I’m a Teen Worried About Hair Loss — What Should I Do?

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

sir,
i have seen your ht results. truly fantastic. congrats.

now my problem is my dad’s bald but none of his brothers (4) are bald. i have had a big forehead and recession in temples from childhood which is hereditary even for my uncles. so i dont know whether i will have hairloss in future? i am 19 years old (nw 2) now. what shall i do?

also i dont know when to start propecia or rogaine. to add further, i heard propecia decreases cancer risk but if a person still gets it, then he will get a very dangerous form of cancer. is it true? plus will propecia cause male breast cancer? i dont know what to do but i want to keep my hair at least up to 55 or so. but i am scared about these info’s here about the side effects? could u please guide me. it would be so nice of you if you mail me answering to my queries and tell me what i shall do to keep my hair on.

TeenAt the age of 19 and a Class 2 Norwood scale balding, you are not a candidate for surgery. If you are really balding, then you will have the appearance of miniaturization in the hair on your head. In that case, the drug finasteride is the best way to stop the balding problem in men who are balding in the earliest stage. Get a good doctor to review your personal situation and please do not have a surgery under any circumstances.

I’ve been getting a lot of similar emails from teens that want to take medication before they need to, or want me to tell them if they’re going bald based on 2 sentences they email to me. I’m going to make this as easy as possible for everyone to digest, and there’s no better way than an itemized list…

  1. You have a family history of hair loss, but that doesn’t necessarily mean you will experience loss to the same degree or at all. It can skip generations.
  2. Some refer to the corners of the hairline as the temples. Corner recession could be the maturing of the hairline. Recession of the actual temples will usually not see benefit from medication and surgery will likely be required to restore them.
  3. I can’t tell you when you should start on Propecia (finasteride), as it is a prescription medication and therefore must be prescribed by your physician. Generally speaking, you shouldn’t take medication as a preventive medication against hair loss anyway. Everyone is different, and some men will need the medication at 18 years old, while others will need it at 35. It depends on when you’re experiencing miniaturization and to what degree. A 25 year old man already showing thinning in the Norwood Class 7 pattern will not benefit from Propecia unless it is caught early and still it may not do much more than stop the loss from occurring.
  4. Propecia side effects are real, but they are also quite rare. Internet reports are unverified and overblown (some people will post the same basic negative messages over and over under different usernames across different sites). The major health concerns that you brought up (prostate and breast cancer) are worth considering, but more information needs to be collected. Studies into these types of issues might have been minimal, but the FDA lists the medication as safe and effective, and I’ve seen the effectiveness first hand (and have posted many photo results on this site).
  5. Get a good, caring doctor who has an interest in hair loss. Most often they build their expertise in the surgery of hair transplants, but there are many good doctors who care enough about their patients that they will not be trigger happy and rush you into a surgery before you are ready. Check the physician search at ISHRS to get started.
Tags: teen, teenage, hairloss, hair loss, propecia, finasteride, hair transplant, cancer

Is There a Good Way to Wean off of Minoxidil?

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

Hi Doc, I have to say, this is really nice what you’re doing in this site. My question is this…

I was using minoxidil for a year and I suddenly stopped. I had hair fall immediately and now my hair is very thin. How does someone stop or taper minoxidil treatment?

Currently I am on propecia medication. Do you think I’m still going to grow back my hair with propecia?

Minoxidil and Propecia are medications you need to take for life. If you stop either medication you will lose the benefits that each provided. Patients for one reason or another (knowing these risks) who want to stop taking the medication wean off from them over the course of several months to decrease the perception of sudden hair loss, but make no mistake, you will lose the same amount of hair. It just may not appear as drastic.

Propecia will likely not grow back all the hair you lost. Sorry, I know the news is not good.

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

Is Propecia Changing My Ejaculate?

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

Hi,
I have been taking 1mg of Propecia once every other day for the last month. Initially there were no issues – I could take the drug and by midday I would even forget that I had taken it as I wasn’t paying particular attention or worrying about side effects or waiting for them to occur.

However, in the last week or so I have noticed just one side effect – my ejaculate appears less white and less ‘sticky’ than it was just a month ago. There are alot of conflicting reports on the internet and my prescribing doctor (who is also a HT surgeon here in the UK) said that side effects usually diminish with continued use. Have you had any experience with this side effect through your work and has this proved to be the case?

I’m only 18, but a NW3 – my self-esteem can’t take any more hair loss, I am becoming concerned about this side effect however with regards to being able to conceive in say 10-15 years from now. Is this side effect really as serious as I am making out?

Thanks very much – your time is really appreciated.

One of the side effects of Propecia (finasteride 1mg) can be less volume or less viscous ejaculate. This does not change your virility or sperm count. If you are worried about this please see your doctor for a check up. The problem may disappear over time.

Tags: propecia, finasteride, sperm, ejaculate, hairloss, hair loss

CellCept (Organ Transplant Antirejection Medication) and Hair Loss

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

I have been taking CellCept for 6 weeks and I noticed hair loss, I have stopped taking it now but this was 8 weeks ago and I have seen no improvement.

Can you advise if it will grow back?

I’ve answered this question about CellCept before and have nothing new to report since then.

If it grows back it would take over a year, though it often does not grow back to its original fullness, particularly in the area where genetic balding is active.

Tags: cellcept, mycophenolate mofetil, hairloss, hair loss, antirejection, anti-rejection, transplant, organ transplant

Could Finasteride Increase Muscle Mass?

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

If Testosterone levels do go up by about 15% by taking finasteride could this drug increase muscle mass?

Doubtful. The slight increase in testosterone is very minor and only temporary.

Tags: finasteride, testosterone, muscle, hairloss, hair loss, propecia

Extenze and Hair Loss?

/by William Rassman, M.D./5 /,

Does Extenze cause hair loss? If you’re on Propecia would that combat any hair loss potential by Extenze?

Extenze I know very little about herbals like ExtenZe that claim to increase the size of a man’s penis, which is what Extenze seems to promote. I have seen the commercials for this product advertising it on CNN and frankly it is unbelievable for me to imagine that it can do what it claims to do. If someone out there has actually used the product (hold the spam, please), feel free to post a comment to let our large group of male readers know. I tried to do some actual research online, but its difficult due to the amount of advertising spam hidden as articles about this product. They really have a large marketing campaign going on the web (and television, obviously).

I did manage to look up the ingredients for ExtenZe and it lists DHEA, which can cause hair loss in some men. I haven’t seen any reports of hair loss from the pill, though. Connecting it with Propecia is well beyond anything my imagination can muster.

Tags: extenze, hairloss, hair loss, dhea, penis, male enhancement

Can Shock Loss be Temporary?

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

Great SITE. Useful info and look forward to my next transplant if I have 1 to be done by you…

A few questions. I been reading about shock loss. In your opinion do most shock loss come back?? If so how long after. If NOT with propecia bring it back?

I did my transplant about a month ago around my hairline and hairs are growing but it’s kind of itchy and a little red still where the graphs where placed. Is this normal cause hair is coming out now?

Last question. I’m 33, dirty blond hair and got graphs in my crown. i can feel hair everythere like a brushcut, and I know it TAKES months to see results BUT what are the chances that the density will cover that crown. Given I have light hair and very fair skinned.. Thx in advance…

Shock loss in the men who are actively losing hair from genetic hair loss is more often semi-permanent or permanent. Some hair may come back, but in my experience it is not common. The use of finasteride (Propecia) will protect the hair in most young men from shock loss and I always insist that the patient go on the medication prior to the surgery for that very reason.

Men with blond hair will often take less hair to cover any area when compared to a man with dark hair and light skin. To be more specific, I would want to know how many grafts you received, what was the hair count, what is the size of the area covered, and what is the weight of your hair shafts (fine, medium or coarse) before I would want to venture a guess about your crown coverage.

Tags: shock loss, hairloss, hair loss, hair transplant, crown

Propecia at the 10 Year Mark

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

Hi Dr Rassman I have a question regarding long term efficacy of Propecia in older men who have been using it for an extended period of time.

I am in my mid fifties and have been using it for 10 years and I’m happy with the results it seems to be maintaining fairly well. However I see posts on other hair sites (by users not doctors) who say it stops working. I tend not to trust some of these people as it sometime seems they are freely expounding personal experience rather than hard facts.

Can you shed some light on this for me?

I’ve written about this before, but if the benefits of this medication eventually becomes less apparent and if you should stop it, then you’ll surely find out if it was still working when you begin to lose more hair. In other words, it is best to continue it even if you think it isn’t working anymore, because it likely is still working and stopping the medication may cause you to lose any hair that it was holding onto.

As an aside, there is great evidence that this medication will reduce the risk of prostate cancer in men over 55 years old.

Tags: propecia, finasteride, hairloss, hiar loss, decade

Two Clinics Just Tried to Sell Me Shampoos and Scalp Massages!

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

Hi Dr. Rassman,

I went to two clinics for hair loss consultation and both places are selling things such as overpriced shampoo’s, scalp massages to help blood circulation to regrow hair. They also try and sell packages that analyze your scalp to determine if the condition is suitable for hair growth and come up with a plan for regrowth, wigs/hairpieces, hair transplants. Or special hair dressers that style your hair a certain way to cover hair loss. Is this common for most clinics to offer all these options? Or are these clinics which I feel are complete BS or operate in a grey area and try to rip people off. What it seems to me is these “clinics” seem to milk money from poor unsuspecting people and when all their hair is gone they charge them for hair transplants? My understanding is the only way your hair can comeback is either medication or transplants. I guess what I want to do is warn people of these things IF these clinics are truly scamming you! Thanks

Your warning is appreciated and you are expressing many of my opinions as well.

In my practice, I only sell hair transplants and Propecia (at cost). We do sell DermMatch (camouflaging agent), but suggest that this can be purchased through the internet without the small fee that we charge just to keep it in stock. I sell no shampoos, wigs, hair lasers, or any other hair aids.

Tags: scalp massage, hair lotion, wigs, hairpieces, hairloss, hair loss, propecia

Fasting and Propecia Side Effects?

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

From your medical point of view, if someone had side effects from a year’s worth of Propecia, could fasting help speed up the side effects going away? I’ve read that water fasting or juice fasting accelerates recovery because energy usually spent on digestion is now used for healing and returning the body back to a baseline level.

I don’t advocate fasting and I really don’t know that water or juice fasting would speed up recovery or increase the speed of side effect disappearance. It’s an interesting idea, but to be completely honest, what you are saying makes no sense to me.

Tags: fasting, propecia, finasteride, side effects, health, juice fasting, water fast

Resveratrol and Hair Loss

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


There is a website called www.hairloss-research.org which has some great natural hair loss information. They note that an Italian company patented resveratrol for a male pattern baldness remedy. The site also notes studies on the positive synergistic effects of various substances like resveratrol, turmeric, cinnamon, and green tea.

Back to resveratrol. I’m the guy who always complain that massive amounts of soy made me hypothyroid. I recently Googled resveratrol and goitrogen and came across a study that notes resveratrol has goitrogenic effects on the thyroid, or it suppresses thyroid hormone. Check out this site.

It notes at least one study from King Saud University I believe. I know that resveratrol is found naturally in red grapes, red wine, and peanuts, and that it’s hard to “overdose” on natural foods eaten in relative moderation, but I’m worried about taking a resveratrol supplement now. I started taking resveratrol in May 2009, about a year after my problems started, so resveratrol didn’t cause them, but perhaps it’s exacerbating things. Yet I assume many people out there take resveratrol on its own and feel perfectly fine, or nothing noticeable.

I came across studies about resveratrol’s potential anti-aging benefits, which look promising, so I don’t want to shortchange my youthful looks by stopping the supplement. Any thoughts?

RatI don’t know how the patent process works in Italy, but if its anything like the patent process in the US, ridiculous things can slip through the cracks. So just because something is patented, it doesn’t mean it is proven to work or has any science to back up the claims. I haven’t seen the patent you’re referring to, so I’m just speaking in generalities.

I found the King Saud University study you referenced, which was carried out as a student’s Toxicology class requirement, isn’t peer-reviewed, and was based on 4 weeks of testing on rats. It might be interesting reading, but I wouldn’t base any nutritional changes on it. Like I’ve said over and over and over though, it’s a buyer beware market out there. I’m not a thyroid expert, nor am I easily convinced that something will grow my hair (or cure hypothyroidism) just because a website with “great” natural hair loss info run by a guy with no medical background told me it would do so… but perhaps I’m alone in that way of thinking. That website also just happens to sell those very same herbal treatments they claim will grow your hair, so keep that in mind when you’re reading about how great the newest “hair loss miracle cure” is.

I couldn’t possibly know how various supplements will react in each and every person, so of course, I think you should discuss this with your physician, who will have a better understanding of your health needs and concerns. As for us, Dr. Pak says he gets his dose of resveratrol from a good bottle of wine with a juicy rib-eye steak, while I (Dr. Rassman) take resveratrol in pill form daily. This will not regrow hair, though.

Tags: resveratrol, hairloss, hair loss, thyroid, natural, hypothyroid

If the Hair on the Sides of My Head Are Thinning, Is It Stress Related?

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

Hi, my basic question is about stress and hair loss.

I do have alopecia, but when I started rogaine/propecia it was only on my temples. However, for the last two years, I have experience severe psychological stress. I used to have extremely thick hair on the back of my head. However, most of it has fallen out, along with the sides of my head.

I read that this could be Telogen Effluvium. When the stress is over, the hair is suppose to come back. In my case, my hair isn’t growing back at all, and it has been about seven months. One note, before I went through my stress period, the rogaine regrew hair. Now that’s not the case.

I’m wondering if my severe stress, along with alopecia, has permanently killed my hair follicles, even in the back and sides of my head.

Thanks

If we were to assume it was from stress causing a telogen effluvium, then the hair should grow back in a year or so once you managed the stress, but it takes a long time and patience. In men, however, the hair loss is most likely from genetic causes and a good doctor would connect the dots and find out what is a telogen effluvium or what is MPB. I can not do this remotely from just what you reported here, particularly since you mentioned hair falling out from the back and sides of the head (which is not generally part of the balding pattern).

You should meet with a doctor that specializes in the field and get an examination of your scalp and loss, and you can find such a doctor by using the physician search at ISHRS.org.

Tags: stress, telogen effluvium, hairloss, hair loss, mpb

I’m Noticing Small Hair Growth at the Hairline After 3 Months on Finasteride

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

Hello Dr. Rassman,

I am a 22 year old male, most likely a Norwood Class 2. I have recently begun taking 1.25 mg generic Proscar, which I started about 3 months ago. I have recently noticed there appear to be some new very small, light, and almost invisible hairs growing at the corners of my hair line. When I say these hairs are almost invisible, I mean that they are very, very hard to see, but in the right light they do show up.

Could these hairs be growth from Proscar? Does initial regrowth usually begin as very fine, light hairs, and later grow in as thicker hairs? Finally, I have noticed that a small number of my thicker hairs are not always uniform in width, one end of a hair my be extremely thick, while the other is thin, and even a different shade of color.

Thanks for your time, and keep up the excellent work!

Let’s not check this out hair-by-hair. If you wait out the full 8 months to 1 year you will see just what you are getting. Patience is a virtue in this business. Do you ever actually see grass grow in real-time? I mean, to see it you need to take a step back and wait to see the change over a few weeks for the grass (and months for the hair).

It would be a very rare thing for you to see growth at the hairline, particularly after just 3 months. But I suppose it isn’t out of the realm of possibilities…

Tags: hair growth, finasteride, proscar, propecia, hairloss, hair loss, hairline

Zinc Deficiency and Hair Loss in Men?

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

Does zinc deficiency cause hair loss in men? If so, how long after taking extra zinc will the hair go bak to normal? How much extra zinc is recommended? Thank you for answering my questions.

It is rare to have a zinc deficiency. Babies, people who are malnourished, and people with bowel disease are the ones that will generally have such a deficiency. Best to look up the extensive write up on zinc at Office of Dietary Supplements.

I have not seen any patients with zinc deficiency, so I can not tell you if the hair loss that comes about from it in an adult will reverse with treatment, but there seems to be optimism in some of the reports I have read.

Tags: zinc deficiency, zinc, vitamin, supplement, mineral, hairloss, hair loss

Transplanting Hair Into a Cleft Lip Scar

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

Hi I have a keloid scar from a failed surgery in the past. My keloid scar is located from my left nostril to the bottom of my upper lip. (cleft lip) Is it possible to transplant hairs on the keloid scar? has such a procedure ever been done before? I know you transplant hairs on lips not sure about on top of a keloid scar.

If this is a cleft lip scar, it is rarely a keloid. These scars make good transplant recipient sites and many people have grown transplanted mustaches to cover the cleft lip scar.

Tags: scar, cleft lip, cleft lip and palate, hair transplant, mustache, moustache, facial hair