I’m 16 With Early Hair Loss, I Wash My Hair Twice Daily, and I Train Mixed Martial Arts

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

I am 16 years old and I think I am starting to show signs of male pattern baldness. I noticed a few weeks ago that the hair on the crown area and top of my head was thinning, but I haven’t noticed any major signs of a receding hairline. I started researching and found that hair loss can be genetic. So I asked my grandfather on my mother’s side when he began to lose hair and he informed me that he started noticing hair loss when he was 18.

Another thing I found while researching was that amount of exercise can be linked to hair loss. Which, if true, can be linked to my hair thinning because I was training in MMA fighting for about two months but recently stopped and suddenly didn’t do any exercise at all. As soon as I stopped training is when I began to notice that my hair was thinning.

Also, I am experiencing slight itching and tingling in the crown area of my head. Another thing is that I do shower and wash my hair, on average, two times a day. I was surprised when I noticed my hair was thinning because I grow hair on almost every other part of my body except for my back. I have already set an appointment with my dermatologist, but it won’t be for another few weeks.

I was wondering in the meantime if it would be a good decision to start using a thickening shampoo and take vitamins. So if there are any suggestions that you can provide I would greatly appreciate it.

Genetic hair loss in men can generally start with the onset of puberty. The hair loss seen after your MMA training could’ve been coincidental, and body hair growth is unrelated to scalp hair loss. I’ve read online chatter that exercise / weight training and hair loss are linked, but I’ve not seen that to be the case.

There is no stopping or reversing a genetic predisposition forever. Hair thickening shampoos and vitamins are not cures, but may make your hair feel thicker. If you are worried about hair loss, you may want an objective examination and diagnosis before starting on an expensive journey of investing in shampoos and supplements. At 16 years old, you should also get a parent involved.

Tags: hairloss, hair loss, mma, exercise, shampoo

Will Propecia Protect My Hair from Loss Following Underbite Correction Surgery?

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

Dr. Rassmann,

I am 21 year old male and I recently had surgery to correct an underbite. I started propecia shortly after my surgery. Will the propecia protect against possible shock loss after the surgery? I’m concerned because I saw in earlier posts that in balding men with shock hair loss, the hair does not usually return.

Propecia is taken for treating androgenic alopecia, not for shock loss following underbite correction surgery. Hair loss after general anesthesia or medical issues is not related to androgenic alopecia.

If you were prescribed Propecia to treat your genetic hair loss, it might protect you… but I wouldn’t recommend the medication solely for protecting from a temporary shock loss.

Tags: shock loss, oral surgery, hairloss, hair loss, propecia, finasteride

My Hair Has Become Thin, And I Wonder If It Is From Cigarettes

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

some time ago i’ve noticed my hair becoming thin, i also have a bad habit of smoking cigs which ive been smoking for 2 years. so i figured if i stop smoking my hair might grow back thicker and fuller.well i just recently stopped smoking cigs for about a week.

not enough time has gone by to see if my hair would grow back, but i wanted to see if i could save my hair and whether or not cigs have anything to do with it

I don’t know anything about you other than you’re losing hair and smoked for 2 years. Smoking might contribute indirectly in some way, but I doubt that it is the reason your hair is thinning. In the great majority of cases, it is your genetics that causes hair loss. Of course I recommend that you stop smoking for your overall health, but I wouldn’t expect that quitting smoking would make your hair regrow.

Tags: cigarettes, smoking, hairloss, hair loss

I’m Scared of What I Read About Propecia AND Minoxidil’s Libido Issues

/by William Rassman, M.D./11 /

Listen guys, I am sure you get this question a lot, but I’m 18 years old. Within the last year, my hairline has receded noticeable and on the crown of my head there is definitely thinning.

The side-effects of propecia (loss of libido, impotence, etc) turned me off to the product, so I first considered minoxodil (aka rogaine), well upon further research it seems that rogaine has a very rare and similar side-effects such as loss of libido and impotence which is long-lasting affecting the youthful and the more elderly.

Can anyone clear the air on this matter, please if you use/used rogaine explain if those horror stories hold any water. The company does not list it as a possible side-effect, but the amount of scenarios ive read on the internet (i know not very reliable) has implanted an idea that this may somehow be correlated with sexual side-effects.

I appreciate all of the help, I would really like to retain what I have, family does not have a good history with balding, yet speaking with them all, I am very young to have already begun experiencing this, most of them began in their late 20’s early 30’s, so I’m crossing my fingers because i like wearing my hair long.

All medications have side effect potential. Growing old also has a side effect of loss of libido, as well. Thinking about a side effect and growing scared to take a medication due to possible side effect after reading (as you state) “unreliable” information on the Internet, can cause that side effect to manifest itself.

I am sure you will find people who used Rogaine (minoxidil) claiming loss of libido, but it’s not a known side effect in the literature as far as I’m aware. Many of the people on forums that talk about various side effects they get from any medication diagnose themselves and look for the easiest answer to come up with as a source of their problems.

Get a clear diagnosis of your medication condition. Then find a doctor who can go over your treatment goals and come up with a Master Plan. After weighing out your risk and benefits, you can make the ultimate decision if you want to take the medication.

Tags: minoxidil, rogaine, libido, side effects, propecia, hairloss, hair loss

Female Hair Loss After Hormone Replacement Therapy?

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

I have lost more then 40% of my hair. My dermatologist said I am still actively shedding. I had hormone replacement. I was told in October of 2011 that my level was a 4. I have had a hysterectomy and am menopausal.

A pellet of testosterone was inserted sub-subcutaneously I February. I developed severe cystic acne, shortly after. My testosterone levels were three times the norm from my age (in the high 200s almost 300) and sex. My dermatologist advised me to not get implanted again- then three months later my hair began to fall out. My dermatologist said this also was a result of the drastic swing in my testosterone levels- they are still quite high.

The men in my family start to experience hair loss around age 20. I’ve never seen a female in my family lose hair,- they have it in their 90s. Shouldn’t women be warned that Hormone replacement therapy can cause hair loss? I have no other health issues, had no disease or took other medications that cause hair loss.

I realize you are experiencing hair loss, but I cannot say if hormone replacement itself is the cause or if there should be a mandatory warning label associated with the therapy. Menopause itself could be the cause or there may be other medical issues, as well. I believe you are under the care of a physician and communications between patient and doctor is the most important element. My point is, before you start any medical treatment, side effects and treatment issues should always be explored.

Tags: hormone replacement, female hair loss, hairloss, hair loss

I’ve Had Sexual Side Effects Since Switching to Generic Finasteride 2 Years Ago

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

Hey Dr. Rassman,

Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)

However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:

1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.

2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?

Thanks

Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.

While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.

Tags: finasteride, propecia, hairloss, hair loss

Handfuls of Hair Come Out a Few Months After Giving Birth

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

I am 26 years old, and I recently gave birth to my 2nd child (4 months old), and noticed a significant increase in hair loss. We are talking handfuls come out in the shower, or even just brushing my hair. In addition, my scalp has become incredibly itchy. Is it the stress? Are they related? What is causing it?

Some women complain of hair loss after child birth. It may be due to hormonal changes your body goes through, but it is not well understood. There is no cure for this phenomenon, but the hair grows back usually after about one year.

Tags: childbirth, pregnancy, hairloss, hair loss

Another Hair Transplant Failure, This Time with Photos

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

We’ve written about hair transplant failures before (here and here), but this time we have some photos that we’ve been given permission to share.

This patient had 1000 grafts placed into the frontal area 10 years ago (not with us). Around 95% of the grafts have failed to grow either initially or since the surgery. In looking for a cause of the failure, I found that the donor area was taken from neck hair, not scalp hair. The incision high in the neck from a strip surgery healed better than most neck incisions, but below the incision the hair is significantly thinner than the area above it (see photos below).

The cause of the failure of the grafts could be from:

  1. The use of neck hair in the recipient area. It is well known that neck hair is not permanent and as this patient has thinning of the neck hair today (10 years after his transplant was done), it is possible that aptosis (cell death) was induced from the neck hair transplant.
  2. A failure of the quality control in the hair transplant process.
  3. A failure of the technique at the time of surgery.

Click the photos to enlarge.

 

Tags: hair transplant, failure, hairloss, hair loss, fail

How Bad Would a Thin Strip Scar Really Look If I Shaved My Head?

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

Hello, thank you Dr. Rassman and Dr. Pak, for maintaining this fantastic site.

You’ve explained that once transplant surgery has been performed, a patient cannot shave his head without scarring (either a FUT line or FUE dots) being visible.

My question is: If someone had a thin scar from FUT, would it really look so terrible if they shaved their head in the future (if Finasteride’s effectiveness waned and hair cloning treatments fail to emerge, and they become an advanced Norwood 6/7)?

Obviously, there are pictures of strip scars online, but it’s difficult to imagine what they would look like on a shaved head. Do you know of any patients who have done this?

You can look at how bad strip scars may look on our scalpmicropigmentation.com website (see some of the before photos of scalp scars). Unless you shave your head, even the wider scar is not visible with long hair. My scar, after three strip surgeries, can barely be seen; however, if I decided to shave my head, everyone would see the 1-2mm scar I have. Now unless you are wanting to completely shave your head, you should not have to worry about the strip scar.

In general, you can keep your hair cut as short with a number 2 to 3 guard on hair clippers without the scar being noticeable in most cases.

Tags: hairloss, hair loss, hair transplant, scarring, scar

Bill Gates Criticizes That More Money is Spent on Balding Cures than Polio and Malaria Vaccines

/by William Rassman, M.D./11 /

Mr Rassman,

I have a question for you regarding Bill Gates. He’s always on TV talking about how there is less money being put into polio and malaria research than there is to balding cures. He criticizes this. I think more money should go to hair loss than polio and malaria combined. Hair loss causes so much grief and difficulty for men. I think he just doesn’t understand it and might change his tune if he were bald. What do you think?

We wrote about Bill Gates’ quote years ago here.

I am in the business of hair restoration, and even I agree that polio and malaria treatments are more important than curing balding. Hair loss, while it causes grief and stress to men and women, is not a disease, but rather a heritable pattern of hair loss. It does not cause death like polio and malaria. Some may not agree with me, but hair loss is not a disease.

Tags: polio, malaria, hair loss, hairloss, bill gates

I Saw Amazing Finasteride and Minoxidil Regrowth Photos, So Will My Hair Look Like That?

/by William Rassman, M.D./13 /

Hi doctor!

I was researching before and after pics for finasteride results when I stumbled on this link from Dr. Bernsteins website.

According to his site these are all patients who took finasteride or minoxidil or both ONLY. No surgical procedures on these patients. And I must say the results are pretty thumping good! I am 22 and recently was prescribed about a month ago for early hairloss. At this point i seem to be heading towards a Norwood 3 with a persistent forelock (as of now) no major recession or erosion of the hairline just many shorter hairs in the front that “appear” The same thickness but just aren’t getting as long as my “long hair”. My coarse dark hair however does look incredibly thin when wet but when dry it’s extremely thick appearing. I get compliments on how much hair I have. So there is no noticeable balding or thinning happening to the outside world yet.

My question is why do you say in many posts that finasteride and minoxidil do not work in the frontal scalp and hairline?

According to these patients almost EVERY person of all age ranges seem to have gotten a good bit of positive results from the medications alone including crown AND frontal regrowth. I only ask because I am hopeful that finasteride will produce similar results for me and if nothing else maintain what I have. I currently have no thinning in crown, that’s actually my thickest area of my hair.

I am 22 and given where I currently stand would you say that finasteride has a good chance of working for me? About what percentage of men see NO RESULTS from finasteride and continue to thin At the same pace? I am worried that I will be one of the patients that see no response from it :(

Thanks for your time and your informative site!

The photos you saw on Dr. Bernstein’s site are amazing, and I have seen results like this for myself on occasion at my office. But regrowth at the front is rare (probably under 5%) compared to the results that are more common in the top/crown.

The photos show what is possible, but you have to remember that everyone will react differently to medication. Dr. Bernstein was not implying guaranteed results, but just showing some examples of positive growth. Medication might regrow your hairline, but you shouldn’t expect it to.

I have no way to know if finasteride will work for you, but you can have a HairDX finasteride response test done if you’re curious. If anything, I would expect to arrest your hair loss to give you more time with hair. If it regrows, that’s the icing on the cake.

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

My Husband Took Propecia for 8 Years and Now We Want to Get Pregnant

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

My husband has taken Propecia for hair loss for 8 years and I am concerned about his sperm count because we want to get pregnant. How long does it take to leave the body? Is there a danger to the fetus? Does it cause fertility problems? I am very concerned and wish he never took this drug.

In general, men can continue to take Propecia while trying to conceive. This is safe and there should not be a danger to the fetus. However, in my practice I generally advise men to stop taking Propecia for the two week mid-cycle so that there can be no question as to the safety issue and to put the patient’s mind at ease. Propecia is out of the blood stream within 24 hours and out of the tissue in a few days.

The most important part to this is to talk with your doctor and discuss these concerns with them.

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

What’s the Average Number of Grafts That Can Be Transplanted in a Lifetime?

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

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

Generally there are around 6,000 to 10,000, but it is depending on many factors, including race, ethnicity, scalp laxity, and hair density. We have transplanted as high as 10,000 grafts in a few of our patients over several surgeries. Others we max out at 6,000. Every patient is different.

The second part of your question was answered here — Can You Get More Grafts from Strip or FUE Over a Lifetime?

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

What Can I Do About a Scar On My Forehead?

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

Hi Dr. Rassman,
I am still waiting to do my first surgery with you in the LA office. An off-topic question today:

I have a 0.7cm scar in my forehead that resulted from a home accident by opening a door. Do you know of good doctors, laser surgery or other means, in the Los Angeles area who can remove such a scar?

I am thinking to do it along with my first strip surgery on a trip to California. All the best doctor.

There is no such product that exists that removes scars. Some scars can be modified in the hands of a good plastic surgeon. There may be ways to minimize the appearance of scars, but this is very specialized to the individual and the type of scar.

We will look at you when you come in and we’ll be able to give you an opinion then.

Tags: scarring, scar, scalp scar

Not Hair Loss News – Egg Yolks Can Be Dangerous to Your Health?

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

Snippet from the non-hair-loss article:

Researchers who have long argued that egg-yolk consumption contributes to cardiovascular disease have now published a study showing that lifelong consumption of egg yolks is correlated to development of carotid artery plaques and therefore should be avoided by anyone at risk for cardiovascular disease.

Dr J David Spence (Robarts Research Institute, London, ON) publish the results of a study of 1262 consecutive patients attending vascular prevention clinics in Canada online August 1, 2012 in Atherosclerosis. All of the subjects had baseline measurement of total carotid plaque area by ultrasound and filled out questionnaires about their diet and lifestyle, including medications they take, smoking, and the number of egg yolks they’ve eaten per week times the number of years they’ve kept that dietary pattern (egg-yolk years).

The results show that carotid plaque area increased linearly with age after age 40 and increased exponentially with both pack-years of smoking and egg-yolk years.

Egg yolkRead the rest — Debate Over Dangers of Egg-Yolk Consumption Continues With New Study

The article goes on to point out that the egg industry says the study was poorly done by a longtime critic of the industry, and they cite a small study that disputes the findings. So while this could potentially be important health news, I guess it depends on who you believe.

Still, this might be something to keep this in mind what you eat eggs. I personally only like the eggs if there is a yolk in it, so I guess that stops another bit of goodness from my healthy diet.

Tags: eggs, cardiovascular, cholesterol, yolk, cardio, medical, health