Young Girl Is Losing Hair

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

Dear Dr. Rassman,

I have a question.. I have a nine year old sister who has been losing a lot of hair for about four months now. She loses a lot when combing her hair, putting up in a pony tail, and when showering. She loses the most hair when she showers. She doesn’t have any bald spots, but my mom and I are getting really worried. What do you think the reason might be? Should we consult this with her doctor? I would really appreciate your help. Thank you.

Yes, I’d definitely would have her doctor take a look. There could be many causes for hair loss in women including an iron deficiency (if she is presently menstruating). The showering isn’t causing the hair loss, as you probably suspect, but constantly combing the hair can cause it to come out.

Tags: hairloss, hair loss, female hair loss, girl

The Corners of My Hairline Are About 2 Inches High

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

Good afternoon Doctor! I just want to thank you for this site.

Im an 18 year old boy, and since i was around 17 my hairline changed into what it now is today. However I’m not sure where to class ito n the norwood scale. The frontal hairline is, like you say in the normal place, exactly half an inch above the furrowed brow, however my concern is asscociated with the corners of the hairline. From the highest wrinkle, if i place a tape measure to the furthest point of the corner of the hairline it measures around 2 inches.

My question is with a corner reccession like this, could i still be placed in the Norwood 2 section? Because if you look at the stage 2 of the Norwood scale, the measurements found on this site for the mature hairline don’t appear to fit with it. The front of the hairline and the corners appear to have a far greater gap than the ‘norm’ of 1 – 1.5 inches…..

And just as a last question, if i start on Propecia at this age, is there a chance i could keep this hairline for the rest of my life? I hope i’ve been clear in what i’m saying. THanks alot and i look forward to your reply.

I’d stop trying to categorize yourself into a particular Norwood class. Perhaps you are a class 2 or class 3, but I really do not know (photos might help). Are you measuring at an angle? Assuming you’re seeing 2 inches when measuring perfectly vertical from the brow to the corner, it sounds like it’s past the Norwood class 2 level. But it seems more like things are changing and evolving as you are maturing. You’re 18 years old, and a maturing hairline is definitely not uncommon at that age. The real issue is finding out if you are actually balding or not.

Before thinking about Propecia or putting yourself into a category, go see a doctor and get your scalp mapped out for miniaturization. If you are indeed thinning, Propecia may be an option to halt further loss.

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

In the News – Kids with Alopecia Areata Treated with Stem Cells

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

Snippet from the article:

Children with alopecia areata, a condition that causes extensive, sometimes complete hair loss, grew hair after being injected with stem cells drawn from their own scalp in a small study.

Most of the five girls and three boys who had widespread baldness showed regrowth of as much as half of their hair in a preliminary study from Marwa Fawzi, a dermatologist at the University of Cairo Faculty of Medicine. Before the experimental treatment, some of the children had splotches of hair and baldness; others were almost totally bald.

Read the full article — Kids Shunned for Hair Loss Get Help From Their Own Stem Cells

Keep in mind that this is a treatment for alopecia areata, not male pattern baldness. That being said, even though it was an early study with only 8 kids, it’s something to research further and I’m hopeful something will come of it.

Tags: stem cells, children, alopecia areata, hairloss, hair loss

My Daughter Has Been Losing Hair Since She Was an Infant

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

My daughter started losing hair across the back of her head as an infant (like many do, from turning their head in their crib). It was breaking as much as it was falling out. It continued to break and be brittle. I was told by her pediatricians that she would grow out of it, and that nothing could be done. 4 years ago a dermatologist could not diagnose her either. She is 13 years old now and her hair has never been 100% haelthy, although she has had times when it was better than others. A week and a half ago she tried using Head and Shoulders shampoo, thinking it might help. As of last night, on the top and across the back of her head there is nearly no hair. She is not “bald” back there per se, but the hair there is less that 1/8 of an inch long. Another trip to a different dermatologist this morning revealed nothing. He had no idea, other than that it was “extreme, and apparently rare” and he did not know what the cause was. He suggested a peanut oil treatment and biotin. I’m considering asking her pediatrician to run some blood tests, but am not sure what to request. Hormones, vitamin deficiency, thyroid? Any insight you can give me would be much appreciated. Obviously at the age of 13 this is devastating for her. Thank you.

I can appreciate that it is very devastating to your child. Unfortunately, I really have no input here aside from the fact that you seem to be taking the right steps and seeing specialists. You may benefit from still another opinion with another dermatologist or a hair transplant doctor who might give you a different perspective after an examination. I would like to help, but I am not her doctor and the blog is not an appropriate medium for such.

Tags: child, hair loss, hairloss, infant, daughter

Young Daughter Lost Hair After Radiation to Brain Tumor

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

I’m hoping you can help us. When my daughter was 20 months old, she was diagnosed with a brain tumor. After numerous brain surgeries and chemo, we decided to have a bone marrow transplant just before her fourth birthday. Thankfully, this saved her life. She also had focal radiation to the tumor site – on the right side of her head – and unfortunately most of the hair on that quarter of her head did not grow back.

She has worn hair pieces since she has been five years old. We’ve talked to people about hair transplants in the past, but were told there was too much area to cover and also, that hair transplants do not work on the side of the head.

I’m wondering if this still holds true for this procedure. I could send you some photos so you could see the extent of the hair loss if you think that would help. Please let me know your thoughts.

Thank you

Most people with large defects are treated with balloon expanders, which stretch the normal scalp to cover the defective areas. There are a few doctors who are very skilled in this specialized technique and although I have assisted in this type of surgery, I would not consider myself at the lever of expertise needed. I have seen these expanders done in children, but every person and every situation is different. I would suggest that you send me photographs and I will forward them on to such a specialist. I have seen some miraculous results from this type of reconstructive surgery.

Usually, at the end of the expansion surgery, hair transplants are done to refine the work and cover remaining scars.

Tags: brain tumor, child, hair loss, hairloss, radiation, hair transplant, reconstructive surgery

My 2 Year Old Has Significant Hair Loss

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

Hello,
I have a healthy 2 year old daughter who up until 8 weeks ago had a full head of hair. Now the front/top of her scalp is experiencing significant hairloss. There are no actual spots without hair (it is either breakage or regrowth). The dermatologist diagnosed her with seborraic dermitits, however upon reading, I’ve noticed that this is not common to cause hairloss. Neither sides of the family have any baldness. The dermatologist mentioned possible TE, but I’m finding it hard to believe that either TE or dermitits would cause this much hair loss in a child that previously had thick healthy hair. Do you think either of these conditions would possibly cause so much hair loss in a 2 year old? Thank you

I agree with you that I do not like the suggestion that this is seborrheic dermatitis. Speak with her pediatrician and get an another referral for a second opinion.

Tags: child, hairloss, hair loss, pediatrician

I’m a Late Bloomer — Is It OK to Take Propecia?

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

I started thinning in one temple at 18 and was prescribed rogaine and biotin supplements. At 20 the entire top started thinning (especially in the frontal hairline area) and I am now nearing 21 and considering propecia, however, I am hesitant to start at such a young age for a couple reasons. I am a late bloomer with no facial hair and am constantly told that I look much younger than I am. I have two questions: 1) Will propecia effect my body’s development including facial hair? and 2) Is it more likely that something other than MPB could be affecting my hair because my body is so early in its development? I enjoy your blog and would appreciate any help you can give me. Thank you

It is possible (but not probable) that Propecia will slow down body hair growth. That has not been my experience. I really don’t know the answer to your perceptions of being a “late bloomer”. Some men don’t grow facial hair well at all, but at 20 years old your body is not early in development. I can’t say for sure what you’re experiencing without an exam, but from your brief one-line description, it sounds like MPB (frontal hair loss, top thinning). Propecia is a prescription drug, so discuss your concerns with your doctor.

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

Do I Have Premature Balding?

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

Well I’m 17 years old and i have a few questions. My hair is completely different both in color and in type from my mum and Dad. My dad suffers from baldness yet my grandpa from my dads family tree didn’t suffer from baldness. My Mother’s family doesn’t suffer from baldness at all. Lately I’ve noticed some thinning in the crown of my head, but i don’t know if i suffer from premature baldness, I blow dry my hair every day, and i wash it everyday I hardly ever comb it, I also touch my hair alot which might make it oily, could all of this be the reason for the thinning or is it really premature baldness?

Genetic balding can start in the teenage years. I can’t say for sure whether you’re losing hair due to genetics as I haven’t seen you, but if your dad has balding you could’ve gotten the gene passed from him. It can come from either side of the family. Also, oily hair isn’t a cause of loss, nor is the lack of combing.

My suggestion is to do a miniaturization mapping of your scalp hair and find out if you are balding. You can learn how to do it yourself if your doctor can’t / won’t do it — click here.

Tags: teen, teenager, hairloss, hair loss, genetics

Hair Transplants for 20 Year Olds?

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

do you do procedures under the age of 25 im 20, because for some reasons other surgions like bernstein wouldnt……also is there another alternative other than propecia that doesnt have side effects to prevent further hair loss?

At 20 years old, you’re likely not a candidate for surgery unless there is obvious recession and you are realistic in your expectations. When Dr. Bernstein turns down a 20 year old, I generally follow his lead as we both are very concerned about your long term prognosis. Hair loss is progressive, so transplanting you now without planning for future hair loss is a bad idea, particularly if your future pattern is uncertain. You have a finite amount of hair that can be transplanted, so you don’t want to use it all up now and then continue to bald years down the line without enough reserves to follow the hair loss. There are many doctors eager to get your money, so you can find other doctors willing to transplant a young man of any age.

As for Propecia’s (finasteride) side effects — they are overblown. Propecia is easily the best medication for those men with early hair loss. The only alternative I recommend is minoxidil (Rogaine), as it is also FDA approved to treat hair loss. Minoxidil will not prevent hair loss in the same way that Propecia will, and has it’s own issues with side effects. Remember, each and every medication has the potential for side effects (look at Tylenol, for example), as each person is different and will respond differently to it.

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

If I Start Losing Hair Early Does That Mean I’ll Go Bald?

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

Doc, I am 19 and experiencing signifigant hair loss in my hairline/temple area. I have heard that the earlier one looses hair, the balder they will go, but no one on either side of my family has ever experienced extreme hair loss or anything past a norwood class A type Va (worst case)

Is it true that the earlier one starts balding the more hair they will lose, or do they just reach their pattern quicker?

The two points are not necessarily connected, but those that lose a lot of hair often start early in their 20s with the process. From a transplant perspective, a Norwood class 5A pattern is a good end stage pattern for most people who want full coverage, where a class 6 or 7 is often difficult to treat for full coverage. In someone with a Norwood class 6 or 7, the supply of donor hair will often not be enough to solve the need for a full replacement hair transplant. I have transplanted a sereis of Class 7 patients with upwards of 7000 grafts (as high as 9900 grafts in one patient) to get the coverage they wanted. These individuals were fortunate enough to have high density donor hair and good scalp laxity. It certainly took more than one session to reach this number of grafts. For the sake of convenience, the Norwood chart is shown here:

Norwood Classes
Tags: norwood, hairloss, hair loss, balding, age

I’m in My 20s — I Don’t Want to Take Viagra Because of Propecia!

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

I’m in my mid-20s and began taking Propecia about 6 months ago. I was quite scared of the possible sexual side effects before I started the medication, and after 2 weeks on it, I think I experienced the erection troubles. A couple weeks later, the side effect went away. I went for a few months with no sign of symptoms, no problems with maintaining the erection… until I started seeing a new girl. We fooled around a few times and I didn’t have any troubles whatsoever. Then one night she got a little liquored up and we started to mess around. I was rock hard, but after several distractions I went to half mast. Since she’d been drinking, I think she just figured my problems in the bedroom were due to that. Like maybe I didn’t find her attractive when she was drunk or something.

The next day I got some Viagra from a friend so I wouldn’t have to worry about my performance and ever since then I’ve been using it whenever I thought I’d need it. But if I don’t take that blue pill yet and we start to get frisky, I start to wonder if I’d be able to keep it up. So is this just a case of me worrying about things too much, or could this be from the Propecia? I don’t want to have to constantly worry about taking a pill before I get physical with a girl.

LibidoIt sounds like you could be willing yourself into having problems like this. I mean, it sounds like you got so worked up about the possibility of side effects that you had a nocebo response. It could be from the Propecia, but erectile issues occur in less than 2% of men and the vast majority of claims made on the internet are unsubstantiated, so that percentage can seem greater than it is if you rely solely on fear-mongering web forum posters. The 2% number comes from actual medical studies. The erectile dysfunction symptoms can occur in adult men of any age without a medicinal cause, particularly in cases where you have a new sexual partner (or maybe even alcohol in excess). It’s not uncommon, but it’s just not something younger men… or men of any age… will openly share with their friends.

Talk to your physician about your own prescription for Viagra or a similar drug if you’re really concerned, and you should let him know that you’re taking Propecia (or go to the same doctor that prescribed that to you). You may want to experiment with Viagra when and if you get a steady girlfriend so you can sort through the psychological effects and the physiological effects. When men take Viagra and build psychological dependencies, that tends to take the fear factor out of sex.

Tags: propecia, finasteride, viagra, libido, hairloss, hair loss, erection dysfunction

My Dad, Grandfathers, and Brother All Have Their Hair — So Why Am I Balding?

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

My dad has hair, both my grandpas have hair, and my brother who is four years older than me has hair. I don’t know if cousins matter, but I have four male ones that all have hair too. Its not just hair though, all these family members have full heads of hair, there is not one male in the my family who is balding, and yet im 18 and seem to be losing all my hair. Im trying to except it, but im curious if there is anything I can do?

The expression of the balding gene does skip generations, though I am not sure how many it could potentially skip. The more generations that are skipped, however, the less likely it will be. I’ve written about it before here.

As for what you can do — I’d see a doctor and ask about a prescription for Propecia. If you have early genetic hair loss, the drug should halt the progression for some time.

Tags: hairloss, hair loss, balding, gene

Common Age for Female Hair Loss to Start?

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

Hi Dr. Rassman,
Searching the internet and various websites I always seem to hear/read about women who have severe diffuse hair loss and have developed female pattern baldness when they are around 20-years-old. Is this very common? Some information I’ve come across says it’s very very common while other says it rarely happens. Do you have any statistics on it?

I am not aware of statistics, but from my experience, women often follow the females in the family that have genetic balding in the time of onset and the pattern. There is a strong one-to-one link between mother and daughter in this condition and it is not infrequent to see it in your mother’s mother or aunts. Female genetic hair loss is not common in very young women, but in each decade, the frequency rises until menopause when almost 50% of women experience the problem. We see hair loss after pregnancy in many of these women as well.

Tags: female hair loss, hairloss, hair loss

I Noticed My 15 Year Old Son Is Losing Hair Already!

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

Hello Dr.

I started losing hair at about 22yrs of age. I am now 39. My son is 15 and is showing signs of significant thinning around his hairline and I was wondering if it is considered abnormal for someone his age to lose hair this early in life, ultimately robbing him of his youth. I have visited the family doctor who could offer no cause or solution for this problem. He suggested rogaine but I noticed on the package that it doesn’t help with frontal hair loss and you should be at least 18yrs of age to use the product. Any suggestions or solutions would be of help.

Thank you for your time

Rogaine likely won’t help him if he’s losing hair in the hairline, regardless of age. It’s not abnormal, but it’s not extremely common to lose the hairline at 15 years old. Perhaps he’s got a mature hairline process starting?

As for the other hair loss medication, Propecia — there are many things to consider before putting him on it. It’s the only medication that might slow down the balding process (assuming that is what is going on), but you need to have a great doctor who will analyze your son and work through the diagnosis as well as his growth phases in his bones and elsewhere. His age is a potential red flag, as Propecia was tested for men over the age of 18. I’ll let his doctor make the determination about prescribing, though. There is help, but you need to address this with his pediatrician.

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

My Hair Loss Just Started When I Turned 50 Years Old

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

Hello, I’m male and have just turned 50. There’s no baldness in the family and up until very recently I’ve had a full head of hair.

My hair started falling out considerably in the shower about six months ago (Oct ’08) and has continued up until now, to the point where I just have to run my fingers through my hair and hairs will fall onto the countertop. Unfortunately I’ve now lost a good amount of hairline and have thinned all over the top of my head.

I went to a dermatologist and supplied eleven vials of blood for testing with everything coming back negative for hair loss – minerals, vitamins, hormones, dhea, thyroid, kidney, liver & bioavailable testosterone were all within range (the last two were slightly elevated, but still in normal range).

There hasn’t been any major stress events in my recent history, nor do I feel depressed. However, I have been taking prednisone since March ’03 after being diagnosed with adrenal insufficiency (addison’s disease) after a bad bout with food poisoning. According to the medical association hair loss is not a side effect of prednisone, but I’m guessing it is the cause of my hair loss, or possibly an autoimmune disease attacking the hair follicle’s themselves.

I was given a dandruff shampoo (Ducray – Selegel) by the dermatologist but that hasn’t slowed the hair loss down, not sure dandruff could cause this type of hair loss anyway. I’m wondering if you might have any advice that could help as this is very frustrating to say the least.

Thanks

You can guess on the mechanisms for your thinning hair, but hair loss from genetic causes can start late in life (50s). I would need to know much more about your Addison’s disease and the impact of the steroid use before discussing your case further. Prednisone can cause hair loss (see here), but dandruff isn’t a cause of hair loss.

Tags: hairloss, hair loss, addisons disease