My Grandfather Rapidly Lost His Hair in His 60s

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

I am 22 and I have noticed over the past two years my hairline changing into a widows peak, but the rest of my hair remains as thick as ever. I am genetically susceptible to balding as I have two uncles either side of the family (one totally bald and the other started thinning around the age of 40)

But when I look through family photos I notice that my hairline most resembles that of my late grandfather (who ironically I am named after) in his mid twenties and he had the exact same hairline. but the thing which confuses me is that the temple recession is much deeper than with what you describe as a mature hairline (as is mine) and he kept his hair until his mid sixties which he rapidly lost due to cancer.

So I suppose what I am asking is whether MPB can occur to an extent during early life then pick later on in life. Or whether there are varying degrees of a ‘mature hairline’

Thanks

Generally male pattern balding (MPB), otherwise known as androgenic alopecia (AGA), has varying degrees of hair loss. It can start as early as your puberty years and progress into your later years. Your grandfather’s rapid hair loss as you described is likely not related to MPB or AGA, as it was more likely related to his cancer. If you are concerned about hair loss, you should consider a miniaturization study, which is a microscopic examination of the state of the health of your hair. We do not always match the hair loss of a relative (hairline for hairline), but the trend can be anticipated.

Tags: hairloss, hair loss, grandfather, genetic, gene, balding

Does Propecia CAUSE Frontal Hair Loss?

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

Sirs,

Thank you for such an informative blog. I have read many things in French language forums about Propecia that, although the drug fascinates me, cause me to question its ability to help me. I’m 29 and moving towards a NW 3.0 (I might already be there). I have read that Propecia causes frontal hairloss. This is frequesntly mentioned in French-language forums and frightens me away from the drug. The only hairloss poblem I have (and it is rather minor at the moment) is frontal.

Can you confirm that propecia does not cause frontal hairloss?

very cordially yours

Those with Norwood Class 3 balding patterns may progress with further balding. Propecia will either prevent this from happening or slow down the process. I have little doubt about answering your question — Propecia does not cause hair loss in the front or anywhere else on the scalp in a person with male patterned balding. It is FDA approved to treat hair loss, not cause it. See Are Minoxidil and Propecia Worth Using? (with Photos) for a great example of regrowth from Propecia (along with minoxidil).

Tags: finasteride, propecia, hairloss, hair loss, hairline, balding

In the News – Smoking May Accelerate Hair Loss

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

We have known for some time that smoking reduces skin circulation, particularly in the scalp. These articles do connect the dots between smoking and acceleration of hair loss in those individuals who are genetically prone to it. Of interest, there is a clear suggestion in these reference articles to the original research, which show that Asian men have a lesser incidence of balding.

Tags: smoking, cigarette, tobacco, asian, hairloss, hair loss, circulation

Steroid Nasal Spray and Hair Loss

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

Dear Dr. Rassman:
I’m confused about steroid-based medications and hair loss. My ENT recently prescribed me a steroid cortasone nasal spray for chronic rhinitis. Can this potentially have adverse side
effect on my already progressing MPB?
Thanks

Yes, steroids can produce accelerated MPB. When using the steroids through a nasal spray, body absorption is as good as any other route. Sounds like you need to have a conversation with your otolaryngologist (ENT).

Tags: steroid, nasal, hairloss, hair loss, cortisone

Warts and Hair Loss

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

Hi, I was wondering if warts can cause hairloss. I just realized that I have had a wart on my foot for quite some time (I just figured out that it was a wart). If warts aren’t treated can they cause hairloss and will the “trauma” of the treatment cause hair shedding? Thank you!

No… unless you are very stressed over your warts. Stress can cause hair loss. Warts do not.

Tags: wart, hairloss, hair loss, stress

Happy Thanksgiving!

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

We’re taking a long weekend to enjoy 4 consecutive days of friends, family, and constant eating and will be back on Monday, November 26. Enjoy your time with friends and family!

Happy Thanksgiving

How Can I Expect a Natural Transplant Result when Donald Trump and Other Rich People Can’t?

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

Hi Dr.

I’ve been looking at your page for some time now and it is loaded with great information. I also consider myself to be fairly well educated regarding the various options available to balding men such as myself since I’ve spent years keeping up on these developments. I am 39 years old and my hairline began to recede when I was about 20. For the longest time, the rest of my hair was so thick that no one really noticed since I wore my hair long. Over the past few years, the top has thinned substantially and I no longer bother to try to style it. I just wear it very short. I’ve never wanted to be one of those guys who look like he’s trying to hide something. The problem is that I’m also not one of those guys who looks good bald. I wish I were, but I’m not. About 15 years ago I had consultations at two different hair replacement doctors and both, to their credit, told me I was not a candidate at that time and to come back in the future when my hair loss was more advanced. I’m sure that time is now. However, I’m not sure I want to commit to a transplant procedure. The biggest question I have is this. Is there really a chance for someone of moderate means such as myself to achieve a natural and attractive result from a hair transplant when people with unlimited resources like Donald Trump, David Lee Roth or the myriad other balding rich people can’t seem to do it? I would say that I’m probably somewhere around a 3 on the Norwood chart.

TrumpI laughed when I read your question; I’ve been wondering the same thing. A good hair transplant today is the norm, but in the days when Donald Trump did it (allegedly *cough, cough*), it was not a procedure that produced undetectable results. Mr. Trump, I believe, had scalp reductions (the bald spot was cut out) and hair transplants of the older vintage. The issue for people like him should be to repair the process, but he can not wipe the slate clean and go back in time prior to having the surgery. We wrote and published in peer-reviewed medical journals; most of the original articles were on the art of repair. I have no hesitation in discussing the repair process, but first, please read some of the articles we wrote on the subject:

For a person having his first hair transplant, you need to find a competent doctor (when you are ready) who is artistic and has a great reputation. I stress the importance of viewing patients (one-on-one) as a doctor who proudly shows off his/her results by giving you the opportunity to meet many of his/her patients. This will give you a very good idea of what you would look like after a hair transplant. I always say that what you see in the patients you meet will be a reflection of the surgical results you will get. Always ask for “before” pictures when you meet these patients yourself! Not to be alarmist, but I know of one immoral doctor who used a photo in a newspaper ad of a man with no balding to promote his practice — he was legally able to call this man a hair transplant patient because he had a few grafts placed behind his thick, normal hairline.

Tags: roth, trump, hair loss, hair loss, hair transplant, hair transplant, repair, plugs, scalp reduction

Best Surgeons for FUE in the US?

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

Hello,

I apologise if this question has been asked and answered previously, but who would you recommend as the more accomplished surgeons performing FUE in the US. Kind regards

There are a handful of hair transplant surgeons who claim expertise in follicular unit extraction (FUE) in the U.S. You should visit the International Society of Hair Restoration Surgery (ISHRS) for a listing of qualified surgeons and there is a sub-group from this list that do this procedure. Some good hair transplant doctors do not do this procedure, by choice. At NHI, we created the FUE technique and published it in medical journals. There are a few doctors with publication credentials, but many claim expertise. Unfortunately, I have heard about many failures by some of the doctors who claim expertise so you need to do the research yourself and meet with the surgeons on your list (who claim FUE expertise). Ask to meet some of their patients so that you know what the surgeon is capable of doing. I realize this may not be the answer you are looking for, but there is some work required on your part to assure yourself of a good result. Even for me, sorting out the doctors who can perform successful FUE procedures is very difficult as there are so many who claim such expertise and just can’t cut it.

For more, please see:

Tags: fue, follicular unit extraction, hairloss, hair loss, hairtransplant, hair transplant, surgery, surgeon

Crescina Hair Regrowth Formula

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

hello Dr Rassman,

i had a hair transplant surgery from a well recognized doctor before 7 months, without noticing very significant results.Maybe a very small change.i have been using that Crescina products for a few months for better penetration of the scalp.(the old skin fell over my scalp 2-3 months ago, after the surgery), and nowadays the skin of my scalp is clean. How long will it take for me to see good results, or shall i worry?please let me know, because i am a bit stressed.

Best Regards

CrescinaIt generally takes 7-8 months after a hair transplant to see enough hair length to show about 80% of the value. At about 12 months, 95% of the value of the hair transplants should be evident.

Regarding Crescina, while I am impressed by the slick product packaging and fancy animations on their site, none of the ingredients listed (including lysine, cysteine, silicon, zinc) blow me away. If its making your scalp feel cleaner and you’re not experiencing any irritation, you should continue doing as you please, but I wouldn’t look to this for hair regrowth.

Tags: crescina, hairloss, hair loss, hairtransplant, hair transplant, formula

Inhaling Finasteride?

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

hey doc!

I love your blogs, they are very helpfull!

This might be a stupid question.. but i’ve heard smoking something is the best way to get it directly into ur blood so what would happen if I smoked finasteride, could this possibly increase results?

Smoke finasterideInhaling an aerosol medication is often the best way to get it into your system from a speed point of view, but what would be the rush with smoking finasteride?

As I believe I’ve already commented, the dose response data is well documented and the oral route for the 1mg recommended hair loss treatment dose taken orally will not be improved… even if you could smoke it.

Tags: inhale, smoke, finasteride, hairloss, hair loss, proscar, propecia

Hair Mildew?

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

I keep hearing of “hair mildew”. I can’t find it anywhere on the net.

I was wondering what HAIR MILDEW is,exactly, how do you get it and what would be the symptoms? And, is there any cure for it or would you have to cut out all of your hair?

Thanks alot

I’m sure each of us has been near someone who doesn’t dry their hair, which can sometimes develop an odor to it. Perhaps that is what one is talking about with the term “hair mildew”. If this mildew is a problem for someone, using a hair dryer after a wash should eliminate the problem. I’ve never heard this term used before, though, so I’m just assuming this is what you mean.

Tags: hair loss, hairloss, mildew, odor

I Had My Hair Permed Twice in One Day, Now Its Falling Out!

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

I am 24 years old female. I had my hair permed in August and I started losing my hair after a month. before the perming I had very healthy virgin hair.(nothing done to them ever no coloring nothing).I am very worried about my hair I am loosing every day and they just fall without my touching them. I am getting split ends as well. Another thing they had to perm my hair twice because it did not work first time at all. please tell me what do you think is going on

You may have damaged your hair with the perms, or maybe it is just a coincidence and you have some cause of hair loss that requires a doctor’s examination. Unfortunately, there’s not much I can do for you without an exam. Female hair loss can be quite difficult to find a cause for. I suggest you make an appointment to see a dermatologist in your area.

Tags: hairloss, hair loss, chemical damage, damage, perm, female, women, woman

Husband’s Hair Is Very Fragile

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

My husband has had long hair all his adult life, usually well past shoulder length. In the last couple years, it is getting noticeably shorter and shorter. Nothing seems to make it grow. But not only will it not grow, It is now barely comes down to his neck. He is 42 years old and doesn’t have any other problems such as bald spots or noticeable amount of hair coming out when brushing or washing. His hair is very fine but otherwise does not look dry or unhealthy. Split ends are not obvious. He has put his hair back in a pony tail for many years and has colored his hair a handful of times through the last 20 years, but not multiple times in a row. We have tried different shampoos to no avail. Recently he has started a vitamin B complex to stimulate growth, but it hasn’t helped yet. Any idea what might be the issue(s) and what we might do to remedy it?

I really couldn’t give any advice without examining your husband’s hair and scalp. What you are describing could be damage from the use of coloring agents. The short hair may reflect a shortening of the anagen phase of the hair growth cycle, something that occurs as people get older. The anagen period is the actual time that the hair is growing and as it generally grows out at about 1/2 inch per month, a shorter growth period will limit the length of the hair. There may be components of genetic balding, so an examination of the scalp, looking for patterned thinning, is critical to understanding what is going on.

Tags: fragile, split, unhealthy, hairloss, hair loss, breakage

What Is a Graft?

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

Most charge by the graft. I was wondering how much hair is a graft? Or is it just one hair? I was also wondering if you can transplant hair in places where it previously didn’t exist and how does that process work. I mean when you put the hair in a certain part, how does it just start growing? Also, is it permanant. And if you have no facial hair, can you transplant hair there? Will it grow like normal facial hair or after the first shave would it not return? Also, what happens to the hair that were taken from the back of the head, does that return to normal?

Hair graft“Graft” can be defined as: living tissue surgically transplanted from its normal location in one part of the body into another part of the body in the same individual (an autotransplant, like hair or bone marrow transplants) or from one individual to another individual (like a kidney or heart transplant) and is expected to grow and function normally in its new location.

In hair transplantation surgery, a graft refers to a unit of hair or a group of hair follicles which naturally cluster together (a follicular unit) consisting of one, two, three, or sometimes four hairs. Typically, a graft equals or averages to about 2 hairs (see photo at right of average density, from the article Follicular Transplantation: Patient Evaluation and Surgical Planning?), but in individuals with very high densities, it might average as many as three hairs per follicular unit.

Hair (usually from the donor area of the scalp) can be transplanted to any part of the body, including the bald part of the scalp, beard, mustache, or eyebrow. It can even be transplanted to the tip of your nose and it will grow to as long as 6 feet (assuming that the growth phase of the hair lasts as long as 6 years or so)! The donor hair that was taken from the back of the scalp will not regenerate and you will then have either a small linear scar from where the strip of scalp was taken, or a series of small dot scars from where the graft was removed by FUE.

Prior to the 1950s, people incorrectly thought that the balding process was a result of a loss of blood supply, because the skin of the bald scalp was not flush with blood vessels, though that notion was killed by clinical scientists who showed that it was a genetic process, not a blood supply process. It was a relatively simple proof. If there was a blood supply problem, the transplanted hair would have died. Instead, the transplanted hair placed in the bald scalp grew well and the blood supply returned to supply the needs of the new hair at its new location.

Tags: hair transplant, hairtransplant, graft, fue, hairloss, hair loss, scar, scarring, graft

Using Propecia at Temples, Wrinkles from Minoxidil, and Other Hair Drug Questions

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

I am experiencing hair loss at my temples and front hairline. I am 24 and it is at it’s very beginning stages. I Otherwise have a full head of hair and have not had problems in any other areas of my scalp. After looking into all the products out their and doing some research I have found that $transplants$, Propecia and Minoxidil are the only real effective options. The transplants are not monetarily possible right now, the Propecia is said to have no results when being used for temple areas and Minoxidil leaves me with unanswered questions. It would be of much help if you could answer all of the below questions for me.

  1. Would Propecia work in my case since I am at an early stage of loss?
  2. Is a 5% solution of Minoxidil better for my situation or would a 2% solution be better?
  3. Will the resulting hair I grow with Propecia or Minoxidil stay permanently as long as I keep using either product.
  4. Will I build up a tolerance to the product after a year or so eventually rendering it ineffective.
  5. I have read of a person who experienced increased wrinkles in his forehead as well as pronounced smile lines in his face as a result of Minoxidil, can this really happen and is it common?

If you can shed some light on these areas for me it would definitely be a huge help. This is the first serious step I am taking in dealing with this hair loss problem and I want it to be the right one instead of something I end up regretting or damaging myself over. Thanks

  1. You need an evaluation by a physician if Propecia is an option. You need a miniaturization study to see just what is going on and to establish a baseline for whatever treatment you elect.
  2. I generally recommend 5% minoxidil over the 2%.
  3. There is no guarantee that if you regrew hair with Propecia and/or minoxidil in the temples, that it would be permanent. However, they should slow down or prevent further loss. See Are Minoxidil and Propecia Worth Using? (with Photos).
  4. You will not build up tolerance, but your genetic fate will eventually catch up.
  5. I’ve never heard of increased wrinkles with minoxidil.
Tags: propecia, minoxidil, finasteride, rogaine, hairtransplant, hair transplant, hair loss, hairloss