My 7 Year Old Son Has a Very Scaly, Flaky Scalp

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

my son is a 7 years old african american. he is having the worst problem ever with his scalp. i have tried every kind od dandruff shampoo there is and still no relief. i wash his hair 2xs a week now because the flaking and the scabs are so embarrassing. after i wash his hair its looks clean and free of scales and flakes but his scalp is red. usually after 2 days of washing this whole process reoccurs with the itchy, scaly flakyness. what should i do?

If I had a 7 year old son, I would want an expert to examine and diagnose him. You need to take him to a pediatric doctor, one with an interest or experience in dermatologic conditions. There are many causes of flaky scalps and you need to consult with a good doctor.

Tags: scalp, flake, scaly, flaky, child, dandruff

My Hairline Started Changing at 15 Years Old

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

Dear Dr Rassman,

I am male and aged 18. My dad receded in his early twenties, while my maternal granddad kept his mature hairline into his 70’s. I noticed a change in the corners of my hairline and have read your articles on the maturation of the hairline which I have found very informative. I noticed hairline changes in the corners probably since I was about 15-16, and the changes since then are negligible, and there is no noticeable miniaturization.

My question is, is it likely that I have experienced the maturation of the hairline in such a short period of time, at such a young age, or is it more likely that I am balding? My temples
are about an inch from the crease when i raise my eyebrows. I’m not sure how revelant it is but I also developed body hair before my peers. Would you recommend I wait and see if its balding or start treating?

Thanking you in advance

Your question is complex. Simply, balding can start as early as 15, but it would have to show miniaturization if it is the genetic form of male pattern baldness (MPB). Hair does change in character from pre-teens to teens to early adulthood and throughout the maturing process into old age. Generally, hair becomes finer over time, usually not very fast in the teen years, but it might change faster in some young people than others.

Tags: hairline, hairloss, hair loss, hair character, teen

Are Men That Start Losing Hair Before 30 More Likely to Become Completely Bald?

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

Hello, after reading a response you made to a question, i noticed that you said that men who start loosing hair well before they are 30 are more likely to be completly bald or have a worse degree of balding. Does this mean that younger people showing signs of MPB have less of a chance of slowing down and stoping the problem using propecia or other treatments? Im 18 with MPB, so is propecia less likely to work for me?

Norwood Class 7Actually, men who become a full Norwood Class 7 balding pattern usually have significant balding by the time they are in their early 20s. If the balding is mild at 30, chances are that the balding will not be advanced as you get older. Once you know you are balding, develop a Master Plan and get good metrics by mapping out your hair for miniaturization so that over the next few years you can see what is actually happening to you rather than guessing.

Tags: norwood, hairloss, hair loss, age

The Best Procedure for a 22 Year Old That Wants His Hairline Back?

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

hello, i am a 22 year old male who has had hairloss for about 3/4 years now, a year ago after noticing quite bad thinning i started using regaine and procerin combined, my hair thickened slightly but not much so 3 weeks ago i swapped the procerin for finpecia (generic finasteride) i now have lots of hairs in my hairline but they seem to stay the same length, realising that these medications don’t re grow hair in the receding hairline area i have been considering some form of surgery, baffled by the procedures and sites recommending certain types only i was wondering if you could tell me what the best procedure is for a young man who just wants to fill in his hairline slightly and maybe help thicken the front as well?

regards

I do not quite know what you are asking. If you are considering a hair transplant procedure, you need to see a hair transplant doctor for a good physical examination and his/her evaluation. Generally, hair transplants in a 22 year old man is approached with great caution for two key reasons —

  1. You may have further balding in the future
  2. A surgical procedure like this may accelerate the balding process

A good Master Plan must be created to account for your hair loss worst case scenario so that whatever is done today, will continue to look good as you get older. The best hair transplant procedures use follicular unit grafts by experienced teams.

Tags: hairtransplant, hair transplant, hairloss, hair loss, propecia, finasteride, procerin, finpecia, hairline

12 Year Old Has Alopecia — Is a Hair Transplant Possible?

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

Hello Dr.

I hope you answer my question. My 12 yrs. old daughter has been diagnosed with Androgenetic Alopecia at UCSF. Her hair has been thinning in the front and at the temples. We have been using the 2% Rogain for 3 weeks, as recommended by her Dermatologist. The hair in the back of her head seems normal. CBC, TSH, Iron, ANA were normal.Ferririn was 18, a bit below normal.

This is starting to affect her emotionally.

Is it too soon to think about hair transplant? should we wait until she is 18 or more? Please let me know.

Thank you for your time

It is extremely rare or unheard of for a 12 year old female to have androgenic alopecia. Androgenic alopecia (AGA) generally affects men past their puberty who are genetically susceptible to the effects of dihydrotestosterone (DHT). Does your daughter have hormonal irregularities? You need a good dermatologist to make an evaluation of her and I am not saying that the docs at UCSF are not good doctors, but a second opinion may have value. There are other forms of Alopecia and considering her age, I would want to explore all possibilities.

Tags: hairloss, hair loss, dht, angrogenic alopecia, aga

Hair Loss from Ringworm in a 4 Year Old Child

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

My 4 yr old son was taking Griseofulvin for 4 months for scalp ringworm with no results. When the dermotologist stopped the Griseofulvin she gave him a topical treatment. The bald spot spread rapidly and became very large. A culture then showed that he no longer had ringworm. The doctor had a chunk of his scalp analyzed-no infection. She then gave him pills for fungus. No result. This is now on the 7th month of treatment. His scalp is as clean as a whistle, no bumps, no hair at all and no signs of hair growing back. The doctor said keep giving him the pills. I’m scared to stop the medication, scared to continue the medication (with blood tests every 2 weeks). Will his hair ever grow back? and should I try stopping the medication? When will I know that he has permanent hair loss from ringworm? and that the ringworm is all gone?

Perhaps your son needs a second opinion from another doctor. I am not his doctor and I cannot tell you if your son’s hair loss is permanent or what is responsible for it, particularly without an exam. I can only make guesses, but your son deserves more than just a guess. He needs a good diagnosis. Find another dermatologist for a second opinion.

Tags: ringworm, hairloss, hair loss, child, children, dermatology

10 Week Old Baby with a Ton of Hair

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


BabyCheck out this amazing head of hair on a 10 week old baby girl.

DailyMail.co.uk – Baby born with a full head of Elvis-style ginger hair

I know some babies (my nephew, for example) are born with very little hair. Then there are some born with a good amount of hair. Then some, I suppose rarely, are born with a massive mane of hair like this gorilla baby in the link I just sent. Why is this? Just genetics? I notice the father in the article has a perfectly straight hairline. Thanks

I wish I could give you a good, solid answer… but to be honest, no one knows the answer to that question. That head of hair sure is stunning though.

Tags: baby, child, hair, hairloss, hair loss, daily mail

Any Correlation Between Father’s and Son’s Ages of Balding?

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

Hi,
My dad started balding at the age of 40, and now at the age of 60 he shows diffused hairloss on top of scalp. I am 26 and I started to show the begining of his pattern last year. In your experience, is there any correlation between the dad’s age of balding, and the son’s, provided that the only “gene” for baldness comes from the dad? Can I maybe expect some stabilization now untill a later age?

Thanks a lot

I am just a doctor, not a fortune teller. Male pattern hair loss is genetic, but there are no firm correlations on how it is passed on from father to son and at what age it will occur. Most bald men experience balding early on in their 20’s and 30’s. If your hair loss follows your father’s pattern and rate of hair loss, you might assume that will be your destiny. Find others in your family (mother and father’s side) and see whose patterns reflect the pattern of your hair loss.

Tags: fortune, hairloss, hair loss, future, father, son, genetic

Why Does DUPA Effect People Aged 16-23 More Than Others?

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

Hello i have a few questions about DUPA, i was wondering how long it took for your patients who responded well to propecia to notice visible result, coz ive bin on it for about 3 months and was wondering if i should quit.

also why do people aged 16-23 get dupa the most, what is causing this do you think?

And also i heard you say once that you prescribe dutasteride to patients with dupa if they dont respond to propecia why is this? has there been someone with dupa who has responded to dutasteride and not propecia.

please can you answer these please i would be most pleased

I do not believe that DUPA (diffuse unpatterned alopecia) is most common in the 16-23 year old age group. I believe it is found in people of all ages. The effects of drugs like Propecia (finasteride) or Avodart (dutasteride) are not confirmed for the treatment of DUPA, but they are the only things available for it. I have seen some benefits from Propecia on DUPA patients.

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

I Use a Lot of Toppik to Conceal My Hair Loss

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

Im 22 and do have severe hairloss that started when I was 17 and has progressed to the point that I barely ahve anything left. I have blonde hair in the begining when the thinning was happening I covered it perfectly with just a little black eyeshadow here and there…but now its to the point that I had to buy brown eyeshadow and just put it all over the top of my head. It looks ok because I use Topix with it. However…will this accelerate the loss? I use *ALOT*

Thanks Muchly

The use of topical products (such as Toppik) will not accelerate the hair loss. Hair transplantation may be a better answer to your problem if your qualify for such a procedure. It is unusual for me to recommend hair transplants on 22 year olds, so you should be evaluated by an honorable expert to develop a Master Plan for your hair loss and then, when and if appropriate, take it a step further (even to hair transplants if appropriate). Many men at your age do very well with medications (Propecia) to slow, stop, and reverse hair loss, but if your patterned hair loss is already locked in, then transplants could be a solution. Blondes do better than most people because of the low contrast between hair and skin color and many blonde men can get away with less grafts than a person with dark hair and light skin.

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

I’m a Teen with White Hairs!

/by William Rassman, M.D./5 /

i’m only 17 and i have already got about 3 white hairs atthe top of my head, one of them has beagn to grow black agian but this is really stressing me out and i’m worried about it. will i get more? is there naything that i could do to prevent this. will i get more? i don’t know whther to cut it or will it just spread?

Getting white hair early on is genetic, just as is balding (though there is no correlation between the two). There is nothing you can do to prevent this and there is no way to predict when you will get your 4th white hair. I wouldn’t stress yourself out about having only THREE hairs that are white, or you might see even more appear. If you want to make the white hairs disappear, look into using hair dye.

Tags: white hair, gene, genetic, hairloss, hair loss, teen

Recommended Age for Hair Transplant

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

Hey Doc! I’m 22 With Norwood Class 3 (with some thinning in the crown) and I was wondering at what age do you recommend one does a transplant. I have noticed that most of the patient photos are from people older than 40. I really don’t want to wait that long. Do I have to? Thanks!!

I generally do not like to perform a hair transplant on someone whose pattern is not clearly evident based upon miniaturization studies when I map out the scalp and hair. Men under the age of 25 generally fall into that category, but clearly I have done hair transplants on men under 25 when there is frontal hairline loss or a clear pattern that has advanced such that the medications like Propecia and Rogaine will probably, in my opinion, not work. Everyone deserves a personal assessment. In other words, there’s no set age.

A good one-on-one examination and the building of a Master Plan with each patient is critical. It seems like you are too early for a hair transplant and should get good results in the crown with Propecia. Get your baseline mapped to you know where you are going and do it yearly.

Warning: It is quite unfortunate, but there are many unethical doctors who recommend hair transplants on young men who are easily swayed by the power of their MD and their fear of going bald. Although this is an important warning for men under 25, it also applies to all men considering hair transplantation. Be sure that the recommendations are in your best interests at all times, not in the interest of the doctor’s mortgage or fancy car payment.

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

21 Year Old Had a Hair Transplant Last Month, Wasn’t Aware of Shock Loss

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

Im a 21 year old male and I had a ht about a month ago and wasnt aware that shock loss could be perminant and im not on propecia yet and now am worried that its too late to get the hair i lost back. Is this the case or will it come back if i start taking the pill now? I have been losing a lot more hair since the ht and am worried i just wasted my time/money. what are the chances that it will regrow? thank you.

You absolutely should have been on Propecia (finasteride 1mg) prior to the hair transplant. You should be on it now although some of the loss with be permanent. Better late than never.

Why did you have a transplant at only 21 years old? I find the combination of a transplant in a 21 year old and not being prescribed Propecia to be very bothersome. Consider sending me pictures of yourself (confidentiality will be maintained — reference this post when/if sending). Also, please read some of the previous blog posts about transplanting hair in young men:

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

4 Year Old Had Hair Pulled Out By a Powerdrill!

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

My four year old daughter had her hair pulled out by a powerdrill. There is a huge patch of hair missing and it looks bald, but there are still a lot of fine hairs still at the scalp. My son is 20 months old and my husband was working on some work equipment heard the drill, reached to get it from my son and as the baby turned it got wrapped in her hair and took it right out. It happened so quick. She has very thin hair as it is and it looks like the amount of what a one year old baby should have. I have had her tested for thyroid and other blood tests but they keep telling me she is fine. Is there anything I can do for her to help it come in better or to get it to grow. I give her vitamens daily but she is only 4, just about 5? Please help!!!! Thank you!!!

A concerned parent

You should follow your daughter’s doctor’s advice. Traumatic hair loss (such as the one you describe) should be temporary and hair should grow back in less than a year. Sometimes there may be an area where hair will not grow from severe trauma. That may be potentially addressed with a hair transplant procedure with good success.

Tags: hairloss, hair loss, trauma, powerdrill, child, hair transplant, hairtransplant

My Hairline Has Matured at Age 17 — Does That Say Anything About My Future Hair Loss?

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

Hello,
I have read a few posts previous to my post, inwhich you reassured people that gaining a “mature hairline” at a early age (17 in my case), certainly DOESNT mean that you WILL definitely experience further balding past the “mature hairline”. on this subject i have two short questions:

  1. Is there any medical evidence based on maturing hairlines that states that they are definitely separate from the balding process (past the mature hairline)
  2. Since i reached a mature hairline at 17, does this mean i will have a greater chance to actually have the balding gene, or is this just me thinking the worst?

thanks for the great service you provide

The answer to both questions is no, but a good Master Plan should be made with sound metrics on the mapping of your scalp for miniaturization to cover you in the future if you should develop hair loss.

For more about the maturing hairline, see Maturation of a Hairline — Moving From Juvenile to Mature.

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