Thank You for Explaining the Maturing Hairline!

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

Hello,

I wanted to send this e-mail to thank you for running such a great site, specifically in regards to your information on “mature hairlines”. I’m turning 31 this year and have noticed over the past 4 to 5 years that my hair has thinned slightly above the temples. I would say I’m between stage I and II. The rest of my hair is thick (for a redhead that is) and my crown hasn’t changed much over the last 10 years.

My father is somewhat bald but the men on my mother’s side have decent hair for their age. When my thinning started, I, like probably every other male out there, started scouring the internet for information. It wasn’t until today that I actually found more than cursory information about normal, mature hairlines. Funny how all those other sites selling “miracle cures” don’t mention that. What you described in your blog entry explains what I’ve been seeing with my hairline over the past few years.

I generally try not to worry about hair loss and I’m truly thankful for what I have; it’s nice to read useful and reassuring information though for those moments of doubt. If I do start losing my hair, at least I know where to look for more information!

Thank you again.

You’re very welcome! :)

For those interested, I’d recommend reading Maturation of a Hairline — Moving From Juvenile to Mature.

Tags: mature hairline, hairloss, hair loss, hairline

I Lost 800 Hairs Over 3 Days!

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

Hello Doctor,
I’m a 19 year old male and have been losing hair for roughly 1 year. It began with a massive shed of about 800 hairs over 3 days. I was emotionally stressed at the time and also found out I had low iron so I took tablets to fix this. At the start I would lose about 100 hairs everytime I showered. A year later it’s down to about 25. My boggle is I still have a full head of hair, all be it a little thinner.I’m currently still losing large amounts of hair and I don’t understand why. I’m not stressed, I have no diseases and my Iron level is high again. It’s like my hair is stuck in a cycle of rapid loss and regrowth!

The answer is simple. Get your hair mapped out for miniaturization and you will know if you are losing hair. You are acting like a doctor and there is an old saying, The person who treats himself has a fool for a doctor! I really wouldn’t know what to tell you until you’re examined.

Tags: hairloss, hair loss

Making Assumptions About Genetic Inheritance

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

Hey Dr. Rassman I have a genetics question if you can find the time. My dad and brother look alike and have all of thier hair and are 61 and 24 (no widows peak). I’m 22 and during the past year ive developed some recession which your site has allowed me to call a mature hairline. My mom and i have always had widows peaks. Would it be reasonable to assume i’ve developed my mothers family hair genes while my brother inherited my fathers?

It may be reasonable to assume, but I really do not know. Nobody knows for sure! Genetic hair loss does not follow specific predictable patterns that we have recognized. Many have hypothesized and observed that male pattern hair loss is slightly more dependent on the mothers side (51% get the balding genes from the mother’s side).

Tags: genetic, genes, hairloss, hair loss

Restoring the Crown

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

Hello Dr.Rassman,
I am 25 yrs old and have experienced thinning (slightly noticeable) throughout as well as the formation of a bald spot at the crown of my head. I have sought help regarding this and was told that transplant procedures were not typically done to replace hair at the crown. Is there no way to correct hair loss at the crown surgically? I have been on Propecia for about a year now.

Take a look at Patient’s Guide– How Many Grafts Will I Need? and you will see that the crown loss can be huge and take up a considerable number of grafts that could deplete the donor supply. You can transplant hair anywhere on your body, including the crown! If you are bald (have no hair) on the crown area, a hair transplant may be indicated. At your age, if you are truly thinning with MPB, I would explore the possibility of a medical treatment such as Propecia. Propecia alone may restore your crown area. The misconception stems from the fact that hair transplant to the crown area often requires more hair to accomplish the task for patient satisfaction and many doctors are reluctant, because the patients may not have enough hair after filling up the crown to address frontal hair loss, if it should occur. The crown area typically requires more hair, because the hair on the crown does not layer well as the hair changes direction at the swirl. There are many patients with good results (when appropriately indicated) from hair transplant to the crown area. See NHI Photo Gallery – Crown for examples.

Tags: crown, hairloss, hair loss, swirl, hairtransplant, hair transplant

Scalp Pimples Are Becoming Resistant to Treatment

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

I am a 25-year-old girl. I -and my sister also- have a severe -I don’t know if by inheritance or not- predisposition of scalp pimples. When we were younger, we used to get rid of it -even for a short period of time at least- using Betamethasone and Clotrimazole lotions along with an anti-dandruf shampoo. But now the pimples seem to become resistive to any sort of treatment and besides They are too severe that have involved the hair follicles and caused a very intense hailoss. Two years ago, I used a solution consisted of Dalacin, Betamethasone lotion, Salicylic Acid and P.G. in the base of Ethanol and my scalp responded incredibly: All the pimples were disappeared and no more hair loss; I got all my hair back… But after I stopped it, it got worse and the scalp never responded to the same treatments again and no specialist could cure it ever again. I wash my hair frequently, almost everyday so there should not be any hyper-occurrence of sebum-sort problem. What should I do? Any new typical (or oral?)antibiotic should I use or should I try a different steroid or both? I’m Eagerly awaiting your response.

You need to see a good dermatologist and get a good treatment regimen. I cannot advise you on a medical regimen, because I am not your doctor. Nevertheless, your acne problem seems to need some form of medical attention. Do not try to randomly guess by trying various medical treatments without being under the care of a doctor.

Tags: acne, scalp, medication, doctor

Feels Like Something Is Crawling In My Scalp

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

(female) My scalp is alway itching and it feels like things are crawling in my scalp. I’ve been to a doctor and I think I need help from some other source. I have hair loss in several spots. I have used a lot of products and nothing is helping. Please help tell me what I need to use

Many people want me to guess at what is wrong with them without at least some pictures. Seeing you would be ideal. You could have Ringworm, alopecia areata… and on and on. Get a good doctor and if you don’t get the answer from one, go to another. I am in California and would be happy to see you, but perhaps a local dermatologist would be much more convenient for you.

Tags: dermatology, ringworm, alopecia, itch, scalp

Hairless Spots in Facial Hair

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

I am a 28 year old male living in the east bay area california, and I have a question in regards to facial hair loss. There are two different areas of my face that are being affected, one on the right side of my face 1″ from my chin, surrounding a mole and the other to the left of my face that starts just under my chin and ends about an inch and a half to the left. Both spots are circular in nature.. and seem to be growing. In the past i had hair in both spots, but now the skin is smooth and the hair (if any) is blonde-ish in color an extremely sparse (almost like the peach fuzz you get when you are in your early teen-age years before hair growth really starts. What could be causing these bald spots on my face, and is this something that I should be concerned about?

thanks

Sometimes hair loss that occurs in patches on different parts of the body may be caused by a condition known as alopecia areata. There is no definitive treatment, but usually hair will grow back in many of these patients. You should see a dermatologist for this condition. For more information please see National Alopecia Areata Foundation.

Tags: naaf, alopecia, alopecia areata, spots, facial hair, hairloss, hair loss

New Findings on Regenerative Capabilities of Hair Follicles

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

Nature MagazineI have posted my comments following numerous questions on the new findings on hair regenerative capabilities at University of Pennsylvania on their website’s blog. I also encourage you to read the trend of this post on Nature.com’s blog. Here is what I said on the effect of these new findings on the treatment of hair loss:

The research done at the University of Pennsylvania has brought about a different concept on the regenerative capabilities of hair follicles. Dr. Cotsarelis and his team have proven that Wnt protein can induce an embryonic phenotype, which can resemble adult hair follicle. Although these findings seem promising for future treatment of many disorders of skin and its appendages, it is too early to conclude we have any treatments in hand for hair loss or other skin disorders based on this research. Regarding hair loss treatment, we are facing three major hampers in our way.

Firstly, the characteristics of mouse hair are remarkably different than human hair. Mouse hair is more of a villous hair in comparison to a mature human hair so called terminal hair. The growth cycle of mouse hair does not follow the same for human hair. Secondly, an alteration of Wnts pathway is proven to be associated with carcinogenesis in all mammals as this is a known gene pathway. The fact that this is a known carcinogen, is a major ‘negative’ and will prevent any human research that may involve manipulation of the Wnt gene. Thirdly, even if we can influence the gene to make it safe for producing a human terminal hair; it is likely that the new hair presents proteins on its surface which will still allow the hair to fall out as the original hair does.

I am writing on this matter in response to the numerous questions from our patients in our hair loss question and answer blog, BaldingBlog, asking what to expect within the next few years on this issue in the treatment of hair loss. It is definitely not to undermine the value of the great work that Cotsarelis and his team did. Although the result of this research may not affect the patients’ imminent hair loss and skin problems, it will certainly affect the future of hair related research possibly leading us to find a cure for baldness and similar disorders in the future.

New Hair Institute

Tags: hairloss, hair loss, follicle, regenerative, mouse, wnt

Lowering the Widow’s Peak Without Transplants?

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

Hi, I am a 27 year old male and I have a widow’s peak. I was wondering if there was any way to lower it with out grafts, such as in a hairline lowering procedure. If it is possible, could you please tell me the cost of it(range) and approximately what is the maximum length (inches or cm) that could be lowered. Also what are the success rates of lowering a widow’s peak without grafts as well.

Thank you

Without a hair transplant surgery, the only other alternative is a hairline lowering procedure which can be thought of as a reverse face lift. It can cost anywhere from $7000 to $15,000 depending on the surgeon.

The maximum length you can lower the hairline can be variable, but 1/2 inch to 1 inch is attainable. In women where balding is rare, the procedure is more common. In men who MAY bald, there is great risk if balding kicks in after the hairline is lowered, as the hair behind the hairline may be lost to genetic balding and then you would be back to square one with a scar on your head. The recovery process is shorter (1-2 weeks with instant hair) than a hair transplant procedure (4-8 months to grow hair) and like all surgeries a hairline lowering procedure carries its own set of risks.

Tags: hairline lowering, hairloss, hair loss, widows peak, hairtransplant, hair transplant, hairline

Can I Shave My Head While Taking Propecia?

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

Dr. Rassman,

I am a 23 year old African American male and noticed a receding hairline and loss of hair in the front of my head on the sides just this year out of the blue. I have been taking Propecia now for about a month. I have 2 questions: Will Propecia work properly if I bald my head so that I can try to hide the receding hairline? AND You said that Propecia takes about 8 months before results start to happen. WIll using Propecia allow me to return my hair back to the normal pattern so that I can have cornrows?

You can shave your head. The efficacy of Propecia (finasteride) will not depend on the length of your hair, but Propecia will likely NOT restore your receding hair line. Propecia shows its most benefit on the top and crown areas of the scalp. It will likely not bring your hair back to a normal pattern, but it will slow down or even stop the hair loss. There is no magic pill or drug that can do this.

Tags: propecia, hairloss, hair loss, finasteride

Boyfriend Lost All His Hair on the Back of His Head

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

A few years ago my boyfriend got a hair cut and a month or so later he begin to get bumps which he assumed were razor bumps. shortly after he lost all the hair along the back of his head.

Now there’s no hair and bumps that at times bleed and cause him pain. What’s going on with his scalp?

This is difficult to answer, because it requires that I guess. One might assume that he got folliculitis from the shave and lost his hair. He needs to see a good doctor first and it should be clear what happened to him at the hands of a good dermatologist.

Tags: folliculitis, dermatology, dermatologist, hairloss, hair loss

Gel, Bleach, Hair Dye — Could These Have Caused My Hair Loss?

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

Hi, i am an African American teen whose hair is shedding and i do not know why. Could gel possibly cause your hair to fall out? Like the edge of the top part of my hair is constantly getting thinner and i dont understand why this is occurring. My hair is really thick and shoulder length. Or maybe the bleach i used in october is taking my hair out, then then it could possibly be the dye i used a two weeks ago. I do not know what is going on. Yet, dr. if you know whats wrong or have any hair loss prevention tips, please let me know. Thanks for your time. God bless

ALL are possible, but there are many other reasons for hair loss. I just can’t diagnose your condition via the internet. The more junk you put on your hair, the higher the risk of hair damage, particularly bleaching or straightening compounds. It is unlikely that commercial grade hair gels will cause hair loss. If you are concerned you should see a doctor for a more complete evaluation.

Tags: hairloss, hair loss, bleach, gel, dye, female, women, woman

Do Juvenile Hairs Miniaturize Before Falling Out?

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

When a hairline is maturing, do those hairs in the juvenile area experience miniaturization before falling out? In other words, is miniaturization a certain sign of male pattern baldness, or only if it is occurring beyond the juvenile hairline?

Most of the time I have seen changes in the juvenile hairline, it has occurred without miniaturization, just a slow regression of the leading edge of the hair. With that said: the frontal hairline in every man and women and finer hairs in the first 1/4 inch or so. That appears as miniaturized hair ,so carefully reading of the micoscopic hair must be made taking the degree of normal frontal small hairs are not confused with progressive frontal balind.

Tags: miniaturization, hairline, juvenile, hairloss, hair loss

Why Did Anyone Get Hair Plugs in the 80s?!

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

Looking at the old school method doctors used to perform hair transplants, with those really “pluggy” looks, Im curious as to why ANYONE in their right mind in the eighties would go in for that procedure! Was it ever done well?? I mean it really looks like crap and nothing like natural hair. Do you have any photos of one of those procedures done relatively well? Just curious. Thanks, really enjoy the blog!!!

Atari joystickThey didn’t know any better back in those days. I know we’re only talking about 20-25 years ago, but technology is an interesting thing. One might say that there was so much excitement to get hair on a bald head, that men did not use their brains. Or that doctors were so trusted in those days, that when a doctor recommended hair plugs, everything was followed like the sheep to the slaughter. It may seen archaic now, but it was the state of the art back then and most men had plugs put into thinning hair so that they only saw more fullness — that is, until the hair all fell out around the plugs. There was a logic put together by the doctor that one could put the hair back in quarter sections, like a checkerboard with four squares. First you transplanted one square than the second, then the third, and then the last. In theory, the doctors and the patients wanted to believe that when all four squares were filled in, the hair was full. But reality took on another face, and the doctors started to push ‘touch-ups’ to fix the pluggy appearance of the rows of corn that grew on the head. It was not unusual for a patient to have 10 surgeries to get their hair back, but that was never a real possibility. I don’t know where common sense played a role and the men walking around with ‘doll’s hair’ were becoming more and more prevalent. Celebrities were leading the way and people like Frank Sinatra became the model that everyone wanted to follow (he had a pluggy transplant), but he really looked awful so he wore a wig and people thought that was his hair transplant, an illusion that doctors profited from and patients wanted to believe. It was an embarrassing con game perpetrated by the medical profession.

Have you seen the old Atari video games back in the 1980s? It was the best back then! Unfortunately, just like the Atari video games of the 80s, the results of the old plugs are not as impressive when viewed today.

Tags: atari, sinatra, hairloss, hair loss, hairtransplant, hair transplant, hair plugs