I know there is often a lot of talk about celebrity hairlines, but one celebrity whose hair I’ve never seen on any blog is John O’Hurley, who is in fact known for his thick head of hair. I take particular interest because my hairline is very similar to his. It forms a stark v-shape and leaves his top brow ridge, but as far as I can tell has not receded over the decades. Is this representative of the “mature hairline,” or has he possibly had this hairline since birth? Any insight would be most appreciated.

Mature hair line is basically a hair line that develops from childhood to adult transition. Many young men think it is a sign of balding and toil over the definition or seek a diagnosis of this phenomenon to assuage the insecurity of hair loss.

John Hurley is not bald or balding. He still has a great head of hair as he had in his earlier years. The shape of his hair line is just his trait. I do not know what his hair line looked like in his childhood. Maybe his hair line changed a bit as he aged, but he is clearly not bald or balding.

I am losing hair at the top of my hair and now my scalp is becoming visible. I have tried strategically placing my hair pieces but its becoming very consuming. Please help me.

If your hair loss is an issue and you want medical or surgical options, you can always contact my office for a consultation. (800) NEW-HAIR

I am 18 years old and i have experience the hairless of a 40 year old man. The front of my hairline is 3 fingers above what it should be, and my temples are about 5. I have no idea what i should do. I tried laser but it does nothing but thicken my existing hair. I am losing hair fast and have been told i am a candidate for FUE. I wanted to ask if this is an acceptable procedure for someone my age and will I have to shave my hair. I am still in high school so obviously shaving my head is going to raise some discrimination on me. I try to hide by keeping it long but now its just a matter of time before someone makes a comment. What can i do

Genetic male pattern balding starts in your teenage years. I am sorry to say what you are going through can be considered normal for a 18 year old who was born with the genes for hair loss. If you want to do something about it from a medical point of view, you need to see a doctor who can guide you and explain to you all the options. Note that there is no cure for genetic hair loss. Hair transplant, drugs such as Propecia and Rogain can help, but there is no clear cut solution for everyone. Every person’s goals and expectations are different. There are many teenagers who shave their head without any discrimination but as you state, shaving your head will be an issue.

I am a 30 years old man, I have a hairy body, full beard and full chest hair, does it relate to baldness? I guess it means high in DHT to grow a hairy body, moreover, I saw most hairy men are bald, then it makes me think they are relevant, but what is your answer? Thank you

Body hair or beard hair does not relate to genetic male pattern balding. It is not the DHT that directly cause balding. It is the genetic trait that cause balding which, when present, triggers the balding process. If you have the genes for male pattern balding then DHT impacts your scalp hair usually in a pattern that is dictated by your genetics. If you do not have the genes for balding, the DHT does not matter.

What you are observing may be observation bias. Plenty of bald men have very full body hair.

(Since these topic tend to be hot debates, the following was taken from a comment section from a recent post) The statistics posted in this blog entry are not correct. The frequency of ED in men in the 20s is much lower than 20% and it does not increase linearly by 10% every decade. It would be nice because the numbers are convenient, but it just simply isn’t empirically observed.

If you look at the Propecia clinical trials which included men under the age of 40, only about 1% in the placebo had sexual problems of any kind. A lot of hair transplants make the argument that sexual dysfunction is common to minimize the likelihood that sexual problems are caused by Propecia, but this is never backed up by fact mainly because it isn’t true.

It is true that it has not been studied in detail how PDE5 inhibitors will affect men suffering from finasteride related side effects, but many men who develop irreversible side effects also report limited benefit from erectile dysfunction medications. These drugs work for certain types of ED, psychogenic ED included, but it is commonly observed that they are not very helpful for men with post-finasteride-syndrome.

The exact number or statistics on erectile dysfunction (ED) may be of debate since most of these studies are based on self assessment and honestly reporting that they actually have ED. For example, if you wear women’s lingerie, have a small penis, or cheated on your spouse, etc would you honestly answer such personal or embarrassing questions? The answers and its accuracy can vary widely depending on the setting of how the question was asked and even who administered the questions. You can lie just as easily based on the person’s agenda. I use the prevalence of ED numbers more as a generality. You can find evidence on the Internet that may affirm the statistics or disprove it.

As to the persistent side effects of Propecia and post-finasteride syndrome discussed around the web I think it is difficult to confirm. Most of it is “speculation” as noted even by the scientific community that supposedly study the phenomenon. It’s based on self reporting and never clearly back up. You’re basically trusting someone’s word that they cannot have an erection or orgasm.

If you really look into the websites that report these persistent side effects of Propecia/ finasteride, the hidden agenda is a legally motivated.

There are so many other medications (that is used to treat depression and anxiety, such as Zoloft, Lexapro, Xanax, even good old fashion alcohol and marijuana use) that can have a much more profound effect in orgasm, sexual desire, and erections. These are never discussed in the context of Propecia and ED.

I am not dismissing the idea that there may be long term issues with Propecia. It just seem strange that I have not come across someone with these long term side effects in my 23 years of practice.

1. Is initial shedding experienced with minoxidil the same as loss due to trauma? That is, does the initial shedding often experienced from a topical solution represent permanent loss (like loss from surgery or medications), or is it simply the start of a new hair cycle, with potentially thicker hairs growing back. Or is this the same as traumatized hair that, once it falls out, regrows weaker and smaller? I ask because I began adding liquid Rogaine on weekends in addition to the foam during the week (it is just too greasy otherwise), and I am hoping that maybe some of the most recent loss might have been caused by the liquid formulation.

Minoxidil is known to cause shedding in the initial use. It is not comparable to trauma. The hair should come back and start reversing from the short term loss within 2 or so months.

2. We discussed formula 82M. So, in addition to 5% minoxidil, it contains retinoic acid, tretinoin, 0.01% topical steroid fluocinolone, and oleanolic acid. I am just curious if you would expect to see any real difference in response to treatment between 82M as opposed to Rogaine. I have not felt any irritation from the 82M upon application, but my scalp has become extremely dry with a tremendous amount of skin flaking (when I wake up in the morning, my pillow looks like it has been sprinkled with confectioner’s sugar). I never had a problem with scalp irritation from either liquid or foam Rogaine. If there is no reason to expect different results from 82M versus regular minoxidil, I do not know that it will be worth using in the long run.

The various acids in the 82M or other similar medications generally cause the scalp irritation, dryness and flaking. The basic theory behind the extra ingredients is to irritate the skin to absorb the minoxidil better.

3. Many doctors promote PRP treatment, and I know you remain fairly skeptical without good clinical evidence, but have you actually seen positive results in any patients anywhere? Is it a hit-or-miss type of treatment, where some people respond and some do not, or is it purely nonsense?

PRP has not shown any value. This came up at the recent international meeting for hair restoration surgeons and after review, it was my conclusion from that meeting (as well as many of the respected doctors who where there) that PRP has little value, if any in the various balding or hair transplant scenarios.

I have not seen positive results or met anyone who claimed positive results.

4. There are no solid studies regarding the effectiveness of LLLT on hair growth. Despite the question of efficacy of LLLT, I wonder if it is still possible to determine which device may be the best choice for the end user. I was considering trying a new laser, if only for better coverage and convenience of use, but is there any reason to think that the hair cap, for example, is any better than other laser products?

I have tried LLLT on patients over the years and I never saw any value and that is my belief. One doctor I respect, told the meeting that of the various devices, the Laser Hair Comb might be the best. I ask the best of what?

I read about a compounded minoxidil solution called Formula 82M.

I have been using Minoxidil 5% for more than six years and I think I am losing the battle against baldness. Can the above solution give me much needed reinforcements?

Can you also please suggest any additives to minoxidil that can help in better hair growth?

Genetic hair loss has no cure. Topical minoxidil can help but there no scientific evidence that any additives or reformulations will help. Many compounding pharmacies and entrepreneurs will re-brand and add extra ingredients to promote a product. It works to generate interest and sales but it really has no clinical significance in overall improvement of growing hair. I always have states it is a buyer beware market. They may be no harm in trying different products other than the financial drain.