imporant question. I am a twenty year old male and its been six months since I had my transplant in the crown area. The only reason why I went for this transplant so early is that cause I had started losing my self confidence cause of really thin hair on my scalp. Now my crown area is becoming thick day by day. But on the other hand, I am losing my hair on the top of my head. Is there any way to retain my existing hair now? I am really worried and it would look really bad if I get bald at such an early age. I have been taking Genesis ‘finasteride’ and it has done a lot for me too. Like it helped me a lot before I had my transplant. But since transplant, I think it has started losing its affect . Please doc I need help. Is their anyway I can stop my existing hair?
I am very concerned that you had a hair restoration procedure at such a young age, especially in the crown area and many doctors including myself might think that this is not an approach that an ethical doctor would do. Of course I do not have the luxury to examine you in person, but surgery is rarely recommend at such young age, particularly in the crown. More importantly, having surgery too early may actually accelerate hair loss and you may end up with negative (worse off) results. It sounds that way to me.
While finasteride (Propecia) is a great drug at slowing and sometimes reversing hair loss, it is not a cure either. Men of your age should start off with a one year course of finasteride first. This drug (in a 20 year old) may reverse hair loss in the crown. If it does not reverse, it will slow down the progression of hair loss, but if you have a transplant too early, the acceleration of the hair loss is an almost predictable conclusion. In one scenario, the hair loss you are experiencing may have been accelerated by your transplant and now you are faced with “chasing” the progression of hair loss. You could eventually run out of hair before completing the hair restoration process if you have one of the more advanced hair loss patterns. With the amount of hair loss you are telling us about, it sounds like you are well on the way to a more advanced balding pattern and may find yourself running out of hair. If anything, I would continue the finasteride treatment and have your scalp hair mapped for miniaturization to track the progression and the rate of your hair loss. You must create a long term Master Plan with a good, reputable, honest doctor before doing any more surgery. Don’t feel like you need to contribute to your doctor’s BMW car payment. Even after one mistake, you still might be able to build a plan that will work for you, but more surgery without a plan is like an airplane running out of fuel at 30,000 feet, for there is no soft landing.
This patient has black hair and white skin, so his short ‘beard’ shows at the hairline where he was transplanted just 3 days before these photos were taken (see photo to the left, below). He just combed his hair forward and to the side (as shown in the photo to the lower right) to camouflage his hair transplant. People who do not wash their transplants correctly, may scab more than those who do wash properly. When a patient has hair to use for cover, creativity in styling goes a long way to cover up transplants. Two days after this picture was taken, all of the ‘scabs’ shown in the below photos were gone. Please click to enlarge.
Hi there!
Im male and know minoxidil can cause an itchy scalp. Used the product for a while but in time it irritated my scalp and wasnt working so I stopped. 5 months later my scalp itches but only at times. Is this a very normal complaint after this period of time? It itches more in the areas I used the product. Thanks for your time.
This is not common. If you have developed a scalp or skin problem, you need to have a proper diagnosis. See a good dermatologist. If you are in the Los Angeles area, I would be happy to recommend one for you.
hi,
i have psoriasis all in big regions of my body mainly my scalp and im balding on the top. my self esteem is already low. i want to keep my hair so bad to hide the disease . i need some answers. and i just started rogaine. no signs
I truly empathize with you. What you described is just what I went through. My psoriasis started in my scalp and moved through much of my body over the years. You need to get a good dermatologist to help you manage the psoriasis. Whatever you do, do not pick on the psoriasis flakes in the scalp, for you could get traction alopecia to compound your problem. There is no magic bullet for this condition. Some newer medications have allowed better control for the really bad psoriasis, but it still can’t be cured.