I’m 21 Years Old and My Doctor Is Rushing Me Into Hair Transplants for a Mature Hairline

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

Dr. Rassman,

I had a question regarding traction alopecia. I’ve always had a widows peak/high forehead. For years I had really long hair. Yet, I never knew the affect of tightly tied back hair would result in hair loss. I recently worked a job for a year where I would tie it back quite tight. Everyday it seemed I was breaking hair and after a few months I started to notice my front corners looking thinner and broken. I saw a dermatologist a few months ago. He gave a quick glance and asked about my family history. I do infact have some family members who have baldness and others who don’t on both sides. I was instantly given the MPB diagnosis. I was prescribed to Propecia on the spot and basically told good luck and that I should look into hair transplants. As I’ve been reading more about shock loss in young men. And as I’m 21 years old. I’m curious to know if I should begin looking into it, or wait and hope the propecia can help what’s been thinned. I’ve read that you’ve seen some patients reverse frontal loss with propecia.

Is it likely to help a hairline that’s intact but thin?

Thanks for your time and most importantly for having this blog. It’s a place that gives many hope.

Do not rush to transplant your frontal hairline. You can just say no!

Stop pulling on the hair and get a caring doctor who is not so much interested in your wallet and get one that is more in your welfare. Get a proper examination. If you are just having a loss of the mature hairline accelerated by the traction, then there is nothing to treat. If you do indeed have MPB, you should take Propecia for a year or so before you even consider a transplant. Then again, at 21 years old and with early hair loss, most respectable surgeons wouldn’t transplant you anyway (you may continue to bald and you don’t want to use up your valuable donor hair just yet).

Tags: traction alopecia, hairline, hair loss, hairloss, hair transplant

Physicians Are Against Prescribing Propecia Unless You Have Later Stages of Hair Loss?

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

Hello,

Unless you are experiencing later stages of hair loss, it seems physicians in Canada are against prescribing Propecia. Can you please advise if you offer prescriptions for patients in Canada that are looking for use as a preventative measure?

Thank-you.

I don’t think doctors are against prescribing the medication until you’re losing a major amount of hair, as the drug will do more good in the early stage, but in your particular case perhaps the doctor does not feel you have balding or even early signs of balding. You should not be taking Propecia (finasteride 1mg) for a preventative measure if you are not even balding. You may want to see a hair transplant doctor for a detailed examination of your hair.

Tags: propecia, finasteride, hairloss, hair loss, prescription, canada

Some Miniaturized Hairs Are Normal in the Hairline?

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

Hi,
i just have a question. I am almost 21, my hair looks good, but the thing that worries me is that I have a widows peak and in the widows peak I noticed that there are like some vellus hairs that are almost invisible between the terminal hairs. The rest of my hair is thick and healthy but the thing that worries me is that they can be miniaturized hairs. I also notices some very fine hairs that dont grow more than 0.5 cm in the very front of the hairline. Is this normal? You said that it is normal some miniaturization at the beginning of the hairline.

Yes, there are vellus hairs in the frontal hairline and that is normal. This is not necessarily miniaturization or balding, but if the miniaturization continues well beyond the front hairline (say 1/2 to 2/3rds inch back) there is reason to take notice. Keep having your hair mapped out for miniaturization at least once a year to see if there is the beginnings of genetic hair loss.

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

Propecia and Paxil

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

Dear Dr Rassman,

Can Propecia be taken along with Paxil (Paroxetine)? Do you have any patients on the combination?

Background: I am a 22 year old male. I have had social anxiety disorder and was prescribed Paxil CR 25 mg. I had weaned myself off it 15 months ago. Now my hair has started thinning and I was prescribed Propecia. But within 2 weeks of use I have had intense anxiety.

Please help me with your suggestions. thank you.

As far as I am aware, you can take Paxil and Propecia, but you need to ask your prescribing doctor before starting or stopping any medication as he/she may have more insight into what is going on with your problems. I am not your doctor and my suggestion to you is to speak to your doctor and ask him/her these questions.

Tags: propecia, finasteride, paxil, paroxetine, hairloss, hair loss, depression, anxiety

Can Daily Washing Damage Your Hair?

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

Hello, Dr. Rassman

I have a question about washing your hair daily. For us minoxidil users it’s obviously recommended to use the products twice a day on a clean scalp. My question is: Does washing your hair twice a day damage your hair? Of course, the more you mess around with your scalp the more hairs will tend to fall. So, does the constant washing “damage” the follicles and weaken them?

Thank you for all the information in your site and all your help.

If you wash properly and do not rub your fingers vigorously into your scalp, twice a day hair washing will not cause a problem.

Tags: hairloss, hair loss, wash, shampoo

Hair Transplant Doctor Credentials?

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

Good Morning Doctor,

My husband is consider hair restoration surgery. We are looking for a qualified surgeon. Are there training programs for hair restoration surgery I SHOULD be asking our doctor if he or she attended? It seems like a lot of dermatologists are doing this surgery, but I don’t see a training program or fellowship in hair restoration in their title or advertisements. Is this something the doctor learns on his/her own? What should I look for to be sure I’m getting a good doctor?

Thanks.

I’ve written about this many times. The first link below is probably the most comprehensive of the articles I wrote on the subject, but the others should also prove helpful:

Many doctors do learn this on their own and some of those doctors learned it well, while others never learn it. I’ve discussed how to select a doctor and what to look out for in the following posts:

Tags: doctor, doctors, physician, surgeon, hairloss, hair loss, hairtransplant, hair transplant, credentials

Is Male Pattern Baldness Not Genetic At All?

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

There was a study done by a Cornell University professor named T. Collin Campbell in conjunction with Oxford University entitled “The China Study”. It’s an entire book, but basically he says genes are expressed by nutrition, and many of his arguments revolve around animal based protein v. plant based protein and cholesterol, cancer, heart disease — not necessarily balding. But this peaked my curiosity. Can male pattern baldness not be genetic at all but instead the balding aspect is expressed by some type of diet balding men eat whether that diet is heavy in red meat or whatever?

China StudyI have been aware of this thesis for some time and one has to give it credibility. There is no doubt that diet does play an important role in one’s health. It is classic “nature versus nurture” type of argument, but things are not so simple. I did not read The China Study book, so I really cannot comment on that, but with respect to balding, although it is genetic, diet may very well influence the ‘expression’ of the process. Some people ascribe diet as a cause of the racial differences in balding when comparing Asians (in Asia) with Caucasians in America, but the science for this is clearly not available.

Tags: china study, genetic, gene, diet, health, hairloss, hair loss

Seborrheic Dermatitis and Hair Loss

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

Hi,

I got Seborrheic dermatitis for the first time last year. I have the problem resurfaced now. I tried several medicated shampoos but the problem didn’t disappear. I went to a general physician and he gave me a topical solution to apply to scalp (fluc.. something). I’ve been seeing more scaling and itchiness after using the topical solution. Is this normal? Also the hair that fall have a small flake attached to them. Is this a temporary hair loss?

Thanks

Your doctor probably prescribed fluocinolone acetonide, which works in the treatment of dandruff. Some people need a shampoo that will treat dandruff, so certain shampoos may contain zinc pyrithione, which is active for such problems. The shampoos will generally state on the packaging if they are recommended for people with dandruff. Other ingredients routinely included in shampoos include panthenol, which some scientists believe helps the hair grow by improving the moisture content of the hair.

You should go back to your doctor and ask more questions and see what else he has up his sleeve.

Tags: hairloss, hair loss, seborrheic dermatitis, shampoo, fluocinolone

Maturing Hairline at 30 Years Old?

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

After reading some of the questions and answers on your board. I am hoping my hairline is just maturing, both my grandparents(both sides) have a full set of hair still. I deployed about a year ago and noticed my hair was receding on the hairline. I thought it was because I was smoking, gained 20 pounds before I deployed which raised my blood pressure and was taking in too much caffeine. Well I just quit smoking, stopped taking in as much caffeine and lost about 15 pounds. I am also using a shampoo called nioxin to help out. My hair however is continually receding on the hairline. I noticed you said it was natural to start in the late teens to early twenties but I am 30 years old. What should I do, wait or go see a doc when I get back? I can handle the insurgents but this hairline thing is driving me crazy!!!

Thanks

A mature hairline can appear at 30 years old. If you are not balding behind the hairline, then wait it out until you can be examined. Gains and loss of weight, plus the stress you are under are not helping, but you did not need me to tell you that. As a former Vietnam vet, I understand what you may be going through. Certainly the stress alone could induce hair loss if you have the genetics. If, however, these factors do not induce hair loss (and you are just moving to a mature hairline), then i doubt that you will ever lose your hair.

Tags: mature hairline, hair loss, hairloss

Propecia and Male Breast Cancer

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

Dr. Rassman,

I have read all the relavent posts on this topic. From what I can see, it wouldn’t appear that there is a significant interaction between finasteride and breast cancer – partcularly when one takes into account that out of the 4 men in the 3047 sample, they were probably not the only ones with close relatives who had breast cancer. Add to this, the fact that this study was based on 5 times the finasteride dose of propecia and I am tempted to think it may not be an issue.

I’m not sure if you can comment on this but i don’t think that I will be carrying the BRCA1 or BRCA2 genes for susceptability considering that there is not a strong family history of the disease and My Mum has told me that her type of breast cancer was not genestically linked (‘estrogen receptive’).

Considering all these points and the benefits I feel propecia will bring to me, I think that I will be proceeding with the drug. I am meeting with my trichologist in a few weeks so I will discuss the issues with them. I will probably follow this up with a doctors consultation afterwards but I can’t be sure that will provide me with much re-assurance.

This is currently the only issue stopping me taking the drug at present. I was rather happy to read the latest news about propecia and prostate cancer in this news link and others like it (ref; – CancerConsultants.com)

If I decide to take the drug I’ll check back on the blog every now and again and follow news reports to keep abreast of any new developments in this area. Then, should there be an issue, one can take appropriate action.

Thank you for reading. In your opinion, do you think I am approaching this from the right angle? Is my thinking sensible?

Many thanks for your time

If there were any statistical information linking breast cancer with Propecia (finasteride 1mg), I would think that it would have already come forward in our information-heavy society. You know the theory of safety in numbers? With over a million men on Propecia for almost a decade now, any reasonable connection with male breast cancer would be public by now.

Tags: breast cancer, cancer, propecia, finasteride, hairloss, hair loss

Bald Spot Since Birth

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

im 18 years old and i have a bald spot since birth. i was wondering if anything could be done about it if so what . my mom told me the part of my hair was damaged because of where the doctor put the heart monitor.

It is highly probable that you could have hair transplanted into the bald spot. I would need to examine you or at the least see some good pictures of the bald spot with a ruler next to it so I can get perspective on the size of the area.

Tags: hair transplant, hairtransplant, bald spot, scar

Would Dreadlocks Cause Hair Loss?

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

First of all, thank you very much for your work in putting this site together.

I have a question(s) regarding dreadlocks.

About two years ago my hair started thinning and so I began treatment with propecia and minoxidil. It seemed to work; there was new hair growth and my hair gradually became quite a bit thicker. In addition to this treatment I’m thinking about having transplant surgery eventually.

My question is, would it be possible/adviseable to grow dreads? I’m concerned about the dreads either making my hair look thinner and/or actually causing it to thin.

With the regimen I mentioned and a transplant (assuming the transplant is necessary) would it be possible to have dreads that don’t produce an appearance of thinning hair and also don’t actually cause the hair to thin.

Thank you so much for your time.

Dreadlocks cause traction alopecia. The constant pull on the hair root will cause the loss of that hair in the long term.

Tags: traction alopecia, alopecia, dreads, dreadlocks, hairloss, hair loss, hair style

Eating Insects and Balding in the Amazon

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

Hello Doctor.

I can’t recall I have ever seen a picture of a balding man from the amazon natives. I can recall I have watched a long time ago a documentary film, in which I have seen an amazon native delousing louses or other insects from another amazon native’s head and then eating the insects. Are they balding-proof thanks to this insects diet?

InsectTo my knowledge, balding afflicts all men with no discrimination to race, ethnicity, social class, and even insect diets — with the exceptions being the Native American with ancestry from the Alaskan Bridge, and Aboriginal Australians. I’ve written before about the possibility that there is an isolated gene pool in an isolated area that doesn’t have the hair loss gene, although it is just a what-if until someone studies it.

I just found some wonderful images of Amazon natives at this site, Amazon-Indians.org… and this photo (contains nudity) in particular appears to show hair loss in a native to the rainforest. I don’t know what kind of bugs he eats, if any.

With that said, do you know where I can get some of those insects? They might be worth selling on on this site (don’t take me too seriously here, we’re just before a long weekend).

Tags: amazon, insect, diet, hairloss, hair loss, balding

My Increased Sex Drive From Propecia Is Destroying My Social Life!!!

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

Hi Doc! this is an excellent site and I am a regular visitor. I really require your professional help as regards to Propecia and increased sex drive. I have searched through your site but couldn’t find an answer suitable for my situation.

I am a 25 year old male and been on Propecia for 2 years, 5% Rogaine Foam and Procerin for 6 months. It has stopped/slowed my hair loss without any noticeable hair growth. My problem is these drugs have increased my sex drive, so much so that I have to regularly masturbate which is destroying my social life, sometimes 6 times a day.

My question is maybe Propecia has increased my sex drive as research has shown that to be possible. I only noticed a high sex drive after starting Propecia, at first it was good, but to be honest with you it is destroying my social life. Would it be advisable to increase my dosage of Propecia to 2 tablets each day (2mg) or move to Proscar 5mg, or even move to 0.5 Avodart? As they have been shown to block more DHT and in order will lower sexual urges?

Dr. I am really confused and my high sex drive is making me depressed and constant masturbation to fulfill my sexual urges is making life a nightmare. I don’t speak to anyone about this because I feel ashamed and I am extremely shy when it comes to discussing these matters.

Sorry for the long message, and I look forward to reply and valuable advice.

I suppose too much of anything can be a bad thing to some people. In our experience, a high sex drive is a common side effect of Propecia (more than a low sex drive), but a high sex drive is a very common “problem” for young men in their 20’s as well, medication or not. I once heard 99% of men masturbate and the other 1% lie. There is nothing wrong with a healthy sex drive.

Would increasing the finasteride dosage lower your sex drive? Doubtful. When the decreased sex drive is seen, a higher dose of the medication tends to make it worse. I do not have experience with increasing the dose in those who report an increased sex drive from the drug. You shouldn’t assume that Propecia (finasteride 1mg) is causing your problem and see a doctor if it is bothersome. Speak with your doctor about what to do about this. Are there other (non-sexual) hobbies you can focus on?

Tags: propecia, finasteride, hairloss, hair loss, side effect, libido, sex