I have question(s) that are part product and part physics inquiry:

  1. I have used Nano shampoo for several years, and I’m not sure if its effective or not – any thoughts?
  2. If using a liquid topical (minoxidil, nioxin, etc) would it be best to apply the topical AFTER wetting your hair completely so that ones hairs do not absorb/wick the topical up onto the hairs, so the wet hair will minimize the ability of dry hair to draw/wick topical fluid away from the scalp?
  3. Are there any mild blood flow stimulators you would recommend similar to Retin-A though not as irritating/burning as you repeatedly advise you are not a fan of with Retin-A? Is this the same mechanism the product Procede uses?

(I’m hoping the creativity of my no.2 physics question makes my submission worthy of a response and/or post.)

Thank you!


  1. Probably not. No shampoo will cure balding or help with hair loss. Hair loss is genetic in 99% of men. You can use any shampoo you wish, but it will not help with hair loss.
  2. It is my understanding that the foam version of minoxidil works best with respect to absorption.
  3. Retin-A (tretinoin) does not work for treating hair loss. It is a mild acid that produces a skin irritation that some believe would help when used with minoxidil, because it might make the skin absorb the minoxidil better. There is no clinical evidence of this actually helping grow more hair. In my opinion, you are just irritating your skin. Procede contains thioglycolic acid, which you can learn more about at Wikipedia.
Tags: minoxidil, blood flow, retin-a, stimulator, hairloss, hair loss, shampoo

hey dr. william.

I’m a 20 year old male who have chanced upon your blog only yesterday and i must say that i’ve learnt pretty much and benefited as far as i could from it. I became less paranoid upon reading on archives speaking of victims losing hundreds and even thousands of hair daily or over a few days. Currently, my problem has persisted over 6 months, well to my friends, this might seem over-reacting and a self-proclaimed problem. But i do have a few burning highlights and concerns as follow:

  1. my hair is naturally very fine for a male counterpart, does that make me more susceptible to hair loss expecially i’m only starting to keep my hair long?
  2. i have yet focus so much on my hair loss more than 7 months ago but only when i started to grow more hair, am i overreacting? i see a little bunch of hair -of about 10-15 each time i finish showering and about 10 after i dry my hair and maybe 5 after combing my hair. Are these considered normal?
  3. last but not the least of paramount importance would be, do i have to lose alot of hair to become bald, or another way of asking would be, if i do not have bunches and bunches of hair dropping, does that mean that i’m safe from balding? I’m safe from genetics influences as far as my paternal great grand father.

Note: i do have oil scalp, contributing to oily hair. What do you suggest dr. william?

I really appreciate your effort and time in giving my message a serious thought and god knows how many have you saved! Keep on going dr. william and i’m looking forward to your reply?:)

  1. Fine hair or very fine hair or long hair have nothing to do with balding. If you are balding it is highly likely that it is your genetics.
  2. You are focusing way too much on your hair. You can lose 100 even 200 hairs EACH DAY. Losing 10 to 15 is lower than normal daily hair loss.
  3. You are born with 100,000 hairs on the average, and you can lose about half that and still not look bald.

You should see a good doctor and develop a Master Plan for yourself. In that, you need to have your hair mapped out for miniaturization. It may even be that you are not genetically losing hair — wouldn’t that be nice to know?

Tags: hairloss, hair loss, genetic, fine, characteristic

From the article —

Naomi CampbellExpert Leonora Doclis believes Naomi may be suffering from hair loss brought on by years of using weaves to make her locks appear straight.

She said: “There is a possibility that Ms Campbell could be experiencing a condition called traction alopecia but, if so, it is a very mild case.

Full text — Is supermodel Naomi Campbell suffering from hair loss?

Upon seeing the photo on that page (before reading the full article text), I immediately thought about traction alopecia. If this is the correct diagnosis, then there will probably be other areas of her head that are impacted. Hair transplants work nicely for this condition and may be the only effective treatment available.

(Photo: WENN)

Tags: supermodel, model, naomi campbell, naomi, hairloss, hair loss, traction alopecia, alopecia, celebrity

Dear Dr. Rassman,
How long does it take for minoxidil dependence to occur ( once use has been started)

I do not know the definite answer to this, as there are no studies published about it (to my knowledge). First, the hair must be responsive to minoxidil for it to become dependent upon it and that means that the hair is thin and not normal. This generally takes many months, to a point where the drug is making a difference.

If you put a non-balding person on minoxidil, I believe that the hair would not develop a dependence upon it.

Tags: dependence, minoxidil, rogaine, hairloss, hair loss

Is it possible to not have any side effects while taking Propoecia, but then expriencing them after quitting?

Propecia (finasteride 1mg) stays in your blood stream only for one day, which is why you need to take it daily. You weren’t clear as to what side effects you are experiencing after stopping Propecia. I would need more information from you to know where you are taking me.

Tags: propecia, finasteride, hairloss, hair loss

two weeks ago I noticed that my scalp was pink and I heard that this is a sign that your hair is thinning. I have no severe itching or flakes. People always tell me that I shouldn’t have to worry about it because I have a full set of hair, but I want to get professional advice to make sure. I did change my shampoo about the same time. Could the reason be that my shampoo is irritating my scalp or could I be thinning?

I don’t really know what you are seeing. If you are looking at your scalp after a hot shower, the scalp may be pink in color. If you have an allergic reaction to the shampoo, it could cause a pink color in a white skinned person. Best to have a doctor look at your ‘pink’ scalp as it may be something there that is wrong. This is not a sign of balding, though.

Tags: shampoo, scalp, hairloss, hair loss

I was diagnosed with Bell’s Palsy last week. I’m pretty sure you have heard of it: https://en.wikipedia.org/wiki/Bell’s_palsy

Well, I have been using Rogaine Foam since July of 2007 and have started to get some amazing results. It however makes my face kind of puffy. Do you think that using the Rogaine Foam will mess up my chances of healing the nerves?

Serious question. I really don’t want to stop the Rogaine, though, but I will if I have to.

Let me know, please.


Rogaine (minoxidil) should not affect the healing of the nerves. You should ask your doctor who is treating you for Bell’s palsy, as he/she should be involved with your medical care.

Tags: hairloss, hair loss, rogaine, foam, minoxidil, bells palsy

From the press release —

HairDX, LLC (www.hairdx.com) pioneers of consumer-friendly genetic tests for hair loss, today introduced the first meaningful test using genetic markers strongly associated with Female Hair Loss (Female Androgenetic Alopecia). The easy to understand test provides an accurate and understandable genetic analysis of a woman’s likelihood of developing this common type of hair loss.

The HairDX test for Female Hair Loss provides women with a score, called the CAG repeat score. A smaller CAG repeat score is associated with a higher risk for significant hair loss (Ludwig grade II or III hair loss) while a larger repeat score is associated with a lower risk for hair loss. To be tested, a woman swabs her mouth (inside cheek) for several seconds and returns the swab to the HairDX lab. The results are delivered confidentially and anonymously via a secure and private Web site.

HairDXFull article — Revolutionary Genetic Test For Women’s Hair Loss Launched

Like the HairDX test for men that was announced earlier this year, this is an exciting finding, but it may be difficult to understand how to use it since there is not a one-to-one ratio between the presence of the gene (the score) and the connection to female hair loss. As we all know (or hopefully know, since I’ve written about it many times before), the hair loss evaluation for women requires many tests, because there are many potential causes of hair loss in women that are not genetic. I certainly will evaluate the value of this test in the diagnosis of female hair loss.

Tags: hairdx, hair dx, hairloss, hair loss, female, women, woman, genetic, gene, test

Hi Dr. Rassman,

I had my hair transplant 3 days ago and I was told that i’m a bleeder. so my head was wrapped for 2 days and after washing off the wrap i looked swollen but after the 3rd day after waking up my eye is swollen and bruised is this normal?

The bruising is rare, but it is normal to have swelling after a hair transplant procedure if your surgeon did not use large dose steroids to prevent it. It should be found in the pre-operative or post-operative handout you hopefully received — and more importantly in your operative consent form. Most of the swelling should be gone by the 5th day.

Part of me is honored that you would be turning to me for hair transplant aftercare advice, but the other part of me is shocked that you would not be asking this question to the doctor you trusted to performed your surgery. You really should have an open line of communication with your surgeon. I really can’t stress enough how a good doctor/patient relationship is so very important.

Tags: hairtransplant, hair transplant, hairloss, hair loss, bruise, bruising, swelling

(female) I’ve been diagnosed with hypothyroidism, and have been taking Levothyroxin 75 mcg for about two years now. I just recently had lab work done, which indicated that my thyroid levels are low again, which means I will have to increase the amount of Levothyroxin I take daily. I have about 30 ongoing medical conditions, and I do take many medications along with this one. I asked my pharmacist about hair loss (as mine has been thinning and coming out for over a year now, but it’s really bad now though), which of my meds could be causing it, and what vitamin(s) I could take to combat it. He told me that my hypothyroidism was most likely the cause of my hair loss, and suggested I take 200 mg of selenium everyday to stop the problem. Is he correct? What kind of doctor would I need to see for this problem? What more can I do? Help me, PLEASE!! There is no pattern baldness in my family. I used to have a nice long full head of hair and now it’s so thin. I cry everytime I wash my hair because so much comes out at once. This problem is making my depression worse as well. Where can I go and what can I do? I’m on disability so I do not have a lot of funds to combat this problem so yet another issue with which to deal. HELP!!!!!
Thank you so much for your help!

Hypothyroidism is a cause of hair loss and thinning. First you must get your thyroid problem regulated. Best to see a good medical doctor who feels that this problem falls without his/her expertise, possibly working with a dermatologist to follow your hair loss. An endocrinologist may be a good choice for a specialty. You also asked about taking selenium — it should not be harmful and actually may help.

Tags: hypothyroidism, thyroid, hairloss, hair loss, female, woman, women, levothyroxin

I am really interested in the Fox technique, do you think it will go down in price over time?

The FOX Procedure (follicular unit extraction) is heavily labor dependent and takes much more time to harvest grafts than a traditional strip procedure. Without a new breakthrough, I doubt it will go down in price much, as there are not many doctors who are doing the procedure completely.

Tags: fue, fox, hairloss, hair loss, hair transplant, hairtransplant

What is the difference between Regaine and Rogaine where I can see that these two products have the same ingredients (Minoxidil 50 mg; propylene glycol; alcohol and purified water) are there any difference between this two products and which one do your recommend thanks for your time.

Rogaine / RegaineNo difference that I know of. Regaine is the name in the UK and Australian markets. Rogaine is the name in the US market (and possibly other markets). They even share a similar logo and packaging.

Tags: regaine, rogaine, hairloss, hair loss, minoxidil

My son is 19 years old he had a spot the size of a half dollar on his head that went bald. after a few months the hair started growing back, but its real dark. His hair is Blonde.

Patchy spots of hair of a different color may be associated with a genetic predisposition or a mole or can be just normal. He may have had ring worm and the regrowth of the hair came in pigmented differently. You may want to have your son follow up with a dermatologist.

Tags: hair growth, hairloss, hair loss, pigment, hair color

I just started using Minoxidil 5% spray, but I’m not sure how many pumps I should use on the affected area (front). The directions just say apply it to affected area and my dermatologist didn’t say anything either, just to use it twice a day. I’ve been using 5 pumps in the front and one in the back for good measure. Is this fine, too much, or not enough?

If 5 pumps is enough to put over the affected area, I would think 5 is your magic number. There is no absolute number. Obviously, don’t drench your scalp with it as a light covering should be adequate.

Tags: minoxidil, rogaine, hairloss, hair loss

A client I have serviced for almost one year accuses me of causing her hair to fall out after a relaxer I gave her. She called me two days after the relaxer saying her hair was shedding. I am very thorough with my rinsing of chemicals and the shampoos that follow. She said her hair was coming out in strands and that her scalp itched a little. I suggested she see a dermatologist. Her dermatologist told her that there was nothing showing in her bloodwork that would cause her hair to fall out. He prescribed her Luxiq which as you know is for psoriasis of the skin and scalp. Would’nt that not mean that she had a skin condition which caused her hair to fall out and not the relaxer?

It sounds like you may be looking for potential legal advice. I do not know your client or the entire circumstance involving her hair loss. This sounds like an acute episode of hair loss happened within a couple of days of the treatment you gave her. There seems to be a direct link between the use of chemicals and the hair loss, based on what you’re telling me. As I’ve written before, psoriasis will not cause hair loss unless you pick at it enough to develop traction alopecia. This does not seem to be a traction alopecia case, though.

There are many possible reasons for female hair loss, ranging from medical illness to genetics to hormonal to stress. Moreover, even with modern advancement in medical technology, the exact cause and/or cure for female hair loss is still elusive. Your client’s hair loss may have been related to the chemical stress or it may just also be coincidental. I really cannot say.

Tags: hair loss, hairloss, female, women, woman, chemical, psoriasis