Teen with Gray or White Pubic Hair?

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

Is it normal for teenage boys to have a few gray or white hairs on their testicles? Is it normal for a pubic hair bump to be a little larger than usual around the thighs and the testicles?

Yes, yes.

Just to repeat my answer from a year ago…

With respect to your gray pubic hair, it is often normal for a brown hair person to have a few random white hairs. Sometimes they can start in teenage years. I have seen men and women who are gray by the time they are 25, and if you have never seen these people walking around, that is because they ‘hit the bottle’ (the dye bottle).

Tags: pubic, white, grey, gray, hair, teen, teenage

I’m 20, and My Hairline Has Matured More Than I’d Like

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

Hi,

I am a keen reader of your blog. I’m 20 years old (male), there is no balding in either my father/mother, or their father’s/mothers.

However, from early puberty, the corners of my hairline have “matured”, but a little too far for my liking. I understand that your general rule is not to perform surgery on young patients, however… if you are satisfied that there would be no further progression, would you “fill in” a young person’s hairline? .5-.75″ and also possibly lower the actual hairline down a small amount?

I know I’m in the UK and your offices are in the US, but I’ve not yet found what looks like a reliable, trust worthy, honest hair transplant surgery in this country! Approximately how many grafts/hours/sessions etc would the process take? I can e-mail pictures if required.

Thank you.

It is understandable that you do not like your current hairline, but even with no evident balding in your family, you may have genetic male pattern balding. It is difficult to tell how bald you may or may not be at such a young age. At the least, you need a miniaturization study, a good history, and exam — and then develop a good Master Plan for the future management of your hair loss.

There are doctors who are willing to transplant hair in patients who are in their early twenties with only slight balding or recession. However, I am cautiously resistant to the idea of lowering your hairline at this point, because I do not know if you will bald further as you get older. With that said, a hair transplant may accelerate balding and cause you to lose more hair, leaving you in a worse position than you are currently at. I would wait for perhaps at least about 5 more years before considering a hair transplant.

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

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

If Dutasteride Is Approved for Prostate Treatment, Wouldn’t It Be Safe for Hair Loss Treatment?

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

Dr,
with reference to the reply you gave me regarding the below thread on the 15th August 2007: ‘Would You Prescribe Dutasteride If It Was Approved for Treating Hair Loss?‘

You stated that the safety concerns have yet to be fully established until FDA approval is give. I believe I am correct in stating that Dutasteride is already approved, but not for hair
loss so wouldn’t it be safe for human consumption irrespective of the fact that hairloss approval has not been given?

The average age of men that seek treatment for hair loss is different than the age of those that require treatment for prostate disease. Older men generally do not have children, while younger men do. So for example, how long does one have to be off the medications before pregnancy is safe? That is unknown. The recommended dosage of dutasteride to prevent hair loss is also unknown. Yes, dutasteride itself is proven to be safe in older men with prostate problems and is FDA approved for treating the prostate, it is still undergoing testing for a greater segment of the adult male population that are looking to use this drug for treating their genetic balding.

Tags: dutasteride, avodart, hairloss, hair loss, prostate

I’m 18 and Want a Hair Transplant So Life Doesn’t Pass Me By

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

I live in Washington, D.C. and I have the hair loss problem, but I’m 18. I have tried Rogaine, I have tried Fo Ti, I have tried everything (except for Propecia) including going to the hair club, where they would glue a wig to my scalp. I called hair loss clinics all around my area to ask them when it would be right to have implants/ transplants done and they say that I have to wait 6 years, that is, until I have completed my transformation into Patrick Stewart. I am about a 50% on the Norwood scale and I don’t want my life to pass me by. Do you think that it would be right to get surgery done at this point in time? I don’t see any other way. Is there a minimum age for implants and if done before the minimal age will the implants fall out? Also, is there a way to keep them in (rogaine, propecia, etc.)?Thanks for your help

I hope to hear from you soon

When a wig is applied to your scalp with glue and other similar attachments, it will pull out the hair and produce more hair loss (traction alopecia). As a result of this, you can be ‘hooked’ on the wig for the rest of your life. There is no real minimum age for a hair transplant, but generally speaking, we tend not to do these in young men under the age of 24, because the hair loss pattern is not clearly defined. Simply said, hair transplants are performed by moving the hairs from the back of the head (donor area) to the areas you need hair (front, top, crown, etc). So as long as you don’t have an underlying genetic condition such as alopecia, your hair transplants will stay in forever (independent of age). As we always want a Master Plan for each patient and their balding pattern, we need time to get there. Propecia (finasteride 1mg) works well in young men to prevent or stabilize the hair loss and that should be your first line approach.

Tags: finasteride, propecia, hairloss, hair loss, wig, hairpiece, toupee, hairtransplant, hair transplant

Late 50s, Noticing Acceleration in Hair Loss

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

I am 57 years old and have maintained a good head of hair (albeit grey these days) throughout my adult life. I did notice in my late teens and early 20’s some recession at the temples, but overall I have what is considered to be good “coverage” when compared to others in my age group.

I have been on Flomax for a urinary flow issue (high bladder neck) and Androgel for hormone replacement for 5 years now. Recently, I added Plavix, Enalapril, 81mg aspirin and Vytorin to the regimen because of an angioplasty and to lower my lipids.

In addition, I take Fish Oil, Folic Acid (5mg) Saw Palmetto and CoQ10 (200mg) although these are not prescribed, only suggested.

Recently, I have noticed some acceleration in hair loss at the crown and frontal area, although it’s progressing slowly and mildly.

I am wondering if the new combination of drugs might be the reason, or if this is simply the natural progression of MBP. I imagine at this point a minaturization study would be a good idea instead of speculating on the impact of my drug cocktail.

Please advise, and thanks for your excellent site as well as your candid, well-researched and scientific approach to this problem.

Yes, I believe a miniaturization study may be of benefit. Genetic male pattern balding (MPB) may be a cause of your hair loss, but is rare (although not unheard of) to occur so late in life. Of note, taking Androgel may contribute to the MPB due to its androgenic properties. However, you should always consult with your physician before starting or stopping any medication. It is unusual that hair loss starts in a person of your age, so I would look to the medications that you use as a possible cause.

If your hair loss is related to MPB, there are medications (such a Propecia) that MAY offset it.

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

Transplanting the Crown In a Young Man

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

My crown is balding, but my frontal hair has a solid hairline. I am a 26 year old actor and a bald beany does not fit the type of actor I want to be. How can I play the role of a seducer of women, a handsome male icon who tries to get those romantic leading man roles, when the crown shines with a beacon that draws the eye like the Luxor hotel lights up the Las Vegas skyline. Many doctors frankly refused to do my balding crown. Don’t I get a say here? What do you think?

There is a general reluctance to transplant the crown of a young man by competent hair transplant surgeons who tend to think long term on the progressive nature of hair loss. I think that transplanting the crown is not a problem provided that:

  1. You are on finasteride (my strong preference) and you give it enough time to see if the drug alone reverses the hair loss in the crown.
  2. You are aware of the long term supply and demand issues to manage your hair loss if it becomes extensive. I would require that you work out a Master Plan with me on what you would do if your Hair loss/Hair supply issues would be a problem in the long term.

People who are body dysmorphic can be treated with transplantation if there is enough education, maturity, and money available in following the course of the progression of the hair loss. With luck, you might just be a pure vertex balder (like me, who had just a crown hair loss and crown transplants) or have great success with finasteride with reversal of the hair loss. Behind every balding head is a balding ‘human being’ whose vote is important in determining what trade-offs the person is willing to accept in his future. Knowing who you are is important to me, so our relationship then becomes a mutual decision (a partnership) and although I agree that for many patients transplanting just the crown of a young man is not a good idea, I would put the doctor/patient relationship to the center of this discussion. Although I understand the general reluctance for good, honorable, and competent doctors to transplant a crown in a young man, rules are just rules and they do not dictate every decision before me.

Tags: hairtransplant, hair transplant, hairloss, hair loss, vertex, crown, young

Does the Follicle Eventually Just Stop Producing Hair?

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

Hi doc,
is it true (..or partly true under certain conditions) that the follicle will go through the growth, release and snooze phases a specific amount of times and then stop to produce hair?

If so, MSM and it’s claimed increase in hairgrowth speed would actually do more harm then good in the long turn.

It is normal to lose 100 to even 200 hairs a day (though the average would be closer to 100, I’d say). As hair falls out, there are hairs that are also starting to grow. Hair may also grow in cycles and you may notice more hair falling out at different phases and seasons of the month. Hair follicle cells have three phases of growth:

  1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
  2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
  3. Resting phase (Telogen phase) which lasts about 1- 6 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

Eventually, as we age, some of the hair follicles will die and stop producing hair. But keep in mind the life expectancy for a hair follicle can be over 100 years (provided that you live that long). My great grandmother had a full head of hair at 114 years of age, so clearly the hair can live longer than we do. I’ve written about this before — At What Age Does Hair Stop Growing Naturally?

Finally, there are no products or medications proven to speed up or increase hair growth. Drugs like minoxidil are thought to prolong the hair cycles and that might mean, in the long term, that hair treated with minoxidil might last more years. I would be interested to see product results on half a scalp to see if that half has faster hair growth, longer cycles, or whatever.

Tags: follicle, hairloss, hair loss, anagen, catagen, telogen, age

Taking Propecia at 50

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

I just turned 50 and have been noticing more thinning on the crown and front areas of my head. When my hair is wet after a shower you can see the thinning sections, but when it is dry I have very good coverage. I do notice more hair than normal in the shower floor than before.

My question is about Propecia and Proscar as a possible treatment. Do they still have a positive affect at my age, or is there an age range that makes these less affective. Also, is this the same with Minoxidil 5% solution. I am trying to determine if I can realistically maintain my current hair thickness and possibly regrow some of my recent hair loss, or is this a problem that needs a medical evaluation.

Thank you.

Propecia is good at practically any age, provided that your have some hair or are in an active form of miniaturization (thinning) or hair loss. For example, Propecia would not help much if you are already totally bald.

My patent attorney, who is almost 80 years old, started Proscar a few years back, and the thinning hair on his crown area has grown back.

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

My 3 Year Old Has a Bald Spot from an Accident…

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

My 3 year-old son had a freak accident involving our treadmill about 7 weeks ago, and sustained several severe abrasions — one on his scalp. His head is mostly healed, except for a small spot in the middle; the surrounding area is pink, with no sign of hair regrowth as of yet.

My question is: how deep would the abrasion have to be to affect the hair follicles? How long should we expect to wait to know whether regrowth may occur?

The wounds that are deep enough to cut the hair follicle below the level of the skin may cause permanent hair loss, but in a classic abrasion, the hair should grow back. I would wait it out for a good 6-8 months before worrying about it. Hair loss could also be seen with any surgical scar that cuts or injures hair shafts below the skin level or if the skin edges separate and are not closed with sutures. Superficial abrasions may cause hair loss temporarily. This latter type of hair loss usually re-grows in a matter of a few months. If your son does not grow his hair back in those areas in 6-8 months, he may have lost it permanently. This type of balding spots could be excised or transplanted with hair successfully.

Tags: hairtransplant, hair transplant, abrasion, wound, child, hairloss, hair loss, bald spot

I’m 14 and Losing My Hair — Is It Because I’m Over Weight?

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

(female)
Yes i am expiriencing hairloss and i am currently 14 years old only my uncle is lossing his hair but i say because he smokes i used to have very very thick hair and well now i have half of it and well i want to know what it is because im over weight or vitamins and PLEASE PLEASE PLEASE HELP!!!!!!!!! I am tired of seeing all my hair go down the drain and im only 14 please help!!!!!!!!!!!!!!!

I do not believe being over weight causes hair loss. However, there may be other health issues that you are not aware of that is causing your hair loss. You should see your primary care doctor for a physical examination and express to him/her these concerns.

Tags: teen, girl, female, woman, women, overweight, weight, hairloss, hair loss

Treatment for Slow Hair Loss as Aging Occurs

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

You usually discuss MPB in men in their 20’s and 30’s. I’ve noticed most men, including myself had slow thinning that starts sometime in their 20’s or 30’s, but not usually noticeable until their 40’s or 50’s. If you look at a photo of someone at 35 with what appears to be a good head of hair and then at 50 you’ll notice a definite receding hairline and general thinness throughout the scalp. This process continues as we age. What course of treatment do you suggest if any for slow thinning over years that eventually leads to increasing visible scalp as we age.

Although most advanced balding men lose their hair actively during their 20s, it often slows down significantly after their 30s. There are some exceptions to this rule and some patients don’t lose much hair before they are beyond those ages. Patient who start their hair loss or continue hair loss in a later time in life usually follow a family trend with a similar pattern of hair loss in another member of family. The recommended treatment is the same as the patients who follow a typical earlier hair loss. We recommend finasteride for these patients and some of them get good results.

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

When Can You Predict Balding?

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

HI DR… When can you kinda predict when you final pattern will be… what age ???? Please let me know sir.. thanks

There is no real age that hair loss is guaranteed to start by, so I can only talk averages. Most men who are going to be very bald, will be there before they get out of their 20s, and often see considerable thinning in their early 20s with considerable miniaturization through the areas that are going to be bald. It is this miniaturization pattern that suggests the final pattern, but in some people, the process is delayed into their 30s. Most men are finished with the large part of the balding process by the time they are in their 40s, but on rare occasions, a few may start at this late age (less than 5% of all men start balding late in life).

Tags: hairloss, hair loss, age, prediction, pattern

Young Daughter’s Hair Has Turned Brighter and Thinned

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

My 3-year-old daughter has had a beautiful head of blonde hair. In the last 3 months her hair color has brightened and thinned significantly. It’s not thinning in patches, but there is definitely less of it all over. She is otherwise healthy and takes multi-vitamins regularly. Do you have any idea what the problem may be?

Hair character does change. We see such changes from ‘baby’ hair in the newborn, to hair in the child, to teenagers, to adulthood, to older age. I would suspect if she is healthy, that she is just experiencing a change in hair thickness. It is not unusual for blonde children to see changes. My children started off blonde (my three boys) and ended brown. My oldest had fine, platinum blonde hair as a young child and now he has coarse, brown hair.

Tags: child, age, hairloss, hair loss

Do Men Have More DHT As They Age?

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

I was wondering Testosterone levels are supposed to be highest when men are in their 20’s, yet for most men the effects of DHT are not seen until later. Do men have more DHT as they get older (past the 20’s), even though produce less testosterone? Do men develop more DHT receptor sites when older or produce more 5AR enzyme when older to convert testosterone to DHT? They don’t have these DHT receptor sites in the scalp when younger, just older? Like a cancer that just appears after so many cell divisions and the genes reach a certain point? LOL, well just wondering why men have more DHT (hormone) when older if produce more testosterone when younger, I’m sure a lot of other people would be interested in that information, Thank you very much for any info or sites that may have info!

You ask a very good and interesting question. You sound like you are just about to take a biochemistry exam. Unless I am mistaken, DHT levels will correspond with testosterone levels. Generally, less testosterone (an aging problem) should produce less DHT. The reason why you see balding men who are older (when testosterone levels are relatively lower than their younger years) is that it is likely a late expression of the genes that affect hair loss. On a counter note, most balding men will report that their hair loss began in their late teenage years (when their testosterone levels were the highest).

Tags: dht, age, hairloss, hair loss, testosterone

My Hair Disappears At Night!

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

I have minor hair loss, but it happened and is still happening during a long period of time. Last winter, i realized there was hair loss on my hair line. I have this skin condition, but my skin doctor told me that it wouldn’t make my hair disappear. I’m 15, and I don’t know what this is. Most of my family (that know about it) say that my hair isn’t disappearing but this is MY body and i know what changes are happening. Now, i have once inch of hair missing from my hair line, more hair above my ears, and the back of my neck. When my hair disappears, it does at night and sometimes after i take a shower. My hair grew very rapidly over a short period of time, and i don’t know what this is. Please, help me.

If what you are saying is that you lose hair at night because you see it on the pillow, you should do a hair count on those hairs you find. The average person loses about 100 hairs per day and regrows that number from below the skin. If you calculate this out, you will see that in three years, the 100,000 hairs on the head (losing them 100/day) will recycle. Get a good doctor who understands hair and teenagers and go about the analysis properly.

Tags: hairloss, hair loss, teen, cycle