Hello – I’m a 38 year old woman. A few years ago I had a couple of bald patches appear on the top of my head, caused by work stress. About 6 months ago they started itching, I went to a dermatologist yesterday who says I have pseudopelade of brocq. Of which there is no cure, I’m told. The patches are about 2cm by 1cm and about 1cm square. I’ve had to move my parting so that I know no one can see it.

Do you know if there is anything I can do to help it? I’ve heard that derma micro needling can help to regrow? What about some form of tattoo? Any help appreciated.

For those unfamiliar with the term “pseudopelade”, here’s the origin from Medscape — “In 1888, Brocq used the term pseudopelade to describe a unique form of cicatricial alopecia resembling alopecia areata (Pelade is the French term for alopecia areata).

In short, it is a scarring type of alopecia without a good medical treatment. Micro needling will not work.

Your last option may be Scalp MicroPigmentation (SMP), but that will only color in your scalp. This may work for men who can shave their head to make it look uniform, but for women with any length of their hair surrounding the patches it may not work to maintain a natural appearance. We have treated many scarring alopecia patients with great results using SMP.

Tags: pseudopelade, scarring alopecia, hairloss, hair loss, cicatricial alopecia, smp

Hi, i’m 22 and i’ve always had a high hairline but i’ve noticed that it moved up slightly lately. When I was about 18/19 I started to notice maybe between 5-10 hairs would come off in my hand when I was shampooing my hair. i’ve always had an extremely thick head of hair and still do so i’m thinking this could be normal and just the hair finishing its cycle hopefully.

I checked the last wrinkle on my forehead and noticed that my hair line has moved up maybe half an inch or less from the last wrinkle and my current hairline runs in the exact same shape as the highest wrinkle. I always check for miniature hairs and couldn’t find any obviously examples of any, maybe 1 or 2 hairs at the front of my hairline were slightly thinner but all were the same length.

In terms of family history on my fathers side of the family they all have my same extremely thick black hair and no one on the that side of the family have ever went bald, father is 53 and his got a full head of hair with no greying. on my mom’s side of the family all my uncles still have good hair and they’re in their 50-60 age group, grandfather that side still has a good head of hair into his 80’s. Only one cousin I can think of in my whole extended family has a receding hairline and he is about 35.

Should I consult a doctor or wait for further signs of hair loss?

ShowerIt’s normal to lose hair in the shower, as the water can dislodge some of the trapped hair (from hairspray or other styling agents) that would’ve fallen out throughout the day as part of the normal hair cycling process. That part doesn’t sound unusual to me.

If your hairline is moving up, that could either be the maturation (normal process) of the hairline or it could be genetic hair loss. There’s really no way for me to know that just based on reading your email. If you’re concerned, get a consult with a doctor that can measure your hair bulk so that you can have a metric to compare to in another year.

Tags: hairloss, hair loss, mature hairline, showering

Snippet from the article:

Daily treatments of dutasteride 0.5 mg were more effective than finasteride 1 mg daily or placebo in increasing hair count and width in men with androgenetic alopecia, according to recent study results.

Researchers randomly assigned 917 men, aged 25 to 50 years with androgenetic alopecia, to dutasteride at 0.02 mg/day (n=185), 0.1 mg/day (n=188), or 0.5 mg/day (n=184), finasteride at 1 mg/day (n=179) or placebo (n=181) for 24 weeks. Hair count in a 2.54-cm diameter was the primary endpoint, while hair count (1.13-cm diameter) and width, photographic assessments by investigators and panel, change in stage and health outcomes also were assessed.

Researchers observed that in patients assigned dutasteride, hair count and width increased dose-dependently. At week 24, dutasteride 0.5 mg increased hair count (P=.003) and width (P=.004) in a 2.54-cm diameter and improved hair growth (frontal view, panel photographic assessment; P=.002) compared with finasteride and placebo (P<.001, all).[/bq] Read the rest — Dutasteride superior to finasteride in restoring hair in male alopecia patients

You can read the study abstract here.

There are still the looming questions about sterility, which have not been addressed in this study. Dutasteride may have more such side effects, as have been reported with the higher dosage for treating prostate issues. Either way, if a doctor prescribes this off-label for treating hair loss, that is a decision between physician and patient.

Tags: dutasteride, avodart, propecia, finasteride, hairloss, hair loss

Snippet from the article:

To evaluate its association with environmental factors, the researchers at Chung-Ang examined 3,114 Koreans with androgenetic alopecia who attended dermatology clinics between March 2011 and February 2012. Then dermatologists evaluated the patients using a questionnaire to ascertain the perceptible duration of hair loss and personal factors including family history, disease and medication history, and drinking and smoking habits. They also medically classified the hair loss based on shape and density of the hair.

The research showed that the men in the “both the drinking and smoking” group tended to have more severe hair loss. In female patients, however, they found no association, probably due to the relatively small number of the women in the smoking and drinking group.

“The mechanisms by which smoking causes hair loss may be multi-factorial. Cigarette smoking may be deleterious to the microvasculature of the dermal hair papilla and to the DNA of the hair follicle itself,” noted the research.

Read the rest — Drinking, smoking aggravating hair loss

You can see the full results as published in Clinical and Experimental Dermatology — An epidemiological study of androgenic alopecia in 3114 Korean patients.

The survey included 1883 males and 1231 female patients in South Korea, and looked at eating, sleeping, alcohol, and smoking habits. It’s an interesting survey, but I’ve noticed that many (if not most) men I see at my clinic do not smoke cigarettes, yet they are balding.

If the study finds that smoking and drinking can worsen hair loss, then maybe this is a good thing. Perhaps it will get some people to stop smoking and drinking in excess, even with the previously established health risks.

Tags: hairloss, hair loss, cigarettes, alcohol, korea

There is a man by the name of Alan Tomlinson (at least I think that’s his name) and he created a product called ZX42. There are videos on youtube as well as websites that sell his product along with before and after pictures that can be found on said websites as well as on Google images, of course.

The marketing used to promote this product is pretty lame, but some of the results I have seen the customers have with it (not to mention the product creator’s own progress with regrowing his front hairline back) makes me unsure as to feel about this product.

Have you heard of this product or not, Doctors? Also, if ZX42 were shipped to you, could you analyze the product and see what, if any, efficacy it has in aiding and abetting in the regrowing of hair and such?

Thank you.

ZX42I personally hadn’t heard of it before, but the marketing for it does look pretty poor. One claim the product makes is “get all of your hair back in a year.” That’s a very bold claim and ultimately I’m going to assume it is complete BS. There is nothing that will bring back all of your hair, and if this stuff had an validity it would be the talk of the internet and medical literature. When I Google it, all I see are people calling it a “fraud” and “scam”.

We do not test products. We basically subscribe to the saying: “If it sounds too good to be true, it probably is“.

Tags: zx42, hairloss, hair loss

Snippet from the article:

Scientists might be able to offer “hair-challenged” males a new glimmer of hope when it comes to reversing baldness.

Researchers from the University of Pennsylvania say they’ve gotten closer to being able to use stem cells to treat thinning hair — at least in mice.

The researchers said that although using stem cells to regenerate missing or dying hair follicles is considered a potential way to reverse hair loss, it hasn’t been possible to create adequate numbers of hair-follicle-generating stem cells — specifically cells of the epithelium, the name for tissues covering the surface of the body.

But new findings indicate that this may now be achievable.

Read the rest — Baldness Cure May Have Inched a Bit Closer

I’m hopeful this goes somewhere, but it’s important to keep in mind that this is still just research in mice. The article ends with: “Experts also note that studies conducted in animals often fail when tested in humans.

Tags: mice, stem cells, hairloss, hair loss

Hello doc. I’ve heard BPH was common for middle-aged men and elderly men. However, I just turned 20, and for some reason I’m having to urinate quite often (5-6 times a day) and when I do urinate I urinate for 2-3 seconds and I don’t overdrink. Do you think Proscar will help solve this issue? Coincidentally I am also thinning on the top, and I’ve heard people use Proscar to not only save money but treat their hair loss.

My question is, will Proscar help treat both my issues? And should I mention to my doctor that I have more than just thinning hair in order to get the cheaper DHT inhibitor?

First of all, you cannot self diagnose benign prostatic hyperplasia (BPH). At only 20 years old, it would be highly unlikely that your prostate is enlarged, but you need to see a doctor and have a physical examination. You can have another serious medical illness that causes frequent urination, such as diabetes, or even a bladder infection.

The thinning hair is another issue, and you should have another exam by a doctor to learn if you have genetic hair loss. If so, then finasteride may be a good medication for your doctor to prescribe. But until you have a diagnosis and a prescription, it’s all just guesswork.

So please, go see a doctor and have your issues properly diagnosed.

Tags: proscar, finasteride, propecia, hairloss, hair loss, mpb, bph

I am a 23 year old male and I noticed about six months ago that my hair was thinning. I went to a dermatologist a month and a half ago and got a prescription for propecia and have been taking it since. My hair has thinned out quite quickly almost seeming like it is spreading to everywhere just above my ears, and lately I have noticed that I am losing more than usual amounts of eyelash and eyebrow hair.

My eyebrows are also starting to grow blonde hairs. I also have a lot of blonde hairs growing on the top of my head, as my hair is naturally brown. I was just wondering if this is normal, or if maybe propecia is causing me to shed this hair? Or if anything else could be the cause? I have to go back to the dermatologist in 4 1/2 months to see how my progress is, but do you think I should go sooner?

What you perceive and what is real may be completely different. You need to follow up with your doctor. Hopefully you doctor took some pictures or took some objective measurements (such as a bulk analysis or a miniaturization study) to validate what you may be experiencing.

With respect to your eyebrow issue, I do not think it is related to Propecia. Maybe you have another diagnosed medical condition. Losing eyebrow and eyelash hair is cause for concern, as that points towards alopecia areata. Again, follow up with your doctor.

Tags: propecia, finasteride, eyebrow, eyelash, hairloss, hair loss

Snippet from the article:

Researchers in the US found of two groups of mice given the same cancer-inducing treatment, the group whose sleep was disrupted developed larger, more aggressive tumors than the well-rested mice.

In the journal Cancer Research, the team also reports how they found the immune system of the sleep-disrupted mice was less effective at fighting the early stages of cancer than the immune system of the well-rested mice.

Study director Prof. David Gozal says: “It’s not the tumor, it’s the immune system. Fragmented sleep changes how the immune system deals with cancer in ways that make the disease more aggressive.”

Read the rest — Disrupted sleep speeds up cancer

There was also a study published last year that linked sleep troubles with men’s prostate cancer risk. You can learn about that here.

Tags: cancer, sleep, tumors

I’m a 23 year old male. I am just starting to notice thinning in the temple region and a slight recession of my hairline. At the advice of my dermatologist, I am taking .5 mg of propecia daily. I’ve been taking it for 3 months. I will eventually move to 1 mg if side effects are a non issue.

So far, I am not experiencing any of the horror stories I’ve read about concerning loss of libido, gynecomastia, ED, etc. In fact, it is quite the opposite. What I am experiencing is premature ejaculation!

I’ve never experienced this before. Actually, I was the extreme opposite prior to propecia. This is a little embarrassing, doc! Any suggestions?

I don’t think I’ve met anyone who complained about experiencing premature ejaculation from Propecia (finasteride). I don’t see anything in the medical literature about it either, based on a few quick searches. It’s easy for people to pin random side effects onto finasteride, such as too much sensitivity, too little sensitivity, premature ejaculation, no ejaculation, etc, etc.

If you believe all the “horror stories”, and you are psychologically affected by it, sometimes you may end up experiencing everything you read about. The power of suggestion can be very strong. My suggestion is to follow up with your doctor.

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

I am a 55 year old man considering a hair transplant. Is there a benefit in taking Propecia a few weeks before and after the procedure? Will it result in a greater success rate of transplanted grafts? Also since I have lost the hair I am going to lose already, would there be a benefit in continuing the Propecia long term? Thank you so much Dr R.

You really should pose this question to your doctor (who has examined you and has a treatment plan for you). I don’t know enough about your hair loss history to be able to give you an idea about your possible successes, but in general, Propecia can be good for the crown and top areas with or without a hair transplant.

Propecia can diminish the risk of shock hair loss from a hair transplant surgery, but less so in a 55 year old. Everyone is different and every doctor has a different opinion, as there is no rule.

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

Female to male transgender question:

My dad’s family has male-pattern baldness. My mom’s family is unknown whether their side does or not. I think they do looking at my great-grandpa, but her father is in prison and I’ve never seen him.

Does taking testosterone make you have male pattern baldness?

If you have a genetic makeup for balding, then I suppose taking testosterone, an androgen, can cause male pattern baldness (androgenic alopecia).

Tags: hairloss, hair loss, female to male, transgender, testosterone

I am a 20-year-old male and I have asked a few questions before but this one is really bothering me. I began Propecia about two weeks ago. I think I am seeing some breast growth. I may be imagining things but I don’t know. I have read so many web forums that I know the side effects so I may just be freaking myself out. I have looked up gynecomastia online and see that it is actually breast tissue growth. Is the Propecia side effect increased breast tissue or just in increase in fat in the breast that could be fixed with exercise?

I would really appreciate a response. Thank you

You need an examination of your breast tissue if you think you have gynecomastia. While it is a very rare potential side effect of Propecia, gynecomastia can even occur in young men who are NOT on Propecia. Having only taken the medication for a couple of weeks, it would seem even more unlikely.

That said… what you’re seeing might be real, but I would think it’s more possible that you’re just freaking yourself out after reading web forum horror stories, as you suggested. I’ve written before about the power of suggestion.

Still, if you’re concerned you should have a doctor examine you, or at least talk to your prescribing doctor about stopping the medication or lowering your dosage.

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


I am experiencing loss in hair on both my eyebrows. I’ve done a lot of research on the internet and it all leads to the “castor oil” solution. I was wondering if you think it is safe to try that solution or if you can recommend me any others. I’m becoming more conscious of my eyebrow problem and hope to find a solution.

Thank You

You can try it, but I doubt it will work. I’m not sure why someone would think castor oil will grow hair on the eyebrows or scalp. With respect to safety, I would just point out some common sense stuff, like to not get the oil in your eyes. If you are going to try it, you should take some good before and after pictures… which, by the way, I don’t think anyone has.

One way for addressing eyebrow hair loss that works very well is hair transplantation to the eyebrows.

Tags: eyebrow loss, hair transplant, eyebrow transplant

I want to know more about ‘artificial hair implants’. i read a few articles on the net, these claim that its much safer now to have artificial hair implants then it was a few years ago. what is your take on this?

Artificial hair implants are not legal in the United States mostly due to safety reasons. I’ve seen horrible scarring from these procedures. I would not recommend having this done, even if new manufacturers claim to be “safer”.

Tags: artificial hair, hair transplant