My Hair Isn’t Growing as Fast Anymore

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

hi. i have fine hair but have always worn my hair long. so i first noticed it was going when i seen it wasnt growing as fast and what does grow is really stringy. i was wondering would propecia reverse this so that when it grows its thicker? im also 24 years old so hopefully i fall into the younger crowd that gets really good results!

Propecia does not grow hair any faster. It is a medication to treat androgenic alopecia. You need to see a doctor who can examine your hair for miniaturization and for signs of androgenic alopecia if you are to be a candidate for such medication. If you are actually losing some hair due to genetic causes and your doctor prescribes Propecia, I still wouldn’t know if you’d fall into that crowd that gets really good results. Each person is different. Some people get headache relief from one ibuprofen pill, some people will need to take a couple. But keep your fingers crossed!

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

Taking Finasteride at 17 Years Old

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

Hello Doctor Rassman,
I have come to you as you are the first and final ray of hope for me to save my hair. I’m 17.5, male, and I play guitar, longing to become a rockstar some day. I started to lose hair one year ago, yet back then it was too subtle and I was able to successfully hide it…But now it’s different. My hair loss is becoming as visible as daylight and is becoming harder to hide as we speak.

As you can probably tell, I live in a place -heck, a country- where, for my seriously bad luck, no Proscar is available. I have explored various online pharmacy sites that supposedly sell genuine Proscar without prescriptions, yet I preferred not to risk such a thing. It is because of this that I come to you and ask of a genuine Proscar prescription that can permit me to purchase Proscar from a trusted online pharmacy.

I heard that taking Proscar at this age may disrupt the growth phase and turn me more “feminine”. Is this the case in every seventeen/eighteen-year old who decides to take Proscar? Plus, do the feminine side-effects instantly wear off as soon as I stop?

I’m really confused as to whether I should take Proscar or not.. I want to grow normally, lead a normal male life, but I’ll definitely be bald by a year from now. It’s a dilemma I really need your help and advice in to solve. Please, I swear to everything holy that you are the only person who can help me in overcoming this disaster.

You’ve referred to Proscar over and over, but I have to assume you mean Propecia since you’re talking about treating hair loss. Just to clarify, Proscar is 5mg finasteride and Propecia is 1mg of the same medication. The lesser dose is for treating hair loss, the higher dose is for treating prostate problems. If you get Proscar (or generic 5mg finasteride), it should be cut into smaller pieces if you’re treating hair loss. Now that that is out of the way…

I do not prescribe drugs without seeing a patient, as it is against California law. The risks for a 17 year old are minimal (it was studied in men as young as 18, however). I have prescribed the drug for men at your age, but you need to have a doctor involved and the dose should be 1mg of finasteride if it is indicated for you. I can’t tell you if finasteride is even right for you, as I’ve not seen you and I don’t know enough about your medical history, family history, etc. Please, please see a doctor. You’re 17 and likely in the early stages of losing your hair, which is when Propecia works best. I’m not sure which country you’re in, but I’d assume if you’re having a difficult time finding Propecia or Proscar name brand, you can find the generic name, finasteride.

Tags: finasteride, propecia, proscar, teen, hairloss, hair loss

What Percentage of People Are Happy with Hair Transplants?

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

Thanks for the forum Dr. Rassmun, it has been very informative. I do a lot of research on the internet and it seems that people are all for hair translplants or they are all against them with many failure and nightmare stories. I saw something you wrote saying hair grows for 99% of translpants, but gaging from other sites it seems like 50,50. I was wondering if you could give me a ballpark number in your experience of people who are happy with their transplant to people who are not.

Anyways I am 24 and have pretty accelerated hair loss, but the back and sides of my hair is pretty strong and thick. Does the regrowth of transplanted hair in the mid 20s have a better look than transplanted hair later in life? Its seems the pictures Ive seen have led me to believe this, thank you for your time and keep up the good work.

Generally, delaying hair transplants just increases the suffering time for those individuals who are bothered by the balding process. Why delay a hair transplant when the young man needs and wants the youthful impact of a full head of hair? If you wait until you are 60 years old, then you will look older until the day you decide to be transplanted. A 25 year old may look 40, a 40 year old may look 50 or 60, and a balding 60 year old may look 80. A hairy 25 year old will look 25 and that is what most 25 year old people want. I have transplanted many 40, 50, and 60 year old men who look 10-20 years younger with hair.

Satisfaction rates in my practice are very high, not just because we are good surgeons and know what we are doing, but because we set expectations correctly, do not employ salesmen who get a commission for selling you what you may not really want or afford, and we give all of our patients access to previously transplant patients at our monthly open house events. Patient education is at the foundation of satisfied patients.

Tags: hair transplant, hair loss, hairloss, satisfaction

I’m 22 Years Old and Showing Norwood Class 4 Already!

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

hi dr. william rassman.

i am a 22 year man suffering from male baldness pattern near to stage 4. at this young age i have lost most of my front hair and from front i am almost completely bald. i want to have hair transplant surgery within next a year or two. what is your suggestion? thanks and waiting for your reply soon.

Norwood 4Without an examination, I can’t tell you whether you are a candidate for transplantation or not. You should have your scalp mapped for miniaturization, which will help determine how advanced your hair loss pattern will get. For example, you wouldn’t want to rush into a surgery at 22 years old only to lose more hair as the years pass, leaving you with an unnatural looking pattern. At your age with class 4 hair loss, your pattern may continue to recede further. You should meet with a doctor that can help you form a Master Plan (an outline of your surgical requirements and plans for the future). The use of Propecia (finasteride) should be an absolute in slowing or stopping the hair loss in its tracks. Don’t get me wrong, even at 22 years old you still might be a candidate for a hair transplant, but you need to have a good doctor focus on building your Master Plan that will protect you for years to come.

Tags: hair loss, hairloss, hair transplant, norwood

50% Miniaturization and Losing Hair When You’re Young

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

dr rassman
in your experience is it always evident that the earlier the balding process begins the more advanced the pattern will be? or can an individual simply be limited to losing only his crown at 20 years old then have the hairloss stabilize?

also when someone is diagnosed as having 50 % miniaturization does that refer to their entire scalp or a specific area (ie the crown is 50% miniturized)

It is possible that you could start losing hair early and have it stabilize. When Dr. Norwood did the original study for classifying hair loss, he did note that of those men who progressed to a Class 6, the hair loss started in their early 20s. But, your hair loss pattern is decided by your genetics. Or in other words, if you lose your crown hair at 20 years old it doesn’t necessarily mean you’re going to be a Norwood 7 by the time you’re 30.

But in your case with 50% miniaturization, I assume whoever did that test was talking about the entire scalp, not just the crown. I don’t know how the measurements were taken, though. If you have 50% miniaturization throughout the top of your head, you’re likely going to have a large balding area. I generally measure each area in the balding patterns so that I can predict where the patient might go as they lose their hair. From these numbers, i will re-look at the patient in a year and see if there were benefits from medication and assess what the value of the drug was in modifying the hair loss pattern and rate of appearance.

Tags: miniaturization, hairloss, hair loss, genetics, norwood, age

I’m in My 60s and Losing Transplanted Hair — Would Avodart Stabilize That?

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

Hello Dr. Rassman,
In your opinion, would avodart as a substitute for propecia in my situation be ok to take & would the avodart dosage be more effective in stabilizing hair loss? I’m in my 60’s & the avodart sterility side effects don’t concern me. I have been taking propecia for approx. 8 years, & have been experiencing substantial hair loss in the last few years of even previously transplanted hairs from two HT’s as I was a Norwood 6-7, & had very thin, fine hair in my donor site, & quite bald on top.

I’m out of state now, but my surgeon is very well known & extremely skilled & I respect him & was enormously happy with my HT’s I had 7-8 years ago. I’m assuming my donor hair is one of the few cases where it wasn’t destined to last a lifetime. I still some have hairs on top, but quite thin & sparse.

I realize you won’t give specific suggestions concerning Avodart, but any direction would be appreciated. I don’ want to go back to wearing a hairpiece (over 30 years)! Thank you!

Taking Avodart (dutasteride) for a man over 55 years old and not concerned about fathering more children is a reasonable approach. I have heard from the transplant physician community that when hair loss is not stopped with Propecia, the use of Avodart may help.

I am curious about the loss of your transplanted hair, however. This should not typically occur and should be discussed with your surgeon. Don’t just assume! Talk to your doctor!

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

I’m in My 60s and Worried About Possible Shock Loss

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

I’m thinking about an HT, and after reading all your topics I see my biggest concern is shock loss. I’m a 61 year old male and have a high degree of miniaturization in the proposed recipient area. In one of your responses, I believe you recommended not having an HT for thinning hair?

You often recommend Propecia for younger men and say it might prevent shock loss for possibly 90+ cases? You also recommend taking Propecia 2 weeks to a month in advance of the HT(but even the day before the HT is better than not at all?). Would this advice apply to an older guy like me? Or if I’m correct that you would not advise cases of older age onset thinning to not seek HT?

Propecia works at any age to prevent shock loss. It is best to use this medication in advance of the surgery (at least 2-4 weeks). Older men generally have less hair transplant shock loss than younger men. I would need to know more about your miniaturization and your last 1-2 year history of hair loss. At 61 years old, few men are actively losing hair.

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

Age and Finasteride

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

Doc,

Do you find older men may need more that 1 mg of Propecia. I’m in my 50’s.

Not usually. The dose is fairly standard and effective for treating hair loss at the 1mg level. More won’t hurt (possibly more side effects), but the impact just might be stronger in a slightly higher dose. Also remember that Proscar (finasteride 5mg) is commonly used for treating the prostate, something that older men should be concerned with.

Tags: proscar, finasteride, prostate, hairloss, hair loss

Mature Hairline and Race

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

hey im really concerned because i noticed the corners of my hairline has went back a little. im only 17 and im african american and i heard its not just a maturing hairline because that only happens to caucasians. please help

The hairlines of different races do vary and the mature hairline of an African American is different than a Caucasian. You need to see a good dermatologist to determine if you are now balding or if this is a maturing hairline you’re seeing. I would be happy to evaluate you if you’d like to send photos to the address on the Contact page. Otherwise, you can find a hair transplant doctor in your area by checking the physician search at ISHRS.org (I’m not suggesting you have surgery, but these doctors will know a lot about hair).

Tags: race, mature hairline, hairline, hairloss, hair loss

My 3 Year Old Has a Scar on Her Scalp with Hair Loss

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

Dear Sir,

I have read responses on your most helpful website. I hope you can help me.

My 3 year old daughter had a laceration to the back of her head 4 weeks ago. The cut was closed at hospital casualty with medical glue. The scar is about 4cm in length. The area around the scar is bald (say 2cm to 3cm either side).

Please could you advise if you think the hair will grow back on the area not scarred? I note with interest that you were in Vietnam. From what I have read the medical glues were first used there. Do you know if they led to such cases of baldness? If so, was it just short term? Also what can be done for hair restoration on the scar itself e.g. will hair grow back? Is it best left? can a transplant be done if necessary?.

This is really worrying me. Kind regards

Some hairs should grow back, but there may be an area where hair will not regrow. Medical glue does not cause scarring, but the lacerations will.

Hair transplantation can be done if necessary, but you should wait at least one year to allow hair to regrow to see what happens. Having a hair transplant at 4 years old is generally not advisable for fixing the scar, so perhaps you should wait until your daughter is older until she has a maturity level to undergo such a procedure. The best age will be determined between you and her doctor. Most girls under 8 years old do not really focus on small scars.

Tags: scar, hairloss, hair loss, injury, wound, laceration, child

My Toddler Daughter Has Had a Large Bald Spot Since Birth

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

My 16 month old daughter has had a rather large bald spot since birth. It is about half of the back of her head. If you were to draw a line from the left ear to the right ear, the entire area below it only seems to grow very short, fine hair. Also, there are numerous tiny red spider veins in this area. I have no idea what this could be. Her hair is growing on the top and the sides of her head, although the hair on top is really short. I’ve had lots of people ask if they are bangs that I have cut. She prefers to sleep on her belly and I very rarely see her sleeping on her back. She is otherwise a very healthy vivacious little girl. She has another well visit in 2 months where I will address it with the pediatrician. She never mentioned any concern before, but it’s starting to worry me. Any help would be appreciated. Thanks.

Although you have an appointment with her pediatrician in a couple months, I would suggest that you bring her to a dermatologist with an interest in children’s hair loss. There is no urgency here, so take your time and find the best doctor. The American Academy of Dermatology site has a dermatologist search, and I’d start with those physicians that list “pediatric dermatology” as a specialty.

Tags: dermatology, dermatologist, hairloss, hair loss, child, pediatrician

Are More Young People Losing Hair Now Compared to In Past Years?

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

In your experience, in the past few years have you noticed a higher percentage of young people (15-20 years old) losing their hair compared to years past?

Shaved headThere’s a couple ways to look at this —

  1. The shaved head look is quite common, possibly more so than in the past, so it’s difficult to tell who is doing it because they’re balding or who is doing it for style.
  2. The internet has changed the lives of many people, especially with regard to education. Balding impacts many millions of young men and women, and they can get educated and become more proactive because of what they learn about hair loss and treatment options. So if anything, I’d expect less young people would be losing hair compared to years past.

However, the answer to your question is that there is no more balding today than in the past.

Tags: hairloss, hair loss, history, teen, youth, young

I’m 18 Years Old and Can’t Cope with My Hair Loss

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

I went to the dermatologist this week to confirm that I had male pattern baldness, which he did confirm. I am only 18 years old, and since I am so young, I am not dealing with this very well. I cannot find much information on people close to my age balding, so I assume it is relatively rare. I am currently on 1mg of propecia a day and will start rogaine shortly. I just do not know how I am going to cope with this. I am so young, and it feels like balding will hinder my social life. I haven’t hung out with friends since I realized I was going bald. I don’t know how they will react of if they will treat me differently. I don’t know how I am ever going to get a girlfriend now. Do you have any advice on how someone as young as me can cope with the feeling that my life has been devastated?

Most of the young men I treat, like yourself, get great response from Propecia (finasteride) and do not show any balding when picked up early. I have even seen men of your age reverse the balding process. Make sure that what you are seeing is not the maturing hairline, because the drug will not reverse this. Speak with your parents and the doctor who prescribed Propecia. This isn’t a death sentence and you do have options. You should be commended for the courage to start the correct treatment early and I’m hoping you will be spared the balding problem for years.

Tags: propecia, finasteride, youth, young man, hairloss, hair loss

I’m In My Mid-30s and I Have No Hair Loss

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

If I have all my hair at 35 (going on 36) and its thick, do not take after my father side of the family genetically. He’s was dark haired, brown eyes had some sort of pattern baldness. Mom is blond hair, somewhat fair and has green eyes. I am somewhat fair, blonde, blue eyes and have a thick head of hair. Will I keep most of my hair for a while? Or would you need more info to make a better determination? Does sexuality play a role also?

If you are 35 years old and there is no hair loss, then statistically your chances of going bald are very, very slim. To be sure, map out your hair and scalp for miniaturization and it should record a number of miniaturized hairs under 20% of what you have on your head.

As for sexuality… if you are asking if you will lose hair from a sex drive in overdrive, the answer is no.

Tags: sex drive, hairloss, hair loss

16 Year Old Girl’s Shrinking Widow’s Peak

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

Hi I’m a female and only 16 but my question is about my widow’s peak. Well, it used to be the same length as the rest of my hair but after messing with it for the past few years its gotten shorter and shorter and now its become a habit and I can’t stop messing with it. I just want to know if it will ever grow out again if I stop twirling it with my fingers? Or is there anything else I can do to make it grow out again? It’s become so short that if I dont use serum or other products like hairspray to keep it down it just sticks out. Please help!

If you play with the widow’s peak, it may produce some level of traction alopecia and that could cause you to lose your widow’s peak. Even if you don’t play and tug on it, it may still disappear. The shape of hairlines may change as you get out of your teenage years.

Tags: hairline, widow’s peak, female hair loss, hairloss, hair loss, teen