Dr Rassman, like many others, I keep an eye on my head every day, not liking what I see. I’ve already been on propecia for a couple of yrs, seemingly with no significant benefits. This has lead to explore other options, theories etc. That being said, I would really appreciate your thoughts on 3 things and whether they earn a spot on the list of possible contributors to hair loss. They would obviously be an aside to the most common ones ie genetic, infection related, stress

1. The first is not drinking enough water, because generally speaking there are a number of ramifications for not doing so.

2. Second one is, benefits from using a boar bristle brush with the theory being: “The other excellent feature of a boar bristle brush is the massaging effect. The hard bristles stimulate the scalp, increasing the blood flow which can be very relaxing and soothing. The stimulation of the scalp also spreads the natural oils of the scalp – the sebum through the hair and down the hair shaft. This results in smoother, healthier hair that is soft and manageable. Increasing the blood flow to the scalp has been linked to stimulating hair growth, creating thicker and longer hair as well.”

3. And last, possible benefits from “supplements” such as drinking wheatgrass or matcha based drinks, both of which seemingly have a number of overall health benefits.

Thanks very much in advance for your time and valuable input!

We have said many times that genetic hair loss is not a curable or completely reversible process. It is what you are born with. Drugs such as Propecia (finasteride) work, but in the long run your genes will catch up. I’m not sure what benefits you’re looking for from Propecia. Are you merely looking for regrowth? Or have you seen continued loss at the same pace?

  1. Drinking water and hydration have nothing to do with hair loss.
  2. Massaging the head with brushes do not impact hair loss (either positive or negative). Blood flow is not the issue. Your hair follicles are programmed to die due to their inherent genetic programming tied to a particular number of hair cycles.
  3. I realize supplements are a big thing in our society, but it really does not impact the hair in my opinion.

Sorry for the negativity, but it is how I see it. Everyone is free to try their own remedies in hopes of stumbling on the cure.

I am starting to take an anti-depressant that is potentially linked to hair loss as a side effect. I am on propecia and minox. I was interested in knowing if these drugs will most likely counter the effects of hairloss related to anti depressants. I know that propecia can combat shock loss after a transplant, so I am just using some logic that this may alleviate this concern of mine?

It’s not likely. The hair loss that comes as a side effect of various medications is different than hair loss that’s a direct result of genetic balding. That being said, I wouldn’t expect Propecia (finasteride) would really help any hair loss related to antidepressants.

But since you’ve already been taking Propecia, talk to your prescribing doctor about staying on it to continue the battle against the genetic loss.

Tags: propecia, finasteride, anti-depressant, antidepressant, depression

I just recently noticed a bald spot on the back of my head. I’m only 17, and both of my parents (who are in their mid 40’s) are yet to show any signs of baldness. Yet, I appear to be going bald before I’m legally even adult.

If you guys could help me out, that would be great. I’m sort of freaking out right now. Any help would be appreciated. Thank you so much!

It could be early balding or possibly something else. Genetic balding can skip generations and come from either side of the family line, so just because your parents aren’t showing any hair loss, it doesn’t mean you’re automatically in the clear.

I strongly suggest that you see a good doctor and get a proper diagnosis. Sorry, there’s not much I can offer you advice-wise beyond that.

Tags: teenager, teen hair loss, hair loss, hairloss

Snippet from the article:

These days, “snake oil” is synonymous with quackery, the phoniest of phony medicines. A “snake oil salesman” promises you the world, takes your money, and is long gone by the time you realize the product in your hands is completely worthless.

But get this: The original snake oil actually worked. Save this one for the next cocktail party; it will blow your friends’ minds.

Read the full story — How Snake Oil Got a Bad Rap (Hint: It Wasn’t The Snakes’ Fault)

I had thought “snake oil” was synonymous with “medical scam” in most of the world, but I still get emails from people in various parts of Asia that truly believe snake oil will cure what ails you and want to know where to buy it. Sorry, snake oil doesn’t regrow hair.

Tags: snake oil, scam, quackery

We’re off today to pay respect to the men and women who gave their lives for their country… also known as the unofficial start of summer, Memorial Day. We’ll be back tomorrow!


As I researched the field of scalp pigmentation, I found a few other places that offer a similar service. How do I determine which place is the best? Its all quite neat to me but I’ve seen some really bad work from people that claim to be experts.

We are the first doctors in the United States offering scalp micropigmentation (SMP). The creation of the hairline is fundamental to what we have been doing over the past 20 years, so incorporating this skill is critical to providing a quality service with a natural looking hairline. We are also the pioneers for today’s ”standard of care” in hair transplantation worldwide, as we published almost every breakthrough in the field of hair transplantation over the past two decades. When this hair transplant experience is combined with scalp pigmentation — something no one else to my knowledge is doing — we can get the best out of both worlds.

Although this process is relatively new to us, having started in the fall of 2010, we have introduced the use of local anesthesia to minimize any pain (common in tattoo procedures, especially on the scalp). Patients who have had hair transplants and want more fullness can add scalp micropigmentation to the areas that still look thin (examples here and here).

Transplanting stubble hair with FUE in the pigmented bald scalp just enhances the illusion that the pigmented scalp is just a short or shaved haircut. The use of SMP in the pluggy patient with transplants from the 1980-1990s can be nicely treated by special applications of the pigment dyes. I just performed a SMP procedure on a patient with massive scars on his head that looked like he had shotgun wounds all over his scalp, and in one session, he walked out without the need for a baseball hat.

Each day is more exciting than the previous one as we explore the uses of SMP in various scenarios presented by interested people. The happiness of our patients is almost immediate.

Tags: smp, scalp micro-pigmentation, pigment, tattoo, hairloss, hair loss, hair transplant

I have been using generic rogaine for over 6 years. Recently, I have noticed the benefits taper off considerably within the last 2 or so years. In recent weeks, I have just begun treating the my thinning hair with propecia, but I never stopped using the minoxidil.

I know how the saying goes “you have to use minoxidil twice a day for life or all that is gained will be lost”. IS this still true once someone has begun a propecia treatment?

I looked online for an answer, but all of the literature relating the two products together only say “give propecia 8 mos to a year before adding minoxidil”. My problem is, I had already been using it, and there was no scenerio for that.

Thanks in advance!

You shouldn’t replace Rogaine with Propecia and expect it to maintain your Rogaine benefits. You’ll need to keep up with the Rogaine to see those benefits remain, even if they’ve tapered off.

In general, we recommend adding Rogaine about a year after starting Propecia so that the individual patient can make an educated assessment of which medication is working without having two variables. Neither medication is guaranteed to work your lifetime. In fact, they usually decrease their effectiveness over time. Stopping them completely will likely result in catch-up hair loss, though.

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

Snippet from a non-hair-loss article:

TylenolPop a Tylenol and take a brisk walk for protection against prostate cancer? That’s what the findings of two new studies published this week suggest.

In the first study, published Monday in the journal Cancer Epidemiology, Biomarkers and Prevention, scientists found that men who took a daily dose of acetaminophen (Tylenol) for five years had a 38% lower risk of developing prostate cancer, compared with other men. Additionally, daily acetaminophen was associated with a 51% reduced risk of developing an aggressive form of the disease. Men who took acetaminophen for less than five years saw no protective benefit.

Read the full story at CNN – Prostate Cancer Studies Find Benefit in Daily Acetaminophen and Brisk Walks

This as an observational study of over 78,000 men, and while nothing is definitively proven here, the findings are interesting.

So why post this kind of health stuff on a hair loss blog? The majority of the readers here are men, and as the article points out: “Prostate cancer is the second leading cause of cancer death in men“.

Tags: prostate cancer, acetaminophen, tylenol

Snippet from the article:

TrichotillomaniaHair loss is a common problem that can be caused by a variety of conditions.

Imagine, though, it happening to a young boy because he pulled out his hair.

That’s what Max Sherwood of Riverdale, Iowa, had to endure. Max, 11, has trichotillomania, a psychological disorder that causes people to pull out hair from their head and other parts of the body to the extent that it causes patches of baldness.

“He started to pull out his eyebrows when he was in second grade, then he quit,” mother Candace Sherwood said. “Then, when he started fourth grade, he started to pull out his hair.”

Read the rest — Iowa Boy Pulls Out His Hair and Goes Bald

The video that plays at the start of the article is about OCD in general, and isn’t specific to this young boy’s story. But for those curious about the disorder and the steps used to treat it, I’d recommend giving the article a read.

Tags: behavior, ocd, obsessive compulsive disorder, tricotillomania, hair pulling, hairloss, hair loss, child

Hi, Im 23 and i had a hair transplant almost 4 months ago. I’ve been on propecia for 3 + years with good results. I have an observation and a question for you regarding shock loss.

I’ve noticed that i’m losing a fair amount of native hairs in my recipient area, BUT, i’m really only losing these hairs after i workout really hard. For instance I went for a very intense run two months and right after i was finished i ran my hands through my hair and i noticed a mass amount of hair falling out from my recipient area. Do you think my workouts are contributing to the process of shock loss? If so how long will this last? ( how long can shock loss last?)

For starters, shock loss usually slows down between 3-5 months following your hair transplant. I really can’t fully address your concerns, because I haven’t had the opportunity to examine you before and after your surgery.

In our office, we offer the use of a device called HairCheck, which is a way of measuring hair bulk. We would’ve had measurements of before your surgery and if you really had shock loss after the surgery, we would actually be able to calculate how much hair you lost. This test could have been repeated monthly after noticing the problem. The first thing is to diagnose what is really happening.

Many men in your young age group are riskier patients for shock hair loss. Based upon your report, I can’t confirm your opinion without at least seeing you and all of your before photos. I would want to know what your patterned hair loss was like, where the recipient sites were placed (I hope that it was not placed in areas where you had significant amounts of native hair), and I would want to be able to predict the status of your miniaturization throughout the scalp. If you had significant miniaturization present and rapid hair loss present before your surgery, that would be an alert of an unusual risk for shock loss.

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

Hi. I’m a 16 year old guy who eats healthy organic food and exercises every day. My mom’s dad went bald but my dad’s dad had healthy hair until he died. Also my dad still has pretty much all of his hair. My older brother has hair like my mom’s dad and he went bald. I, on the other hand, have hair like my dad. So, enough background info.

A couple months ago I started to notice that hair on the sides of my head were getting smaller. Now I have smaller and less hair on the sides and a little less one the front of my hairline. The hairs on the sides are shorter and thinner than on the rest of my scalp. What should I do?

It’s possible that a 16 year old with a strong family history for balding can detect early male pattern baldness (MPB). The first thing I would want to do is to measure the hair bulk throughout your scalp. This is a great way to help make more accurate predictions of hair loss and it documents the status of the hair each and every time it is used.

At 16 years old, I would want to know this FOR SURE, because it would either tell me that I do not have a problem with early hair loss or that I do. If you had documented bulk reductions with this test, then the use of Propecia would probably be worth exploring with your doctor.

Tags: hairloss, hair loss, teen hair loss

Is it possible for a general practitioner to prescribe finasteride 5mg if he knew what I was taking it for? The only dermatologist in town moved far away and will not refill my prescription unless I have yet another appointment. I have little time to visit a specialist outside my town.

Any physician can prescribe almost any medication… so the short answer is: Yes. Some doctors do not like to prescribe the 5mg finasteride pill under the assumption that you are going to split it into quarters. If your doctor won’t prescribe it at that dose (which is available in generic), try another doctor.

For those not familiar, 1mg finasteride is for treating hair loss and 5mg is for treating the prostate. The 5mg is available in a much cheaper generic form, the 1mg isn’t yet available in the US due to patent laws.

Tags: finasteride, propecia, hairloss, hair loss, doctor, physician

I had general questions re hair loss. I’ve had several mini strokes. 1st one @ 2002 which is when hair loss began. It itches horrendous which is irritated at different times. Not sure if this is due to certain foods eaten that triggers this. Any advice will be greatly appreciated. thank u

After a major stressful event to your body (stroke) hair loss can be an issue. It can reverse with time, but often for men, many patients do not report full recovery of their hair. I do not have an explanation for this.

Tags: hairloss, hair loss, stroke, stress

Is there any risk of allergic response to the pigments?

I have had increasing allergic responses to a number of medications and foods over the past few years (hives). It would be catastrophic to have a whole scalp covered with this and then find out it triggers a hive response.

There is a risk of allergies to the pigments, which contain metal oxides. While generally rare, the most common allergy is to these metals. All patients are skin tested to the dyes prior to starting the full process, but this only covers short term detectable allergies.

According to BMEzine:

    It should be noted that allergies can develop over time with exposure (which is why there are more rice allergies in Asia than North America; but those allergies don’t start occurring until fifty or so), and that they may not show up until years later (when the allergy develops).

    – snip –

    While you could get spot tests done in theory with tattoo ink, this is virtually unheard of and in my opinion not entirely viable, and there is no readily available way to know in advance whether you will have such a reaction. Thankfully they are quite rare.

Tags: smp, scalp micropigmentation, allergy

I’m 31, and have been using Nioxin for about 6 years. My hair has always been thin and my hairline has been continuously receding since my early twenties. I do believe the Nioxin has helped slow my hair loss (I have a younger brother whose head is nearly bald!). But I still have major shedding every morning in the shower.

Now I see a new product called “HairSil” – which is “clinically proven with Bioactive Peptide TA-5.” What the heck is that stuff, and how would it benefit a balding head? I’m considering giving it a try but don’t want to throw away all those years I’ve invested in Nioxin already.

I read on a forum where someone said the product claims “100% of patients in the study saw increased hair growth” and “80% saw a reduction in hair loss by 8 weeks“, but I can’t find an official site for HairSil that says that. If indeed that’s what the makers of HairSil actually claim, the FDA should probably look into it.

On the surface, HairSil just sounds like it’s a shampoo like any other. It’s hard to find much information on it outside of what others have written on hair loss forums. It’s worth noting that they offer a 20% commission to affiliates that sell this shampoo, so it might be another in a long line of products that people are hyping up just to get your money.

Tags: hairsil, shampoo, hairloss, hair loss