Hey Doc,
Firstly, what an amazing job you guys do with this whole set up: Dr Rassman your blog has provided so much insight for those of us scared about hair loss.

I’m a 22 year old male student. To combat my hair loss problem, last year I used Minox 5% (Rogaine) for about 1month, but due to the subsequent irritation it caused, I ceased use.

The area that I applied this to is now dead, straw like hair, and so much thinner than other parts of my hair. I have read about minoxidil dependant hair, do you think this could be the case for such a short application period? A trichologist I consulted over here, dismissed that as being unlikely, as 1month was too short a time frame. He emphasised to me that stopping minox would return hair to the ‘base level’.

The thing is, my hair loss has accelerated greatly in the past 10months: I touch my hair and it falls out. My scalp is clearly visible on top. What cuts me up inside, is that I think I brought this upon myself by trying minoxidil.

Do you think propecia would be of any use in this situation, if stopping minoxidil has damaged my hair? – I understand that the mechanisms are different. I am merely speculating as to why I’m losing hair so much, so quickly, but I am keen to give finasteride a go. Any feedback would be greatly welcomed.

Kind Regards

Straw baleYou are describing what might be genetic hair loss as well as some side effects from the minoxidil on your hair texture. I doubt your current hair loss has anything to do with minoxidil use and any new hair that grows out from the scalp should be as it was before the minoxidil use. Here’s your scenario as I see it — You started using minoxidil because you were losing hair… minoxidil caused irritation and hair texture issues, so you stopped using it… then your hair loss continued, because hair loss is progressive. I don’t think it’s clear that minoxidil accelerated the loss, though.

At 22 years old with early balding, Propecia is a good idea to help slow the loss down (if it is genetic hair loss), but you will likely not see results unless you take it daily for at least 9 to 12 months. It’s a prescription drug, so talk to your doctor if you’re interested in that. You should also have a good doctor examine your hair and perform a miniaturization mapping so that you can see the progressive nature of your loss over time.

Tags: rogaine, minoxidil, finasteride, propecia, hairloss, hair loss

I’m 9 1/2 months into Propecia 1mg a day treatment and everything is about the same since I started. I’m currently a NW2 but under miniaturization I have a NW3 with mid anterior thinning. Right now I have early frontal loss all I needed is thickening of miniaturized hairs and that would give me a way fuller look. I’m 22 1/2 year old guy and started Propecia only like 4 months or so after I noticed I’m losing hair so I would be a candidate for reversal but now it looks slim because I’m close to hit that 1 year mark! Is there a still a chance? The reason I want to have those hairs thicken because I’m very worried if Propecia would lose effectiveness and MPB will start again those hairs will be gone before I know it but if they would thickened up I could at least spot it that I’m losing hair again and do something about it and also I want to do different hairstyles!

Sorry to break this to you, but there is no cure for male pattern baldness (MPB) and no guarantee that Propecia will work on you. There’s a new genetic test to determine if finasteride (Propecia) will be of benefit to you — HairDX Tests for Finasteride Response.

Propecia does work, but it is not the cure and will not completely stop hair loss. The drug very rarely reverses hair loss in the frontal area, but you should be able to retain the hair you had (which is what it sounds like it’s doing if you say everything is the same 9 months later). You need to sit down with your prescribing doctor and have a discussion on realistic expectations.

Tags: propecia, finasteride, hairdx, hairloss, hair loss

Dr Rassman, What are your feelings concerning Aderans Phase II trial that is commencing this month?

I am sure I will hear more about it in detail at this year’s ISHRS conference in July. I will keep you posted, but I have no knowledge of the details in the approach that they are using.

I did find this press release they sent out to announce the start of their phase 2 clinical study. In the press release, it reveals that Phase 2 “is being conducted in six U.S. cities: Atlanta, Boston, New York, Raleigh, Houston, and Washington DC”… but that’s really the gist of it. I don’t know how many are in the trial or how long it’ll be going on for.

Tags: aderans, hair cloning, hair multiplication, hairloss, hair loss, phase ii, phase 2, clinical study

If the maturing hair line is so common, why isn’t it discussed in high school or college biology or health classes especially when the genetics and human male anatomy sections are taught?

I really don’t know the answer to that question. It should be taught, just like “how to manage a checking account” or “practical economics,” but there are tremendous holes in our education if it’s just textbook learning. We are still fighting practical sex education in our schools and paying with lots of teen pregnancy. With all of our educational problems, defining the maturing hairline seems like a bit of information that may be only valuable to those impacted by the change and it rarely occurs in high school.

Tags: mature hairline, biology, school, hairloss, hair loss

Hi, you talk about miniaturization alot, but i was wondering if you can actually feel the smaller hairs? I can feel smaller hairs in my scalp when i press my fingers between my hair, but i pull my hair quite alot so i don’t know if this is regrowing hair or miniaturized hair. I was just wondering if you have to do a miniaturization test, or you could feel the hairs physically?

Feeling your hair has less precision than a visual miniaturization test (under a video microscope). Also with a miniaturization mapping, you can take photos and compare the appearance of areas over time… but how would you be able to keep good records over time by feeling?

Tags: miniaturization, hair loss, hairloss, history

if honey applied on hair, will it turns white?

It will turn sticky for sure, but it will not make your hair white. Try it with some cut hairs and find out for yourself.

Tags: white hair, honey, white

This 22 year old patient came to see me for hair loss she’s been experiencing for the past 2 years. She did all of the right things, saw two dermatologists, and received a complete medical work-up for a variety of disease entities and vitamin deficiencies and was found to be normal. What I told her is as follows:

  1. Obtain a new test for androgen sensitivity of her hair based upon a genetic test
  2. If she is sensitive to androgen, we might try her on an androgen blocker such as finasteride or dutasteride in the hope that this will block enough of the androgen to allow better hair growth.

The science is minimal that support this thesis, but it is better to try to block the androgens on women who are positive to the genetic test for androgen sensitivity than to put all women on the drugs.

In addition, as we could not offer her an immediate benefit with drugs, we used a concealer treatment on her hair and showed her how to do this herself. Her comment after the application of DermMatch was, “I have been reborn”.

I apologize for the blurriness of the before photo. Click the photos below to enlarge. Before (left); After (right)


Tags: dermmatch, concealer, hairloss, hair loss, female hair loss, photos

For the past two weeks or so I have noticed that my hair is falling out a lot more than usual. I recently started using a new acne face wash (it is not prescription) that is very strong. I also am taking Wellbutrin for depression, but I have been on it for a few months already. Also, I had a hairloss phase in the past that I thought was related to high blood sugar and unhealthy eating habits, but I recently have lost 30 lbs. I do not know which of these factors, if any, is causing this hair loss. What do you think?

Thank you

There is no way to separate the various causes for hair loss and blame the one or a combination of them. Weight loss on its own shouldn’t cause hair loss if it’s done in a healthy way, but I don’t have enough info on how fast you lost weight or in what way you did so. Extreme dieting can cause hair loss, though.

Also, Wellbutrin and other antidepressants are known to cause hair loss in some people. A full list of side effects can be found here (it’s listed on that page as alopecia). Stress can also be a cause of hair loss, and dieting and depression will likely involve stress in some form. There’s just too much going on for me to be able to pinpoint a cause of your hair loss. Sorry.

Tags: antidepressant, wellbutrin, bupropion, hairloss, hair loss, diet

It’s not hair loss related, but prostate cancer news is important and I’d like to share some recent articles I was sent from readers…

1st article:

Vitamin D is an effective treatment for prostate cancer in some patients, a UK study suggests. A once daily dose reduced PSA level – an indicator of severity of disease – by as much as half in 20% of patients. There has been much interest in vitamin D in prostate cancer after studies linking risk of the disease to sunlight exposure, the researchers said.

Read more at the BBC — Vitamin D hope in prostate cancer

2nd article:

Taking cholesterol-lowering statins may be an effective way to keep the prostate healthy, research suggests. One study found statins were linked to reduced risk of prostate cancer, and enlargement of the organ, which can cause urinary problems. And a second study suggested the drugs may hinder the growth of prostate cancer by reducing inflammation.

Read more at the BBC — Statins link to healthy prostate

Tags: prostate, cancer, bbc, statins, cholesterol, vitamin d, sunlight

Hi Doctor, I’m moving to Japan shortly for several years, I’ve read some contradictory information about green tea interacting w/ propecia as well as soy products. Since Asian cuisine uses much soy as well as green tea on a daily basis, I’m wondering if this will effect the benefits of propecia. I do enjoy green tea & would like to drink it & use soy products, do you think either of these natural can be consumed regularly while still receiving all the benefits from propecia? Thanks.

I have covered this before, so it is best to refer you to these past posts:

To sum it up, I don’t believe there’s been any proven links to soy and green tea causing problems with Propecia (finasteride 1mg).

Tags: green tea, soy, propecia, hairloss, hair loss, finasteride

I have read that rogaine promotes hair re-growth by enlarging the hair follicle. I have also read that propecia doesn’t do as well with hair re-growth but maintains hair by preventing excess DHT from shrinking the hair follicle.

Will propecia prevent the shrinking of a hair follicle that was enlarged by rogaine? So that you could use rogaine to get re-growth, but then stop using the rogaine as long you continue with the propecia?

Or will the new growth hair fall out when you stop using the rogaine even if you continue the propecia?

You are attempting to make a logical conclusion to things that we just don’t understand (at least I don’t). This is a far stretch of logic. It’s been my experience that once you stop using Rogaine (minoxidil), the Propecia will not retain those hairs (and vice versa).

Tags: rogaine, minoxidil, propecia, finasteride, hair loss, hairloss

I have been taking vitamin b12 at 1mg daily of the sublingual tablets. Is this considered a megadose? I have noticed better mood and even skin tone. However, I have also noticed more hair shedding and fallout. Do you think this could be related? Could taking too much b12 cause hair loss? I thought excess of these vitamins were just passed out through urine? Thanks.

Vitamin B12 at those doses should not cause hair loss. That isn’t a megadose. There’s a lot of B12 info that I found at VeganForum.com (via Google). But as for hair loss, I’d look elsewhere for the diagnosis… like genetic causes.

Tags: vitamins, supplement, vitamin b12, hairloss, hair loss

hi dr rassman
i just had a question regarding asymetrical hairlines. if as a young child 12 or so you had a natural non symmetrical hairline and as time went on and your hairline matured, would it be possible to misdiagnose the patient as having androgenetic alopecia due to the unsymmetrical patterns produced by this condition?

thank you for your time

Early balding should show signs of miniaturization if your hair loss is genetic. Either see a doctor or take charge of your diagnosis by mapping your scalp. The choice is yours.

People with asymmetrical hairlines will develop maturing hairlines that may even out the symmetry (or they may not). Balding occurs in those with the genetic propensity for it, whether the hairline is symmetrical or asymmetrical.

As hair in the maturing hairline undergoes apoptosis (cell death, possibly because the number of hair cycles in the juvenile hairline may be limited and reached), it could just fall out without going through miniaturization. It could be an incremental fall-out, starting close to the leading edge of the hairline and then working its way back. I don’t get the opportunity to study the young man who matures his hairline and then keeps everything else without signs of balding, other than in my nephew as I watched his maturing hairline appear without miniaturization. One case study does not tell us the answers, so I look at these comments as academic.

Tags: hairline, miniaturization, hairloss, hair loss

Thank you Doctor for a great blog and for taking my question. I am a healthy 44yo male and have been shedding hair for almost 9 months now. I have seen a GP, a Derm. and a Endo. doctor who all found my thyroid to be slightly hyper. ( 3.4 , range 0.40-4.50) My derm. said I do not have MPB and diagnosed me with global telogen effluvium and feels my thyroid MAY be causing my hair loss. My DHT level is 29 (range 25-75). The GP and Endo. state that my thyroid is only a little hyper and that is not the reason for my hair loss and will not treat me for it.

My question Doctor is can a slightly hyperthyroid cause hair loss and is that loss permanent? Also, is there anything I can do for it aside from avoiding caffine, soy and shellfish. Thank you very much for your time.

Thyroid issues can lead to hair loss, and it can be permanent, particularly if you’re genetically inclined to lose hair anyway. Of course I would have to see you to determine if you have hair loss with miniaturization present in a pattern that reflects the genetic process.

There is also a genetic test to determine if you are carrying the gene for hair loss which, if negative, would rule out that as a cause. If your genetic test is positive and the miniaturization testing shows a pattern of hair loss, then drugs like finasteride (Propecia) should work and is something that is worth considering assuming that you have a doctor willing to abide by my plan. For more about the genetic test, see HairDX.com.

Tags: hyperthyroid, thyroid, hairloss, hair loss, hair dx, hairdx

Hi doc

People who want to change sex never lose its hair because of hormonal therapies. Now, obviously I don’t want to do that, but I’ve got an idea: If we inject onto the scalp estrogen using a dermoroller, would hair loss be stopped forever?

Please answer to my question

Derma RollerWhile it is a creative approach, estrogen injected superficially into the scalp with a Dermaroller can not add value nor prevent balding. I have seen some effects of such injections by dermatologists in the “old days” and what happened is that they lose hair at the injection sites. The end result is that some came to see me about their hair loss.

Tags: dermaroller, derma roller, roller, hairloss, hair loss, estrogen