Can Half of My Hairline Be Juvenile and Half Be Mature?

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

First I’ll like to say, I really enjoy your blog. I found your blog about a year ago and love it.

I have a question about hairlines. I have an asymmetrical hairline. I think its mature on the right and juvenile on the left. So could it be that my right side is juvenile and my left side is normal? I know you said they eventually even out, but are there any cases you know of where they DON’T even out?

You can have both the appearance of a juvenile hairline and genetic male pattern balding occurring at the same time. Unless you have an examination and also followed over a course of a year, it is likely difficult to tell. Other factors, such as your age, family history, degree/pattern of miniaturization, and even bulk measurements can aid in a more objective diagnosis.

Unfortunately, I don’t know enough about your case to give you a decent idea of what is happening to your hairline. Having an asymmetrical hairline isn’t impossible, but I wouldn’t be surprised if in time you see the other side catch up.

Tags: hairline, hairloss, hair loss, juvenile hairline

I’ve Had Significant Diffuse Hair Loss On My Entire Scalp and Face

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

I’ve experienced significant diffuse hair thinning/hair loss over my entire scalp and facial hair about 8 months ago.

Could this be anything else besides Androgenic Alopecia? I’m 41 and was slowly losing hair only on top since I was 20. Been on finasteride for 7 years. Should I see a dermatologist first?

You should just see your primary doctor to make sure you do not have any other medical causes of hair loss.

Androgenic alopecia is also known as male pattern baldness (MPB). As the name implies, there is usually a “pattern” to the balding. Diffuse hair thinning all over your scalp, including in the donor area, would not be MPB… but could point to something like alopecia areata.

Tags: hairloss, hair loss, alopecia

Can Rogaine Cause Impotence and ED?

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

I have a question about taking Rogaine. I read a lot of people saying that when they took topical Rogaine that they noticed soft erections and impotence. Is this possible and do you hear a lot of people reporting this? thanks

I personally never heard of this from any of my patients. Moreover, I do not believe erectile dysfunction or impotence is a side effect of Rogaine (minoxidil).

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

You Say Norwood 2 is Just a Mature Hairline, But Can It Be Treated Surgically?

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

Hi Docs, thanks for the great site, it really helped me figure out my options. I finally got a check on what I thought was a receding hairline after seeing my brothers lose their hair and after a couple of checks with a hair specialist in the UK I was told I have a matured hairline but no apparent signs of real balding, recession or minituarisation. I was told that there was no apparent need for me to use Propecia or Minoxidil. I am aged 32 now and my hairline looked to have matured by around 21 and hasn’t moved noticeably since then.

My question is that you tend to mention on this blog that a Norwood 2 is approximately a mature hairline and you don’t consider this male pattern balding from a surgical standpoint – but on your New Hair Institute site you show Norwood Class II patients and count that as hairloss that could be treated surgically? Would this be strictly for a cosmetic adjustment of the hairline? (I realise it’s all cosmetic surgery but as in there’s no balding to cover, just a hairline change). Although I’m happy with my hair more or less, I’d still prefer a slightly straighter (closer to juvenile) hairline as I have quite a high, thin forehead and I’d be interested in surgery simply as a cosmetic adjustment.

Thanks for any clarification.

Norwood 2Hair loss is not a medical illness. Hair transplant surgery is considered cosmetic surgery. If you want to enhance your appearance, it is your choice. So for those with a Norwood class 2 or a mature hairline which is more like an early Class 3 pattern, we can certainly treat it.

The point I generally make in my medical practice and here on BaldingBlog is to have open communication between the patient and doctor. We give our opinions on what may be too low of a hairline and how it may not be age appropriate, but in the end each and every patient has a right to choose their own “look” and hairline.

There is nothing wrong with, as you put it, a cosmetic adjustment.

Tags: hairline, hair loss, hairloss, hair transplant, surgery

I’m Seeing Baby Hairs Growing at My Hairline After Taking Propecia for 8 Months!

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

Hello doctor,

I’ve been on propecia for about 8 months and its going well my hair is stronger and the crown is looking better every day..

I’ve noticed some long thin white ‘baby’ hairs on the front of my head where my hair recedes that were never there before. Could I be one of the lucky ones and get hair growth on my front too?!

Perhaps you are one of those rare lucky patients that sees some regrowth at the hairline from Propecia (finasteride). It would be nice to see your before and after pictures.

What you are calling ‘baby’ hair is not the strong hair that you need to consider it regrowing, but give it a full two years to see what emerges.

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

I’m In My 50s and My Hair Started Thinning After I Took HBP Medication

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

I am 56 years old. i have been taking medicine for high blood pressure for 10+ years – Lisinopril10/12.5 and Ziac 2.5. My hair has been receding since i have been on this medicine like male pattern baldness but within the last 6 months it had thinned all over.

Do you think it could be the medicine i take, vitamin deficiencies, or poor circulation? I have been using hairloss shampoo Curetage and Nizoral and it seems to be worse. I can see lots of little tiny hairs about an inch long in my scalp. Is this MPB or something else.

Lisinopril and Ziac are both known to cause hair loss. Of course, the treatment of high blood pressure is important to your health. Speak with your doctor and ask him to consider switching your medication routine.

If you are in Los Angeles, consider paying me a visit so I can make an assessment of your hair, your hair bulk and the degree of miniaturization.

Tags: lisinopril, ziac, hpb, blood pressure, hairloss, hair loss

Telogen Effluvium After a Medication Overdose

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

Can antidepressants, antipsychotic, betablockers & more medications after years on and off using cause hairloss? different structure, color and even thinning like miniaturization thin? I found sometimes a very long thin hair in the back and side of my head with less pigment in my hairline i can found them to.

I also now have Telogen Effluvium for the second time. 6 months ago i had a big telogen effluvium shed overall on my head. The cause was dramatic stress and heavy dieting. Now i still have TE, 3 months ago i had a overdose of medication. The overdose really damaged my health now, how long do you think TE will continue?

I’m losing thick hair overall and also in the front, occasionally a thin hair. If i had have hairloss from medication that i have using for 7 years can it lead to permanent hairloss? Can TE make the hairline worse?

Thank you for helping, i really appreciate it

Let’s keep it simple. Telogen effluvium (TE) is not permanent hair loss. It is temporary and the hairs should grow back within a year. Stress (extreme stress – as you write about) can also cause some diffuse hair loss but most people generally recover and grow back their hair with in a year. Genetic hair loss for men is known as androgenic alopecia (AGA) or male pattern baldness (MPB). There is a “pattern” to the thinning / balding… like a receding hairline. A receding hairline does not usually happen with stress or TE.

I don’t know what medications you’re specifically taking, but it wouldn’t be unusual for some people to see hair loss from some antidepressants. I couldn’t say one way or the other if it was your medication that caused your hair loss, though. The reason for your hair loss could be from other medical or genetic causes.

Bottom line — if you are worried about hair loss, see a specialist or discuss it with your primary care doctor. There’s only so much I can offer online without an examination or proper medical history.

Tags: telogen effluvium, hairloss, hair loss, medication

I’m 15 and Want a Hair Transplant

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

Hi my hair has been thinning when i was early-mid 14, its been almost an year now and my hairline is going bk more. I also noticed my hair gets really oily if i dont wash it for one day. I have been going to doctors but most of then said they cant do anything about it.

I’m currently using rogaine 2% for 4 months now but nothings really changing. I was wondering what can i do about this? Whens the earliest age to get hair transplant? I’m really scared to go bald as i’m still only 15.

At 15 years old, your idea for a transplant is likely not reasonable. Rogaine (minoxidil) probably wouldn’t do anything for your hairline, and at only a few months after starting it, I don’t think you’d even see any benefit at the crown (where it works best).

If you’re in the Los Angeles area, you can visit me at the New Hair Institute for a consultation. I will give you an opinion and not brush you off. You would also need permission from your parent(s) or guardian since you are underage.

Tags: hairloss, hair loss, teenager

People on Forums Swear by RU58841

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

I hear about a substance called RU in a bunch of the forums on the internet.Many of the people using it swear it helps the hairline. Do you have any on this at all?

I assume you’re referring to RU58841, which I still don’t know much about besides that it is an experimental anti-androgen out of Europe. I mentioned it earlier this year in a post, but I can’t comment on forum members swearing something works or doesn’t work. I prefer published proof in peer-reviewed medical literature, which I haven’t seen yet.

Tags: RU58841, hairloss, hair loss

I Mapped My Scalp for Miniaturization and Found Finer Hairs That Could Suggest MPB

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

Hello Doc,
I mapped my scalp for miniaturization (since no central European doctor or rocket scientist does). What I found was there was none in the front, crown, mid- anterior or top of my head, only as expected in my hairline corners. However, when I went further back at the temples, a narrow space between the sides and top of the head, going about half an inch to one inch further back than a Norwood 2 had also more fine hairs. (no recession up to there yet) This suggests Mpb, right?

Still I’m glad that after one year of hairloss it doesn’t look like I’m going bald soon, although at age 22 and a NW6 maternal grandpa one can not be sure (still all other male relatives are Class 1 or 2). I’m well aware that a self examination does not fully replace a medical one, so perhaps one day I’ll get it confirmed

After all, I wanted to thank you for your site, delivering infos, without which I would still not know about scalp mapping, mature hairlines or a master plan.

Thank you for the comments. While it may not replace a good medical examination, it is good to know that some readers can be empowered to take a proactive and objectively see the degree of thinning / miniaturization.

What you saw could suggest early MPB, but I couldn’t say for sure without seeing what you’re talking about.

Tags: hairloss, hair loss, miniaturization

Great Hairline, Thin Top and Crown, Low on Donor Hair (with Photos)

/by William Rassman, M.D./9 /, , ,

This patient had 4608 grafts. As you can see from his photos below, the frontal area is great, but the top and crown are lightly covered. He lost much of the original hair in the top and crown from the balding process and as the transplant process was going on over a 10 year period in three sessions.

I am posting these photos to show that frontal hair can go a long way to making a balding man look fuller. We will still do one more surgery on him to fill in areas that need more density and then offer him Scalp Micropigmentation (SMP) to finish the creation of the fullness he wants.

Click the photos to enlarge:

 

Tags: hair transplant, thinning hair, donor area, hairloss, hair loss, photos

After I Had a Scar Revision, the Area Is Very Itchy

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

I had 3 FUSS transplants over a decade. It left a wide scar. I had a scar revision. It resulted in a liner revision line. However after the scar revision, 5 years later, I have bouts where the scalp area is really itchy. It ceases in a day and then restful for awhile

1. What causes this?
2. What can one do?

thanks for the tip and your powerful website!

You can try an over the counter hydrocortisone treatment in small doses 3 times a week or once a day, whichever relives the itching. I can’t say a scar revision and scalp itch are related — at least, it’s not something I’ve heard of before. If it continues, I would see a dermatologist.

As an aside, we are no longer doing scar revisions, but rather offer Scalp Micropigmentation (SMP) as the treatment of choice for scars. Most people who have scar revisions still have significant scarring, and SMP literally wipes out the appearance of the scar.

Tags: hairloss, hair loss, scar reduction, smp, itch

I Don’t Know If My Doctor Knew How to Transplant African Hair Type

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

I am a 30 year old African American male. I had hair transplant surgery a year ago. Mainly to fix my hair line fixed. It’s been a year and barely any improvement, there’s barely any new hair. I don’t if the doctor knew how to do an african american hair. Should i have it done again by another doctor? what should i do? thank you!

African hair requires considerable experience and few doctors have mastered the process. We have had no problem with this type of transplant of African-American hairs that are kinky.

After a year, the results from your transplant should be noticeable by now. I hope you didn’t have a transplant failure, but an exam would be able to tell that. As you are in Los Angeles, please consider making a free appointment with me in my LA office.

Tags: hair transplant, african american, hairloss, hair loss, failure

Having SMP and Hair Transplants Done as a Combo?

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


Thanks for the amazing blog, doctor(s). I believe it literally saves people’s lives.

You’ve briefly mentioned previously that some people haven chosen to get FUT transplants, buzz their hair short, and get SMP, but I was wondering, why don’t more men who have gotten transplants but suffer from the “see through” look get SMP to help combat this issue? Does this SMP+HT combo idea work, aesthetically?

Look at our SMP site and you will see that this technique is a great adjunct to a hair transplant, properly timed of course. We are doing more and more of these every day.

Tags: smp, scalp micropigmentation, hair transplant, hairloss, hair loss

Big Problem – Unfinished Hair Transplant Work

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

When it comes to hair transplants, some people don’t always finish what they start — perhaps due to money issues or just not wanting to go that route ever again because of disappointment in the results, failures of the surgery, or severe pain with the surgery. The pain and costs of more surgeries is a real turn-off for many of these people, but times have changed. Surgery is rarely painful, prices have come down, the results are not detectable as being any different from your natural hair, and alternatives are available… so exploring the sum of today’s options may be worthwhile.

Patients with an unfinished hair transplant hasn’t really been a problem in our practice, because we get personal with all of our patients and get to understand their goals, never promising them a rose garden, but setting up realistic expectations with regards to how many surgeries they will need to hit their targeted goals. In the old days (1980s) one rarely saw a finished hair transplant patient and few, if any, looked normal. I ran a large hair transplant practice in 1989-90 (before founding the New Hair Institute) and I was amazed that I never really saw a finished job while I worked there. Today, that is not the case as many completed hair transplants are undetectable.

If you are one of those individuals who did not finish their hair transplant work to meet their expectations and still look like an unfinished piece of poorly done art, I would suggest that you look at the Scalp Micropigmentation (SMP) process as a surgical alternative for thickening. This could possibly be a way of thickening up the appearance of your hair transplant without having another hair transplant. SMP works to camouflage even some of the old type of plugs when done properly.

For many people, SMP can contribute to completing the process, but a consultation with us is critical to defining your needs and the ability to achieve your objectives at a reasonable cost.

Tags: hair transplant, hairloss, hair loss, pigment