How Common Is Asymmetry in the Hairline When MPB Begins?

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

How common is it for men to have obvious asymmetrical hairloss at the start of balding?

My hairline was deadly straight, however now I have just one side that is minaturising about 2cm behind at the corner for about a year now, and getting gradually worse. The other side is still fine and the hair is still thick all the way to the edge. This is painfully obvious if I brush my hair back, so I have to brush forward and slightly to the side to cover it. How often do you see something like this?

I’m thinking about going on finasteride but wondering whether you usually wait for both sides to begin minaturisation, as at the moment this doesnt look likely any time soon.

Thank you

It is very common to have asymmetry of the hairline, which often gets more pronounced as the balding increases. But don’t be too concerned about things being uneven… the other side usually catches up!

You’ll need to talk to your doctor about whether you should be on finasteride. Generally for hair transplant surgery, we don’t necessarily need to wait until both side are equal.

Tags: finasteride, hairline, uneven hairline, asymmetrical hairline

Can Rogaine and Propecia Work on the Same Follicle?

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

Hi Dr. Rassman, strange question I have for you.

If, hypothetically, one responds well to finasteride and regrows some hair, and also, is ABLE to respond well to rogaine (minoxidil) and regrows hair, can the two drugs work together on the same hair follicles that one regrew? In other words, can the hair that rogaine regrew be maintained with finasteride, and vice versa?

They have different mechanism of action, so I’d assume they could work together for maximum benefit on the same follicle… but if you stop using one medication, the other medication won’t maintain it 100%. In other words, Rogaine-grown hair isn’t maintained by finasteride alone (and vice versa).

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

The Value of Using Non-Head Hair for Transplantation?

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


Dr Rassman

In contrast to transplants using scalp donor hair, I appreciate that the probability of technical and cosmetic success with body hair and other nonhead hair transplants for severe cases of baldness remains unclear. Today I read an article in a well-regarded journal that describes 3 patients who had a significant cosmetic need resulting from poor previous surgical procedures and exhausted scalp donor supply (Umar S. Ann Plast Surg. 2011 May 2. [Epub ahead of print]). The article appears online in this month’s journal before its appearance in print and can be accessed here.

The outcomes with nonhead hair appear to be excellent. Given the varied and anecdotal results with BHT (and nonhead hair, in general) infrequently reported (in blogs) by different patients and physicians (1) do you see a role for nonhead hair in individuals who are in situations similar to that described by Umar?, and (2) wouldn’t it be of great value for those who perform nonhead hair transplants to pool their experiences and data to potentially better understand (and publish in a peer-reviewed journal) those patient or physician factors, or both, that may contribute to and predict good outcomes?

I have seen some good results reported from body hair transplants (BHT) so there may be instances where it could be an option, but I don’t generally recommend it due to the variability in texture and growth cycle. I’ve previously written about using scalp and body hair together in transplantation, and remain neutral. My opinion continues to be that body hair should only be used when you run out of donor hair from the scalp, but having said that, I would consider it as one of the last options.

With respect to pooling the experiences and data for a better understanding, I believe it is a great idea. In practice, I don’t know how the accumulation of data from all the body hair patients and their surgeons would be delineated. By that I mean that most surgeons wouldn’t want to publish or admit to bad outcomes, nor would certain patients want to participate in the study. My point is that it stands risk of a skewed study… but perhaps I am just a skeptic.

Tags: body hair transplant, bht, hair transplant, hairloss, hair loss, nonhead hair

Born with Receded Hairline Corners

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

Hi there.

If someone was born with receded corners does it mean his hairline will not mature?

The hairline you have at birth isn’t an indicator of where your hairline will go as you age.

We are all born looking different — rounded corners (Bill Clinton), low hairlines (Sean Penn), etc. These can be changed with a good hair transplant doctor if you do not like it. Receded hairlines generally refer to maturing hairlines in many men or early frontal balding in others, but I generally do not like changing these in very young men (under 26 years old) as you may continue to lose hair as you get older.

Tags: hairline, hairloss, hair loss

Is Propecia Making My Penis Tingle?

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

Hello Doctor,

I am a 22 year old male with NW3… but I’m likely heading towards a NW6. I was recently prescribed Propecia to help combat my hairloss, I don’t seem to have any side effects, However, but my Penis “tingles” during most of the day. This is not listed as a side effect… but could this be because of Propecia?

I have to say that your website is a great service to balding men everywhere, but other sites that promote fear of Propecia have made me worry about it. How can you tell if a side effect is real, or just in your head? I have a habit of over-thinking things.

I’ve not heard of Propecia use and penis tingling. I would suggest you have it checked out with the physician who prescribed it to you. How long have you been taking the medication?

As for how to tell if a side effect is real or all in your head… well, that’s not easy. And as I’ve said before, the power of suggestion is well documented. Rather than focusing on the rare negatives, try focusing on the overwhelming positives.

Tags: propecia, finasteride, side effect

My Hair Falls Out When Applying My Seborrheic Dermatitis Treatment

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

HI Doctor,
I have been loosing hair for the last 4-5 years now. Not until recently i tried Procerin, which didn’t work and seems like increased shedding. Now I’m trying Generic Propecia(Finpecia),for about 4 months now. But the results are similar. I am rapidly loosing hair. I have seborheic Dermatitis, for which i am using some Desonide 0.05% lotion. My problem is i can not apply the lotion as required because my hair falls out a lot when i just try to apply anything to them or during shampoo. The frontal region is thinning a lot and i can feel overall thinness too.

Can Seborrheic dermatitis be causing the hair loss? and should i stop taking the generic propecia which might be leading to increased hair fall. My hair don’t look healthy at all and are always falling when i run my fingers through them. Any advice what can cause such rapid shedding.

The only connection between seborrheic dermatitis and hair loss is the way you apply the treatment. If you are not gentle, you can pull out hair. Desonide is a prescription topical medication, so you should be asking your prescribing doctor what he/she suggests.

Tags: seborrheic dermatitis, hairloss, hair loss

Some People Prefer the Stubble Look with Real Hair (with Photos)

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

I believe Dr. Rassman I can shed some light on a recent post. You have answered the question many times in regards to BHT and short cut hair. I agree that it does seem somewhat pointless to shave ones head after recieving a hair transpant however I do understand the logic behind it. With a short cropped haircut (even a #1 clipper shave) you can still see a visible hair line that defines the face much like the tattooing service you are now offering. With a completely shaved head it is not visible.

Many people such as myself would prefer real hair on their head rather than ink although I must admit that the results do look pretty good. None the less body hair is different than scalp but cut short can offer a more realistic illusion of stubble that in this day and age appears acceptable if not attractive. Counter argument it is very expensive for just stubble. Agree?

Why would you bother with body hair transplants (BHT) when you can use your scalp hair? Body hair tends to be texturally different. If you truly want a stubble look with real hair, using Scalp MicroPigmentation (SMP) with scalp hair extracted with FUE is a good way to accomplish this. On the flip side, patients who’ve had a hair transplant and want the closely cropped look would already have stubble, so SMP is a great option to add the appearance of fullness.

Here’s an FUE patient who had very little restoration work done — under 600 grafts to the front corners — and later decided to shave his head. On the top of his head, the hair is miniaturized so it appears thin and lighter in the picture. The following result shown is immediately after the first SMP session. This will fade slightly as the color sets and the client will return in 3 to 4 days for a touch-up. (Note that because the photo was taken immediately after the SMP session, you can still see some initial redness.)

Before SMP on left; After SMP on right. Click photos to enlarge:

 

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

In the News – Hair Stem Cells Regeneration

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

Snippet from the article:


In one of the first studies to look at the population behavior of a large pool of stem cells in thousands of hair follicles – as opposed to the stem cell of a single hair follicle – Keck School of Medicine of USC scientists deciphered how hair stem cells in mice and rabbits can communicate with each other and encourage mutually coordinated regeneration, according to an article published in the April 29 edition of the journal Science.

The team collaborated with mathematical biologists from the University of Oxford on the article, “Self-Organizing and Stochastic Behaviors During the Regeneration of Hair Stem Cells,” which was just named an Editor’s Choice in Science Signaling, a sister publication of Science.

The researchers analyzed over many months the changes in the hair growth patterns on shaved mice and rabbits, which indicate cyclic progression between active and quiescent states by stem cells in hair follicles.

Read the full text — USC Researchers Learn How Hair Stem Cell Populations Achieve Large-Scale Tissue Regeneration and Growth

Hair stem cell communication in mice and rabbits is different than that of humans, but the article states that the study’s results are promising. This builds upon a 2008 study of mice and their hair growth patterns that we wrote about back then.

Tags: stem cells, hairloss, hair loss, hair follicles, regeneration, science

Strattera and Teen Hair Loss

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

My 16 year old son has been on Strattera for about 3 and a half years. His hair has been getting thin now I can see his scalp. The only medication he has been on is Strattera.

Medication is one of the last things we look for in men’s hair loss. The majority of hair loss in men and young men (past their puberty) is genetic male pattern baldness. Perhaps you can notice the pattern to your son’s hair loss.

That being said, Strattera (atomoxetine) doesn’t list hair loss as a known side effect in the literature, but people have attributed hair loss to this medication on occasion. We’ve written about it before here.

Tags: strattera, adhd, medication, hair loss, hairloss, teen hair loss

Insulin Resistance and Hair Loss?

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

Hi Docs

Some research suggest a connection between insulin resistance and hair loss. Do you agree with that? It there is a connection, will a low carb diet (high protein and fat diet/Atkins) be effective at combating hair loss?

Cheers

While there seems to be some anecdotal evidence out there, there is no proven connection between insulin resistance and balding that I know of.

Tags: hairloss, hair loss, insulin

Face Transplant Patient Also Got a New Hairline

/by William Rassman, M.D./4 /

This is the article about the face transplant patient: Face transplant patient ready to go home

From the pictures in the article, the picture on the left shows his mid-scalp area has no hair at all due to his injury, and the after picture shows him with ample amount of hair in the mid-scalp area. The article points out, ‘even the hair on Wiens’ head, from the mid-scalp area, is part of the donor skin (the hair on the back of Wiens’ head is his own).’

Is there a possibility scalp transplants will be available in the near future?

Dallas WiensI’ve received more than a few emails about this case where people have excitedly pointed out that this patient also received hair. Yes, full face transplants are possible thanks in part to some amazing surgeons, and yes, it’s possible to have part of the donor scalp and hair survive during this type of procedure. But surgery like this not practical or safe for someone that just has genetic hair loss and wants a head of full head of hair from a donor.

The key issue preventing person-to-person hair (and scalp) transplants is with the anti-rejection medication he must take. For the face transplant patient the risk is worth the reward, but for someone that wants to have hair harvested from someone else, the side effect risks from these immunosuppressive drugs are quite serious. The risks include massive infections and even cancer.

However, let’s look at this from a realistic point of view. Who would even volunteer for a scalp transplant just to treat genetic balding? Keep in mind that the scalp has to come from someone… and that someone is likely a cadaver.

Tags: face transplant, scalp transplant, surgery

Any Additional Data on Men That Experience Propecia Sexual Side Effects?

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

Dear Doctor,
Love the site, find myself popping in and out all the time for the latest buzz in “hair loss warfare”

So anyways, I have been on Finasteride for about 7 weeks now, no noticeable change yet,nor did i expect any results this early in the game. No weird and wild side effects either – my libido is full tilt. One thing though I am absolutely certain of is the slowing down of facial hair growth, and possibly body hair too. This is not a problem of course but i just thought I would share my experiences thus far. I used to shave everyday or I would wake up to serious “scruffyness” the next morning but now its like every third day if that! This change I swear to be true and can provide no other explanation for. But like i had said before is no problem what so ever.

Now for my question, which is no relation to the information I shared above. For the people tested on propecia, was there any similarities in the 2% that experienced those “weird sexual side effects”. For example:

-Their weight
-hair type
-whether or not they had lots of body hair
-age
-race
-diabetes

Thanks so much for your time, and I look forward to hearing back from you,

You need to be on Propecia for 6 to 12 months to see any noticeable change. Keep in mind that NOT noticing any change in it of itself may be a good thing as well, because that means you aren’t losing more hair. Loss of body hair has been mentioned, but is not listed as a side effect of the medication.

If you want to know more about published data, it is in the bulky folded paper that comes with your medication bottle. I don’t have specific statistics for those men that experienced side effects, though.

Tags: propecia, finasteride, side effects, hairloss, hair loss

I’m Shedding Tiny Hairs That Looks Like Dust

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

Hello Dr,

Since I’m on fin for more than 12 months, I’m constantly shedding 1-2mm long really tiny hairs which exacty look like dust but darker. They are really hard to notice and I can only see them on white backgrounds like my mobile phone’s screen, my monitor and on my hands if I look for them carefully.

Can you tell me if they’re miniaturized hairs or sign of something else? Thanks.

I’m at a loss here. I can imagine dark dust, but not in the context of hair loss. I really couldn’t tell you what is going on and I wouldn’t know if they were miniaturized without seeing you myself. I’d need to examine these dark dust particles you’re talking about.

Is your hair cut really short to begin with?

Tags: hairloss, hair loss, dust

Can I Get a Beard Transplant If I Have Alopecia Areata?

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

Hi, I am a 22 year old male studying in New York. Since August last year, i have been facing hair loss from my facial beard. Doctors claimed it is alopecia areata. I was under meds for about 4 to 5 months and it got better momentarily but i guess it came back since i am loosing my beard around my chin and neck area! I read a couple of your stuff on this website and i was eager to know if i would be able to do a beard transplant on the affected area considering i might be suffering from alopecia areata. Your help would be much appreciated. Thank you.

Alopecia areata is an autoimmune disease, potentially affecting all of your hair follicles. It could attack any transplanted hair that is placed into the balding area and those hairs will die. So unfortunately, transplantation isn’t a wise option for you. For more on alopecia areata, see the National Alopecia Areata Foundation.

Tags: alopecia areata, beard, hairloss, hair loss

I Occasionally Get Dizzy While Using Rogaine

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

I seem to have many problems with Rogaine including occasional dizziness and erectile dysfunction which appeared when I started Rogaine. What should I do about this?

DizzyThis type of question is really for your doctor… and that’s not me. Dizziness can be the result of Rogaine (minoxidil) and if it came on with your starting the drug use, then it is highly suggestive that the symptoms and the drug are connected. The easiest thing is to stop the drug and see if the symptoms go away, but you might have some heart problem underlying these symptoms and the Rogaine brought them to light.

Rogaine has many reported side effects, including dizziness, headaches, nausea, selling of the extremities (hands, feet), rash, chest pain, blurred vision, etc, etc. So as you can see, nothing about taking medications is simple. The right thing would be to see a doctor and stop treating yourself.

Tags: rogaine, minoxidil, vertigo, lightheaded, dizziness, dizzy, hairloss, hair loss