I have a question about baldness. I’m only 21, but kinda was rudely pointed that I may have a balding spot. I’m kinda nervous, as I have long hair (I’m a musician), and wanna keep it. Here’s a link to my Facebook (it’s the only pics I can find), with some where the light could be misleading. A friend told me it’s because I’m so blonde it looks thin, but I also may have thin hair naturally. Any help would be appreciated. Thank you!

I didn’t want to post your Facebook profile link so that I could keep some anonymity for you, but I was able to see a few photos.

I don’t know if it’s lighting or a thin hair character (I can’t tell just based on the small photos I saw), but your hair looks thin to me. You need to get analyzed with a miniaturization mapping and a bulk analysis of your hair to determine if this is a progressive process and beginning of balding. From there, you and your doctor can figure out the best course of treatment.

Since you’re local to Los Angeles, you may wish to see us for a consultation. You can call my office at 800-NEW-HAIR (or locally at 310-553-9113) if you’d like to setup an appointment.

Tags: hairloss, hair loss

Hi Dr. Rassman,
I have a question regarding my hair loss situation. My hair texture and quality seems to change frequently. One day my hair is thick and curly, and another day it is flat and thin. Could this be due to a hormonal imbalance? Also even though I am 28 years old I am unable to grow a beard, and do not have any chest hair. However, my hair seems to be receding at times. As I mentioned before could this be due to a hormone imbalance? I thought DHT was responsible for promoting facial and body hair growth? So if DHT is responsible for my hair loss why can’t a grow a beard and chest hair? Thanks for your help.

I doubt that you hair character changes daily, but your hair can reflect things like humidity in the air that make make it appear to change its character. I don’t know what kind of climate you live in, so I’m just speculating, of course.

The presence of chest and beard hair is genetic. DHT does play a role in the process, but not on a one-to-one basis. Some men just don’t have much body and/or facial hair. There is no direct correlation between body hair and the hair (or lack thereof) on your scalp. But, if you are receding one day and it reverses another day… you probably need eye glasses.

Tags: hair texture, hairloss, hair loss

I have a quick question: since my balding area is small i have started using Regaine’s Extra Strength Solution rub-on applicator. so i wanna ask after applying or rubbing 1ml of it do i have to massage my scalp the part where i apply or i can leave it as it is?

There should be application instructions in the packaging, but you are supposed to rub the minoxidil gently on the scalp twice a day, and leave it on. The foam systems may work better for you with easier application and no significant rubbing.

More questions and answers about Rogaine (sold as Regaine in some markets) can be found here.

Tags: regaine, rogaine, minoxidil, hairloss, hair loss

I’m 34 yrs. old and I was born with a scar on my head I had surgery and as I grew older it turn into a bald spot and hair never grew. Is there any cure for any type of bald spots?

Surgery would probably be your only solution. There’s no cure for bald spots or hair loss, and if you never had hair in this spot you likely won’t get it to regrow from medication use.

Tags: bald spot, hairloss, hair loss

I am a little confused by Wayne Rooney’s hair transplant. He only got the procedure done a couple of months ago and already has what appears to be complete growth. Even immediately afterwards it looked as if he had just a shaved head which I didn’t realise would be the case.

RooneyFor those unfamiliar, we’ve written about soccer star Wayne Rooney’s hair transplant a few times (see here).

I have had some patients that had their transplanted hair grow out very fast. I might see such growth in 2-3 months if every graft grew out immediately, but this is rare. I’m not Mr. Rooney’s surgeon, so I don’t have the benefit of examining his scalp. From the looks of the couple recent photos I’ve seen, styling and hair color have more to do with his new look than full growth does. I am sure he still has a way to go before complete growth is seen. Generally, it’ll take up to a year to see the final results from a hair transplant.

One of my reasonably bald cousins that I did a hair transplant for had full growth of 2 inch long hair in 4 months… so while every patient would like to see the immediate visual impact from the surgery, it’s the lucky few that see such speedy growth.

Tags: wayne rooney, athlete, hair transplant, hairloss, hair loss, hair growth

Dr. Rassman,

What can you tell us about this new German development?


Exciting stuff. Thanks for sending the link! I’ve embedded the video below.

The first two researchers are certainly stimulated to find a cure (they are very bald) so I would trust them. Growing hair follicles in a petri dish has been done before by Dr. Jahoda in the 1990s (here and here). When grown in the petri dish, it is exciting, but moving them into a scalp and having them grow is much, much harder.

Tags: stem cells, hair loss, hairloss, hair cloning

Hello Balding Blog Team. Thank you for your very informative site. I have a question that I could not find a clear answer to in previous posts. I am a very early Norwood 3v and have decided to commence medical treatment in the form of finasteride and monoxidil.

I am wondering your opinion on the benefits of laser therapy combined with these systemic and topical medications. I could go on a treatment plan via a specialist company which would cost close to $4000 but the only difference between this and getting the medications via my general practitioner is the laser therapy…so in effect I will be paying $4000 for a laser session every 2 weeks for a total of 8 months. Do you think A) laser therapy per se is of benefit and B) if so do the professional machines give better results than any home based machine I could buy. I REALLY appreciate your advice. Kind regards

I’ve written extensively about laser therapies, and quite frankly, they don’t work. In my opinion, they’re a good way to sell something to the desperate patient, but the results are not what one might expect. I had a large professional machine in my office some years back and offered it free to my patients. No noticeable change was detected.

See many past posts about low level laser treatment (LLLT) here.

Tags: lllt, laser, hairloss, hair loss

I’m a male patient. i’ve been recommended to go to your practice for grafts by another CA doctor. he says i’d need maybe 1000 at most…can that be done in one session? I have a severe case of stress/surgery-induced telogen effluvium and a maturing hairline not MPB according to my doctor, who is a member of ISHRS. he says he does not see miniaturization beyond the mature hairline position, only thinning (effluvium). my concerns are…will the FUE grafts (when placed) be put over live hair follicles and damage them? Or is the magnification procedures used during surgery good enough to make sure the grafts are placed over dead follicles? Thanks,

Telogen effluvium could be a contraindication for hair transplants if the process is still going on. A visit to my office is critical before any conclusions be drawn. I would want to do a pull test and measure your hair for miniaturization and bulk. That will help me confirm your active diagnosis.

Tags: hair transplant, hairloss, hair loss, telogen effluvium

Hi Dr. Rassman:

Once again, thank you for contributing to a great blog.

I am a 32 yr old white male with dark hair. Approximately 2 years ago I first noticed thinning hair on the Crown (about the size of a ping pong ball). I went on propecia and have been on it ever since. There has not been any visible progression (at least to the naked eye). In terms of family history, all of my immediate family members have their hair except once uncle in his 50s has a bald spot around his crown. My one deceased grandfather buzzed his hair but according to my Dad, still hair hair (not completely bald).

I went for a consultation with a hair transplant doctor who advised me that I would need around 2000 grafts to cover that space but since I have an unstable permanent zone (i.e. miniaturization) he did not recommend it.

  1. The doctor did not use the acronym “DUPA” but is that what he was essentially saying?
  2. I have had fine hair since I was in my teens. Is DUPA progressive or stable? I have what appears to be a full head of hair – will it stabalize here or continue to progress?
  3. Dr. Bernstein states that those with DUPA can look “fine” if they keep their hair very short. Does he mean short as in the same look achieved through scalp micro pigmentation?
  4. Can scalp micro pigmentation be of use to someone with DUPA?
  5. There has been a lot of discussion about hair cloning/manipulation being available commercially within 10 years (according to Dr. Bernstein). In your professional opinion, do you think such an advancement be of any use to someone with DUPA?

1. Genetic male pattern baldness doesn’t include the permanent zone, so diffuse loss there could be DUPA.

2. DUPA is often progressive, but it can be stable for a number of years. These conditions tend to be unstable if it is associated with genetic balding.

3. No, not that short. I am sure Dr. Bernstein means clipping it to 1/4 or 1/3rd inch.

4. It can be, but I do not like to generalize on this without examining your scalp and hair loss.

5. That 10 year mark has been moving every year. There’s no use speculating on what cloning can or can’t do for treating various issues, as it won’t be commercially available in the near future. If hair cloning becomes closer to reality, I’m sure the answers will come.

Tags: diffuse unpatterned alopecia, dupa, hairloss, hair loss, cloning, smp, pigment

A website called ‘faces of meth’ shows mug shots of men and women before and after abusing the drug. Here is an article – link.

The included picture shows a man with a notably receded hairline before the use, then after one year, a ridiculously full head of hair. Anything could have happened in that year I suppose but I was just wondering what your take on this was.

Those are some… disturbing photos. People see what they want to see. The two pictures are not comparable, as the one with long hair does not give us a view of the frontal area in details worthy of my opinion. He could still have thinning at the hairline that we can’t see. I doubt he styled it that way on purpose for his mugshot, and in all likelihood it is just dirty and matted. But who knows — maybe he used minoxidil along with his meth.

If you are suggesting that meth is a cure for balding, I just smiled with the inference. Sorry, but I am afraid advocating meth for treating hair loss is just not what I want to do!

Tags: meth, speed, hairloss, hair loss, hair growth

I’m a 26-year-old black male. I have suffered from razor bumps in the back of my head for about 10 years. The razor bumps have now caused hair loss in that area. I have a scar in the back of my head and hair won’t grow in that area. What can I do? I want my hair back. Is it possible that it will grow back? What type of treatment do I need?

If this has been progressing over 10 years or so, then it is likely that you have lost your hair in the various areas where these bumps are. Consider not shaving your head completely, but perhaps just clipping it with a #1 guard electric shaver. Then wait up to 6 months or so and then you may know if this process reverses. Hair transplants could be used if the problem is not too extensive. I’d have to see what you’re describing to recommend much beyond just playing the waiting game.

Tags: razor bumps, hairloss, hair loss

Are rockers in rock bands immune to balding. would loud music keep the DHT away from attacking your hair follicles? most rockers i see have long thick hair!

I have had many famous rockers (and not-so-famous rockers) come to my office after experiencing hair loss and then got it back with transplants. So no, loud music is not protective… it will just make you deaf.

Tags: rock music, loud music, dht, hairloss, hair loss

From time to time we treat patients that will then refer other family members. Both the man below and his brother had hair transplants, and they’ve both been just delightful. Jokes and humor abound during the surgeries and the follow-up visits. Such a good natured, fun person to be around. It took 4 surgeries spaced over a few years, but he met his hair restoration goals and is excited about the results. I am too!

Click photos to enlarge.

After a total of 4539 grafts:




I should’ve explained the case better in the initial post, so I’ll attempt to do that here.

The before photos that are posted above actually reflect far less hair than the pictures indicated. The patient’s hair is fine, so each hair shaft has less bulk than an average person with medium weight hair. The hair thinning went back some 5 inches beyond the leading forelock shown in the picture, but I originally decided that just advancing the hairline would suffice without going back to the thinning area. The entire forelock disappeared after the first procedure and he had more hair loss behind the area that was originally transplanted, so the second procedure was done to thicken up much of the forelock area which was lost.

The original plan that was created brought the hairline down considerably. It took two procedures (3288 grafts total) to get him what he wanted and to fill the area behind the site of the original transplant. For the patient that is taking the drug finasteride, rarely some additional hair loss may occur after the first transplant, as was the case here.

He is a bit of a perfectionist and the two other smaller procedures (553 grafts and 698 grafts over a year apart) were done to deal with some more hair loss behind the transplanted hair. He also wanted to put some more grafts in areas where he thought additional hair would help.

Tags: hair transplant, hairline, hairloss, hair loss

My 13 year old daughter annually starts complaining about the area over her right eye hurting. Within about 2-3 weeks the eyebrow hair will fall out while sleeping, or I just have to rub my finger over it and it comes off. This has happened 3 years in a row. Her pediatrician thought she may have used a razor the first time but now I KNOW thats not happening. I personally see it rub off at the root. What is happening?

It sounds like she might have a medical condition known as trichotillomania, which is a compulsion to pull hair out (which could also explain pain felt in the area). This can occur while your daughter is sleeping, and she is probably unaware that she’s doing it. If a doctor looks at it with magnification, he will see “Exclamation point” hairs and broken hairs at different levels in the eyebrow hair.

You could treat it by putting a head band around her head securing the eyebrows within it. Keep this for 3 months or so and see if the hair grows back. That would confirm the diagnosis. Often, a doctor can look at the eyebrows and see changes in the hair that point to this diagnosis.

Tags: trichotillomania, trich, hairloss, hair loss, eyebrow, teen, teenager

From my favorite satire site, The Onion:

According to a study released Wednesday by the California Pain Medicine Center, subjects suffering from male- pattern baldness were found to experience a level of physical pain at least seven times more intense than that experienced by women during childbirth.

Read the rest — Report: Male Hair Loss 7 Times More Painful Than Childbirth

If you’ve visited The Onion site before, you know they have some hilarious articles and photo captions there. And if you’ve got some time to laugh, other classics include: