I Want to Rock and Roll All Night (And Keep My Hair)

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

Doctor Rassman
I’m 20 years old and afraid I’m losing my hair, probably a mature hairline but I still fear the worst. I’m in a successful rock band and was wondering what my option are if i start to bald because i can’t just shave my head. I know i can use propecia but that would only last for so long right? Would a wig or weave stay on with all the constant head movement associated with playing rock concerts?

Rock!Genetic hair loss is due to genetics (as the name implies)… meaning, if you are going to lose hair you will lose hair and there is nothing you can do to stop it 100%. Drugs such as Propecia or Rogaine can slow it down or sometimes reverse some hair loss, but over the course of your life you will continue to lose hair (if you have the genes for genetic hair loss). Propecia is the best solution for a young man like yourself, if there is early hair loss going on. I would start by seeing a good physician who can diagnose you with genetic hair loss (also know as androgenic alopecia / male pattern baldness). There is no need to start any medication if you are not balding.

Wigs and weaves can stay on if fitted and attached properly, which many performers wear without it falling off while they “rock and roll” all night.

Tags: musician, hairloss, hair loss, weave, wig

I’m 19 and Want A Nice Hairline Now with Hair Transplants

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

Hi Doctor Rassman and Staff, thank you for this informative blog. I am 19 years old and I was wondering if you guys would consider filling in temples and creating a lower hairline for a person my age. I know you say you do not do this because of future balding, but I would rather have this done so I can have a few years with a nice hairline, than have no years at all. I am in college and I am forced to wear my hair long and for the most part no one realizes I am starting to bald. I just want to be able to have a short hair style again.

Thank You

Before I could give you an opinion, I would need to see you and probably even meet you. I would then be able to determine if you are just experiencing a maturing hairline, which would be likely at your age, or actually have male pattern baldness. There is no substitute for an in-person examination, and over the internet does not meet my needs as a doctor. Some of the doctors in this business would want to rush you into the surgery even if you are just evolving into a maturing hairline. Any doctor too enthusiastic about performing a surgery on you might not be honorable.

Whoever you take on as your doctor, make sure that they are not just doing it to make a buck. Think long term! The great majority of 19 year olds aren’t candidates for a hair transplant because most are experiencing changes of the maturing hiarline, and there are dishonest doctors who will prey upon someone with cash in hand… like you, who may not want to accept the maturing hairline. A young man with a maturing hairline can cut his hair short, so first find out what is going on with you before you jump into a life time of hair transplants chasing what you may never catch (your 13 year old hairline).

Tags: hair transplant, hairtransplant, teen, hairloss, hair loss, hairline

What If I Want a Hair Transplant, But Don’t Want to Take Propecia?

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

First off, thanks for everything you guys do! Doc I am 26 yrs old and I had several questions. I apologize in advance if any of them are stupid questions! I am closest to Norwood III Vertex, but not completely there yet. I actually have a fair amount of hair on the top, problem is it’s really thin. The back and sides of my hair are complete opposite, they are very thick. I want to do a hair transplant, but is there any point to doing so if I do NOT want to take Propecia? I am open to taking Rogaine. Everybody keeps telling me to wait till my 30’s to get a transplant, since if I do 1 so early now, I will still lose other hair. If this does happen, I just get a 2nd transplant, correct?

The problem with a 26 year old experiencing hair loss is that your balding pattern is in transition. Will you become more advanced in your hair loss? You can try to predict it by performing a miniaturization analysis and see how far back this process goes (see Mapping Your Own Scalp).

Having a hair transplant at age 26 without Propecia on board will just accelerate the hair loss you are likely going to see in the years ahead. Not taking the medication will allow what nature has planned for you to happen. The choice is yours. Rogaine will not offer the same degree of protection. Why keep putting yourself through more hair transplant surgeries as your hair loss progresses if a daily pill could be the solution?

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

Hair Loss from Mono?

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

Our Dr did a blood test on our 15 year old and it came back that she had mono. I had taken her to the Dr because of severe hair loss. She said the loss was from the mono and it could last up to 6 months. Have you heard of this before?

Illness is a cause of hair loss. Telogen effluvium (see eMedicine article) is what occurs in some people, though it is more common in women than men, and can occur after a bout with mononucleosis. It should pass with time, but this is something she should discuss with her doctor.

Tags: telogen effluvium, mono, hairloss, hair loss, illness, female hair loss, mononucleosis

Great American Dream Vote Winner, Follow Up (with Photos)

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

I’m very curious on the progress of the TV show contestant, Russ Jowell, that you transplanted in April of 2007. How is his progress? how was it compared to the photoshop projection that was shown the day of the show prior to the transplant?

For those that missed it, ABC ran a special called The Great American Dream Vote where this young man with a Norwood Class 6/7 hair loss pattern (pretty extreme for a 22 year old) won his dream of getting a head of hair. Unfortunately, the show was canceled before his results could be shown… so here we are.

Russ’s results came out well, but he’s not at that Photoshop projection the producers of the show asked us to make. He has very fine hair, and the projection was made by taking the results of another patient’s hair transplant (who had a medium weight hair), so that will account for the difference in fullness from the frontal view. A coarser hair will have three or four times the volume (visual effect) than a fine hair with less bulk to it. Russ had another surgery after that 1st one for a total of 5816 grafts (photos below) and he just recently had yet another procedure (2856 grafts), this time to the top and crown to give him more coverage. We heavily weighted the transplants in the front on the 1st and 2nd time around, and it’ll take some time before we get photos of his 3rd procedure results, since that surgery was recent. Russ is very happy with the results thus far and can’t wait for the top and crown to grow in. Click the photos to enlarge.

After two procedures totaling 5816 grafts

 

Before

 

Tags: russ, great american dream vote, abc, tv, hairloss, hair loss, hair transplant, surgery

My Doctor Found Out I Was Taking Propecia at 26 Years Old and Is Quite Concerned

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

Hello doctors,

I am 26 years old (male) and have been taking Propecia since age 24 (when I noticed my hairline starting to recede). When I last visited my family doctor (this was the first time he found out I was taking the drug), he was quite concerned that, at my age, I was taking it. He said that the long term effects of Propecia are not known, and that he would advise against me, being only 26, continuing on with the drug.

I have never noticed any negative side affects from the drug yet, but I wanted to get a few more opinions. Do you know of significant endocrine effects?

Thanks.

Propecia can be used safely from the age of 18 and up. If you wait on its use, the balding will progress far too much to have the types of benefits it has when it is started early. Sounds like your doctor needs to be educated. You haven’t seen any side effects, so I’m not sure where your doctor’s concerns are based in.

Tags: propecia, finasteride, hairloss, hair loss, concern, doctor

Should I Hold My Breath for Hair Cloning?

/by William Rassman, M.D./6 /, ,

I am almost 22 and have had a shaved head for at least 3 years. I began going balf when I was 17 out of nowhere and the process was faster than lightning. By the time I was 18 or 19 I felt I had to shave my head because I looked ridiculous compared to my peers, since none of them (still) has any trouble growing hair. At 17 I saw a dermatologist who gave me a rather pathetic once over and concluded that it was normal male pattern baldness, just setting in at a rather unfortunate age. He recommended rogaine which I used for almost a year but to no effect.

I am now almost 22 and completely loathing my appearance, it really is the cause of some pretty severe chronic depression. Now I’m interested in absolutely any solution, but I’m told (or given the impression) that there really isn’t one. Even hair transplant, apparently, is not viable for someone as far advanced as I am. (Can that be true?)

And I’m NOT going to be the 22 year old who brings back the toupee. What are your thoughts?

Also, with regard to hair cloning, is there anything worth holding my breath for in the near future?

Thanks

BlueYou need to find a good, caring doctor to sit down with you after a thorough examination of your scalp and give you a Master Plan to work with. I couldn’t tell you if you’re a candidate for a hair transplant without at least seeing you… but even if your balding is as advanced as you hint, a hair transplant might still an option. I’ve transplanted men your age with very advanced balding (see here, here).

I would not hold my breath waiting for cloning. You might turn blue before you die.

Tags: hairloss, hair loss, hair cloning, hair transplant, young

My Wife Has Alopecia — Will Our Children Have this Disease, Too?

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

Dear Sir, My wife is 1 month pregnant . She is alopecia patient & complete bald since at the age of 5 years old. Her 2 other sister are also bald and having the same disease. They all wear wigs.. But her parent is having full grown hair.

My worries is that will it affect our future children ? Will my future child inherit this disease from her mother. how can i be assure for that. What test can be done to confirm it. Please advice.

Regards

Alopecia totalis sounds like the diagnosis and in one form of inheritance, the problem starts appearing in the very young at between 3-4 years old. Once the process starts, all of the hair falls out within months. Angela Christiano, Ph.D., of Columbia University in New York researched this in a town in Pakistan where the population was inbred. She found that many of the children in that town lost their hair at ages 3-4 and it fell out in a distinct pattern. She took samples of their genes, and tested them at the university, finding a connection between their disease and some of the genetic patterns in our more common form of alopecia areata, a disease which she has. Your child may very well inherit the condition. See our previous post on this subject here.

Tags: alopecia areata, alopecia totalis, hairloss, hair loss, alopecia, gene, genetic

My 9 Year Old Daughter’s Hair Isn’t Growing and Falls Out!

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

My daughter is nine years old and is of the african american origin. Her hair is not growing and is falling out at the nap and temples. Yes I have gone to a doctor and still nothing works. I relax her hair about every six months with a PCJ just for me kids relaxer. Please help me I am at my wits end! What do I need to do to fix her problem?

It is highly probable that you are doing something (without realizing it) to cause hair loss, unless your daughter has some genetic disease. A good doctor should be able to tell with an examination. Make an appointment with a good dermatologist.

Tags: hairloss, hair loss, child

20 Year Old with High Metabolism — Could Propecia Work in Just a Week?!

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

Hello Dr. Rassman. I am a 20 year old male. I have been loosing my hair for about a year and a half and have thinned quite a bit all over the classic horse-shoe area. My questions are as follows: My hair has thinned, but not receded, my hairline is still intact, just diffuse. I’ve been on Propecia for about a week now,and I swear my hairloss has slowed. Is it possible that it could be working already? I have a VERY high metabolisim; could that be a factor? I’m crossing my fingers! Thanks….

I doubt Propecia would show any regrowth in only one week, but I suppose it is possible for slowing the hair loss. You should take a photo of your hair and keep it as a reference to see how it changes in the next year. That will tell you a great deal. Also, you can map out your scalp for miniaturization and follow the mapping results over time. Changes in miniaturization will show if the medications are working even if your metabolism is high.

20 year olds tend to do really, really well with finasteride (Propecia) and I have seen miracles with this medication on those in your age group. Good luck.

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

What Are the Odds a Teen Girl Will Bald?

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

Hi Doctor, I wrote to you and want to thank you for posting my question. I have taken my daughter to two different doctors and I received two different opinions. The first doctor said TE due to stress and the second said AGA due to family history. I did not think AGA could cause such loss on the corner forehead down to the temple. I wanted to know what the odds were that a 17 year old could have AGA. I know it can happen, but how unlucky would we have to be? Also, the area I’m talking about looks bald in photos. This has been going on since March with no regrowth.

One doctor says telogen effluvium (TE) and another says androgenic alopecia (AGA), but without an examination, I really couldn’t and shouldn’t try to help break the tie. So while I cannot comment on your daughter’s diagnosis, the general fact is AGA is more common in men. In fact, AGA (also known as male pattern baldness) is the most common cause of hair loss in men in post puberty years, including teens. I have seen rare instances where genetic hair loss can impact young women as well, but I don’t have actual statistics off hand for you. Luck doesn’t play a part, but based on my experience genetic hair loss in teen girls isn’t a common occurrence.

Tags: teen, hairloss, hair loss, balding, aga, mpb, teenager, puberty

13 Year Old Getting White Hairs

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

Hi. I’m 13 years old and i’ve been having a lot of white hairs. about 5-10. I’m not sure if its because of stress. but i’ve only started to notice when i was about 11-12. Do you think it’s maybe generic or something on the lines of that? because my dad thinks i have an illness…

Getting white hair at an early age does not mean you have an illness. Some people will see their hair turn white or gray at a very early age. It is genetics. In very rare instances, if there are gray hairs in a patch it can sometimes signify a rare genetic disease such as Waardenburg Syndrome, but you are not describing that problem.

Tags: white hair, teen, hair color, grey hair, gray hair, teenager

Who Sees More Propecia Side Effects — Young Men or Older Men?

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

Would you say that a young man is more prone to side effects from Propecia than an older man? Maybe this is related to the fact that Propecia has more effect when started at a younger age than an older age?

The studies that were done did not classify sexual side effects by age. As young men are far more sexually active than older men and more prone to demand the best sexual performance with their young girlfriends, I would suspect that there are more complaints from the younger men. Many older, married men accept a lesser libido and the incidence of erectile dysfunction is much higher as a man ages, so men may not challenge their penis to do what they may feel it will not do.

Tags: propecia, finasteride, side effects, libido, penis, hairloss, hair loss

Is Age More Important than Donor Density in Hair Transplant Patients?

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

Hello Dr. Rassman and staff,

Doc thank you for your time, you speak your true feelings and I appreciate it. Ok, I started losing my hair around 19, which wasn’t very fun. Within a few months, I did start taking Propecia. I’m 21 years old right now, Propecia has been working for me but the damage was done early enough. I would say I’m a Class 3 on the Norwood Scale and would someday hope to change that. Personally I would love to have all of my hair back right now but it doesn’t look like that will happen too soon, but I’ll live. The hair loss process actually hasn’t been all bad; it actually has been a good humbling experience for me, although, in the end I plan on winning the battle.

I’m not really looking for a hair transplant in the near future, from what I have read on your website almost every 21 year old isn’t a good candidate. Although, is age always so relevant? I would think the biggest factor would be the donor density. Lets say you have two men who both have the same amount of hair loss (Norwood 4), one in his early twenties and the other in his mid thirties to forties. Wouldn’t a healthy 22 to 24 year old with a high density be a much better candidate than a person who is 35, 40 with an average density?? What’s your opinion on this, also where would someone go and get their hair density tested, would a dermatologist typical offer some type of test?

Donor density and where you are on the balding process are two different variables. Maturity of the balding pattern is also important for that 21 year old you referenced. There are no absolute rules with regard to having a hair transplant, but a bond between doctor and patient is critical in understand the meaning of all of the variables (age, donor density, hair characteristics, donor laxity, etc…) including the maturity and financial stability of the patient considering a hair transplant.

Tags: hair transplant, density, hairloss, hair loss, age, maturity

Should Teens Be Proactive About Hair Loss?

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

Should teenagers be proactive about their hair i.e. can they take propecia as a safeguard against losing their hair in the future especially if both parents have experienced hair thinning? At what age can young men take finasteride?

The best way to be proactive is to get serial mapping of the scalp for miniaturization. When early hair loss occurs, the use of finasteride may be a good idea. You will need to get medical attention for this process.

Propecia studies that lead to the FDA approval were conducted on men age 18 and up, but if a doctor should prescribe to a 16 year old, for example, that is up to him/her ultimately. I would never recommend just popping a Propecia pill each day or applying minoxidil if you have no hair loss.

Tags: propecia, finasteride, hairloss, hair loss