Should I Take Propecia at 16 Years Old?

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

Hi doctor, I have a question. I am sixteen years old and I feel my hair is falling because I have like a balding twirl in the vertex. It seems like if the hair in my vertex is starting to fall. Also, the hair on the top of my head is thinning. I don’t have a receding hairline, but I am scared to loose all my hair before I am twenty. I don’t know if this could be the cause of genetic hairloss (my dad is bald, but he is 52) or if it is another thing. Also, my pubic hair seems less dense. Do you recommend any drug like finasteride or propecia????

Any good doctor can do this and it is critical (particularly at 16 years old) that you get excellent metrics from a miniaturization study to determine what is happening to your hair before starting on a life long course of Propecia (finasteride 1mg).

You need a Master Plan for your overall management of your hair loss and you should have your scalp hair mapped out for miniaturization prior to starting any treatment. There is no reason not to take it if you are really balding, but you may not be balding, so find out first! That being said, safety of finasteride was studied at age 18 and above. Your prescribing doctor will have to be the one to make the call on whether the benefits outweigh the risks. Get a good doctor to help you with this.

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

Teenager’s Eyebrow Never Grew Back After Shaving It 3 Years Ago

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

(male) I shaved a good bit of my eyebrow when I was twelve – I’m, fifteen now. In short, they never quite grew back right. Will rogaine work? If not, what can I do?

I don’t think that giving a 15 year old advice on medication should come from me. Assuming that you were of legal age to make such decisions on your own, minoxidil might grow back eyebrows… and then again it may not. See a doctor and have your problem managed. You should also get a parent/guardian involved in your situation.

Tags: hairloss, hair loss, teen, eyebrow

Long Black Hairs Growing on My Shoulders and Back

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

Well, let me try to explain my situation: I am a 30yo male with hairy legs and dark eye brow hair and I’ve been told I have a very hairy public area (I am Italian and Spanish). The thing is, the hair on top of my head is very thick. But My chest has a little bit of hair and occasionally I find single LONG black strands of hair on odd parts of my shoulders and back. So I am wondering, being that I just turned 30yo, is it possible that those lonely ONE-hair strands will be joined by a whole team of others? In other words, should I be expecting to be a hairy man when I get much older? Do people still grow body hair after 30yo? Is there any way one can speed up or “help” the growing process to get a healthy full hairy chest? I’d rather be either very hairy or smooth, not in between. I’ve also noticed that older men with thick eyebrows usually are hairy allover. And I am the only sibling out of 5 boys that has thick eyebrows. (I am not sure about their pubic areas as that would be embarrassing to ask, hehe). Thanks!

I really can not predict what will happen to you. Generally, as you get older, more body hair appears in most people, but “most people” are not you. I couldn’t say for sure whether these few stray hairs are going to result in a wild forest of hair as you age. Some people have reported that they lost body hair as they aged. Each person is different.

Tags: hair growth, shoulder, back

Heavy Baldness In My Family and I’m Already Thinning At 23…

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

To whom it may concern,
Thank you for maintaining this site; the information is valuable and welcomed.

Well, I am a 23 year old male. My father and his entire side of the family experience heavy baldness. My hair is definitely thinning.

My question: Rogaine, Propecia, hair transplants – these are the major treatment options I’m aware of (and to some extent, experimental laser treatment). With only the few short details I’ve given you, can you give me an educated guess as to which option or combination of options might suit me best? I’d love to hear your opinion on hair transplants for males in their mid-twenties with projected substantial hair loss.

Thank you so much

If the hair loss is early or just starting, simple drug use with Propecia (finasteride 1mg) is often the best approach to slow, stop, or reverse the hair loss. Propecia is a prescription medication, so you’ll need to meet with your doctor. I’m not convinced that the laser treatments actually are worth the time or money, and a hair transplant would likely not be an option for you yet, particularly because you haven’t been on any medication to treat your hair loss — a simple pill may eliminate your need for a surgery.

The first step in addressing your hair thinning problem is to have an examination by an expert doctor who can help you navigate the diagnosis and develop a Master Plan. This would include a miniaturization study. There is no substitute for a one-on-one consultation and examination to understand what you want and need. If you’re in California, I’d be glad to meet with you. If you’re looking for a doctor more local to you, I’d check the physician search at ISHRS.org to find a doctor in your area that specializes in hair loss.

Tags: hairloss, hair loss, propecia, rogaine, hairtransplant, hair transplant, ishrs

From a Reader — A Note to Teenagers About Hair Loss

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

Well doc, I’ve got to hand it to you. You’ve solved all my problems. I’m 20 years old, and had been losing hair for over 2 years now. I was worried,stressed,depressed.. dreaEverything you can imagine.

I also tried all the products on the market that claimed to stop hair loss- creams,oils,herbal ‘remedies’. I didn’t use propecia though,it required a prescription which would mean I’d have to tell someone I was losing hair. No product seemed to work. Suddenly,long after I stopped using these products, my hair loss stopped.

Finally, I realize that my hairline was just maturing. All thanks to your site. I never knew such a thing existed!

Anyways, the point I would like to put across is to teenagers, who seem to be flooding your site with questions. The point is, your hair will be there till you are in high school, and till you graduate from college(assuming you arent unusually old for school). These are the two places where girls would superficially judge you (and where you’re just looking for thrills). After high school and college, its a different world. Girls turn to women, and they’re looking for more than just arm candy then. Your hair would NOT matter as much as you’d think.

So don’t worry about your hair too much; even if it’s rapidly falling,it would take a while for you to bald completely. And by then,you’d be through the superficial stages of life. And remember, nothing really causes hair loss apart from your genetics, which you cant change. So don’t worry about things that are not in your control.

Otherwise,there’s always Dr.Rassman ;).

Thanks for the comments! For those that still don’t know what a maturing hairline is, you should certainly read Maturation of a Hairline — Moving From Juvenile to Mature.

Tags: teenager, teen, hairloss, hair loss, hairline, maturing, mature

Mustache Problems — One Spot Is Growing Slower Than the Rest!

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

Hi, I’m 19 and I am trying to grow a mustache. However, theres this one little spot that takes longer than the other hairs to grow out. I can see little hair in that particular spot and it also seems very faint in color. I was wondering what would that mean? Would that spot ever grow out to be the same length as the other hairs or is it always going to be like that? Why is it like that? And does shaving have to do anything with it, like if i shaved that spot more, it’ll come out faster? THANK YOU!

At only 19 years old, you will see one part of your beard grow differently than the other parts. In ten years, you will wish it never grew out! It is possible you had a scar or burn in that area, or that your genetics are at play here. Shaving it will not get it to grow faster.

Tags: teen, mustache, moustache, facial hair, hair growth

Transplanting Hair While Still In the Early Hair Loss Stages

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

Hi,

Why do you say it is such a bad idea to thicken up an area that you may lose in the future? Say if you had hair that was 50% of it’s original density and thinning continually, could you not get 50% of the original transplanted into the thinning so that as the remainder eventually thins out and has gone your still left with what was transplanted earlier?

Thanks!

Shocked!If your hair loss is in its early stage and a hair transplant procedure was in that early stage there are problems with that approach. I have little doubt that in the young man with early hair transplants, the hair that is destined to fall out, may fall out at a faster rate than they would have had a transplant not been done. I am not talking about hair transplant shock alone (which is short term by months), but rather mid and long term by years from a time frame point of view.

Even though Propecia (finasteride 1mg) works in most men to prevent hair transplant shock, there is no better treatment for hair transplant shock than not having a transplant into areas of early thinning. So if you transplant hair that causes native hair in the vicinity to fall out, you could possibly wind up just replacing miniaturized hairs with a lesser number of transplanted hairs. The net effect may be zero and the preventive hair transplant would have been unnecessary and wasteful. Hair transplantation is a permanent process and it must fit the Master Plan of your hair loss process.

I do not believe surgery is in their best interest for younger men thinking about getting hair transplantation when the hair loss is just starting. All hair taken from the donor site is ‘finite’ which means that transplanting donor hair depletes the donor supply. If a person had 6000 grafts in his lifetime and he uses 2000 of them in an attempt to anticipate what might happen, the reserves for treating what will happen will be less than had the person had no surgery. The young patient can always delay the decision to have a hair transplant. Perhaps meeting again 8-12 months after your initial consultation will allow your physician to reassess the Master Plan to see where your hair loss is going.

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

There Should Be An Anonymous Survey of Propecia Users About Side Effects

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

Hi Dr:
I have read several of your postings regarding men on propecia and a decrease in penis size. It has happened to me also. I can clearly say that propecia has had an effect on libido and penis size while flacid. I have always been very sexually active, but since I began propecia all has changed. Getting aroused is more difficult – but i do get there eventually. My erection seems normal. I am 50, in shape and in good health. Patients confronted in person may not be apt to disclose that their flacid penis has shrunk. I wouldn’t. We’re men. Perhaps there should be a nation- wide anonymous survey of propecia taking men to once and for all prove that there is an effect.

Thanks for your comments.

I generally ask my patients on finasteride about their libido and the ability to get erections when I see them. I couldn’t say for sure whether everyone is being 100% truthful, but I do get some very candid, honest responses and I like to think that there is a good doctor/patient relationship and everyone is being honest.

Perhaps many men would be embarrassed to discuss these issues amongst friends, but not everyone is embarrassed about these issues when it comes to speaking to a physician. I will consider adding a question about flaccid penis size to my regular questions and report back in a future blog posting.

Tags: flaccid, hairloss, hair loss, penis, propecia, finasteride, libido

My Testosterone Boosting Supplement Contains DHT Inhibitors

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

i am a young male and have recently been experiencing thinning hair and a slight receding hair line. recently i started using a testosterone boosting product as I frequently weight train. This product as well as boosting testosterone, claims to lower estrogen, cripple shbg, as well as inhibit DHT. The ingredients are: tribulus, fenugreek, tongkat ali, red clover extract, chrysin, kudzu root, diindolymethane, avena sativa, zinc, pygeum africum, stinging nettle, beta sitosterol, saw palmetto, flaxseed, glycine, l-arginine, magnesium oxide, dipotassium phosphate, malic acid, and l – methionine. while the products mainly used as a testosterone booster, do you think i can continue its use to combat hair loss due to all its dht blockers? after i few months of use i have noticed significantly less hair fall in the shower. I have done some research on the internet and most of the ingredients in a lot of hair loss products are quite similar. What is your take on the use of this product since it claims to (and has) increased testosterone considerably?

The only FDA approved and proven medication for treating hair loss by combating DHT is Propecia (finasteride). To use saw palmetto as an example, since it is listed in the ingredients list you sent — saw palmetto is claimed to treat hair loss by way of DHT. A big difference between FDA approved medications and these non-FDA approved supplements is that the dosage required for treatment is well defined in the medications, but not in the supplements. For starters, who knows how much saw palmetto is in various supplements? It is most certainly different amounts in different products.

If you’re going to take something specifically to treat hair loss, I’d go with something proven to be effective. If this testosterone booster is something you’re taking and is working for your hair, that’s great news and I hope it continues to work. I couldn’t tell you for sure whether it’s actually working or will continue to do so, however.

Tags: supplement, saw palmetto, dht, testosterone, hairloss, hair loss, propecia, finasteride

Transplanting Younger Men — You Do It Too, Dr Rassman!

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

Dear Dr:

I visit your website everyday and find it really informative and reassuring….in some instances.

My question is, I see a lot of young people (between the age of 25-30) getting hair transplants. Now, I remember one time you had posted a message saying that people under the age of 35 should not be getting hair transplants because it is hard to tell the “final pattern” of a person’s baldness. So, why do you as well as other doctors elect to do transplants on young patients (even as young as 22 who have minor thinning but will go bald later on in life) when you know in the future the hair behind the transplants will fall out. It doesn’t make sense?

I’m sorry if I targeting you personally, I don’t mean to do that.

MagicYour question is a good one, but firstly, I’ve never used the age of 35 as a minimum requirement. I will readily transplant any man if:

  1. They have a hair loss pattern that is clear and bald. For example, a 22 year old Norwood Class 3 pattern patient who has lost his corners or his hairline has risen significantly above the mature male hairline (see Maturation of a Hairline — Moving From Juvenile to Mature). I will consider doing a hair transplant even on a younger man once I get to know them well and see the support of their family in the process.
  2. They are mentally mature, understand that the hair loss process is progressive, and have the financial ability to stay the course.
  3. They are on the drug finasteride for at least a month before surgery (to prevent potential shock loss) and agree to continue it for years (to halt the progressive nature of hair loss).
  4. They have donor densities which are adequate for harvesting as well as enough reserves to follow the hair loss to mid-scalp. In this way if they became a Class 6 or Class 7 pattern and were willing to accept a bald crown (the worst case) then they would always be normal looking.
  5. They are healthy and have no contraindications for surgery, such as bleeding disorders, etc.

Once the pattern is clear, the scalp is mapped for miniaturization, and the patient is on Propecia (finasteride 1mg), I don’t see how you could say that I’d “know” the native hair behind the transplants will fall out. That is not necessarily true, and is precisely why it is important to seek out a physician that will microscopically examine your hair rather than just waving their hands around the head like a magician and tell you what you want to hear.

Tags: hairtransplant, hair transplant, age, hairloss, hair loss

Teen Losing Hair On Sides and Back of Head

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

I am a 17-year old boy and have been losing my hair for a year now. Im losing quite a lot of hair on top but thats not the thing, the thing is that im losing some hair on the sides and the back of my head and its really scary. There is no doubt that i have male pattern baldness but im wondering if lets say one becomes a 5 in the norwood class doesnt that person lose some(lose som density) hair on the sides and the back. Is it just the norwood 7 and beyond that lose their hair their there or what? Please answer there is no one that can answer my question!!

With a traditional balding pattern as outlined in the Norwood chart (see below), the sides and back are spared. All thinning is limited to the front, top, and crown in patients with genetic male pattern baldness (MPB). So if you do have thinning hair on the sides or back of your head, I might think about diffuse unpatterned alopecia (DUPA) — but this is all complete guess work without examining you myself. The questions you asked me via email should be asked of your caring doctor in person following an examination of your hair and scalp. I don’t know what you’re seeing, so I can’t provide much more than that.

Norwood Chart

 

You need to establish some measurements with mapping your scalp for miniaturization at a minimum in following your hair loss. You also need to have a good doctor establish a Master Plan for your potential progressive balding.

Tags: hairloss, hair loss, teen, dupa, alopecia

In the News – Stress from Being Bullied Causes Teen Girl to Go Bald

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

From the article:

A teenage girl who was the victim of disgraceful bullying for three years has been left so traumatised that her hair has fallen out.

Faith Hawley, 14, said she was verbally abused, punched and even had her hair set on fire after starting at secondary school.

After three years Faith was diagnosed with alopecia, which doctors say was down to stress.

Bullied girl - before and after

 

Wow. This is a horrible case of stress, and for a 14 year old girl to lose all of her hair, it must’ve been quite extreme. Read the full article at the UK’s Daily Mail — ‘I was so badly bullied my hair fell out’: Girl, 14, reveals ordeal at hands of school yobs

Tags: stress, hairloss, hair loss, alopecia, teen, girl, female, women, woman

If I’m in My 30s And Have Early Hair Loss…

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

In a recent response you wrote: “It is in the 20s (pretty much from age 20-29) that men are most likely to see most of their hair loss.” What does that mean? I am 33 and I started to notice some minor thinning in the last year and a half. My derm has said it may be “very early MPB” or the result of inflammation I had – and he would not prescribe propecia as he said “You’re not there yet”. If most men see most of their hair loss in the 20s, and my dad and older brother (38) have no thinning, should I assume since I am older than 20s and dont have that pattern in my family, that the thinning will be mild or stabilize soon or is caused by something else(though it is on the vertex)? Again, I was not prescribed propecia because “I’m not there yet” – but I thought it was best early. Just wondering about my age, and what it means if most see most loss in the 20s and my family has none.

The hair loss in the 20s is a statistical thing. Some men start balding in their 30s, less in their 40s, and some even in their 50s and 60s. There is no hard rule, but whenever you start balding, the drug finasteride is effective at slowing and/or stopping it. I do not agree with your dermatologist, as once you know you have genetic balding, the earlier you start the drug the better it is.

Tags: finasteride, propecia, hairloss, hair loss

Hair Spray and Female Hair Loss

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

(female) I am getting bald on top. Does cheap hair spray cause this cause I do use a lot of it? I am only on medicine liptor and zetia . Can this medicine cause hair loss. It is getting worse. What can I do? I am 67 years old

Although not a known side effect, the medication you are on may cause hair loss — or you may be experiencing genetic female hair loss, which is present in half of post menopausal women. You need to be examined by a good doctor and tested for a variety of medical conditions which can cause hair loss.

I highly doubt that it is caused by your hair spray.

Tags: hair spray, hairloss, hair loss, female, women, woman, zetia, lipitor

13 Year Old Girl Found a Bald Spot After a Haircut

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

Hi, I am a 13-year old female girl. A few months ago in December 2007, I got a haircut and noticed a bald spot about the size of a dime on top of my head a few days later. I was really worried, and told my parents about it. They said me that it was due to stress in school etc., but I wasn’t completely sure.

It is now February. I’ve noticed a few days ago that there was a small part above my forehead that had very little hair (I have bangs). I have a feeling that I’ve been losing more hair, but I could be overreacting. I think that the previous bald spot had expanded.

My parents have made an appointment with the doctor, I will probably be going to see her in a week or so. Since I was a baby, I’ve had eczema, a skin condition, and I don’t know if it has any links to it. I don’t really remember, but my dad told me that around 5 years ago I’ve had this hair problem. The doctor gave me some medicine to put on my hair, and it seemed to work.

After looking on the internet for information, I’m really worried about any conditions I might have. I’m scared I’ll lose all my hair in the next few months or so. Any info will be greatly appreciated, thank you so much.

The right thing to do would be to see a doctor. There are many causes of bald spots appearing, some of which have been discussed on this site before (ringworm, alopecia areata, etc.). A doctor should give you a diagnosis after an in-person exam. Via the internet and based on just an email, I would just be blindly guessing.

Tags: hairloss, hair loss, haircut, bald spot, girl, teen, female, women, woman