16 Year Old is Losing Hair, Wanting Transplantation

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

I am a 16 year old male. When i turned 13 I dyed my hair about 5 times, and bleached it once. The following year I began to lose my hair. You can see my scalp on the back of my head, not greatly, but very noticablly. The hair on top of my head is very thin now, and u can almost see through to my scalp. My hair has stopped falling out since then but the damage has been done. I have been to several doctors, and dermatologists, they all say it’s hereditary, since my father is bald. My questions are, if the hair loss is hereditary why did I start losing my hair at such a young age? If my parents and I consider hair transplantation am I guaranteed to have a full head of thick(er) hair? If we decide to have the surgery should I start taking Propecia to prevent any future hair loss? I would love nothing more than to have a full head of thick hair again. This has been a very stressful situation, being in my prime teen years, and entering my junior year of high school in September. I would greatly appreciate it if you respond to my message. Thanks for your time!

You are almost certainly too young to have hair transplants. Seeing through the hair to the scalp means that you hair is probably very, very fine. This is a common look, something that my generation called a towhead. I would not be surprised to hear of balding in your family as 50% of men in their lifetime do have some form of balding. Before you start on a treatment plan, please read Miniaturization: Critical to the Master Plan for Hair Loss and develop a Master Plan for your hair.

Tags: hair transplant, hairloss, hair loss, towhead, tow

Propecia, Minoxidil, and Age for Hair Loss Protection

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

hi dr… do you think you increase you chances of stopping the hairloss if you use minoxidil with propecia???? also does hairloss tend to slow at age 40… please let me know .. thanks

The combination of minoxidil and Propecia may make a difference in a few patients, but I personally do not recommend its use together unless the Propecia is failing to achieve the goals. Hair loss does slow down (on average) at about 35, more so at 40 and rarely is it very active in the 50s. There are exceptions to this rule and I do see men at the ripe age of 50 who experience hair loss for the first time.

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

3 Year Old Shedding Hair?

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

My son is 3 year old and has relatively long hair, however I have noticed that in the morning there must be around 20-30 hairs lying on his PJ’s or pillow, is this normal.

This may be his normal. Thirty hairs is not a concern unless you think that there is a real ‘bulk’ problem with thinning. People (children are people too) cycle their hair and lose about 100 hairs per day. These will be seen in the drain or on the pillow.

Tags: hairloss, hair loss, child, children, youth

Using Minoxidil At 15 Years Old

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

Hey Doc, your site is awesome. I have a question. I am a 15 year old Indian male, and I recently discovered my receding hairline. For a week or so I thought it was a mature hairline since everyone in my family has one (noone is bald though). Anyway I went to see a dermatologist and she said it’s male pattern baldness because of the recession on the sides. She prescribed Minoxidil 5 % for 12 months. I just wanted to know if you think I should take Minoxidil at such an early age or get another opinion. BTW, when I raise my eyebrows my last fold of skin is 3/4 inch away from my hairline. And the recession of my left and right sides are an inch away from my hairline.

I do not have the benefit of examining you in person and this site is not intended for personal medical advice and second opinions. From what you are describing, your hairline may be advancing from a juvenile hairline to a more mature hairline, albeit a bit prematurely. This is generally not considered male pattern hair loss. To be more certain, you should have your scalp hair evaluated for miniaturization with a hair densitometer.

Also, I am curious as to what you mean by “recession on the sides”. Are you saying the the sided temple prominences are a problem as well? If that be the case, then there is more here than meets the eye.

Tags: hairloss, hair loss, minoxidil, mpb

18 Year Old Female’s Bald Spot

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

I am an 18 year old female, about to enter her freshman year of college. In my freshman year of high school (2002), one night before bed, I was brushing my hair and I screamed. I ran out to my mom and yelled that I was dying!!! I bent over and showed her the spot on my head the size of a quarter where there was not a single hair. Now, four years later, I do not have that one spot, but when I am in the shower washing my hair, I notice large amounts of hair that fall out into my hands, then, after my shower, I often wonder how much more will come out when I comb my hair with a wide tooth comb, and again, a lot. I do not know the cause of this, and I was wondering if you could please help me in telling me some of the causes of this that are in an 18 years olds life. Thank you.

See a dermatologist and let him/her examine you to answer your questions. It does require a good doctor and the knowledge that he/she has between their ears. Sorry, this isn’t the type of question I could easily answer over the internet without examining you first.

Tags: hairloss, hair loss, female, woman, women, bald spot, dermatologist, dermatology

Senile Alopecia

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

I’ve been searching your wonderful blog for treatment information on what is apparently termed, “Senile Alopecia.” My still beautiful mother at 84, may be experiencing this. She has been having a rather sudden increase in overall hair loss. Her scalp is showing through mostly on top, but also in the back and sides. I’ve copied your suggestions for possible medical causes in younger women. Once those are eliminated, is there anything at all that might halt this fast progression to almost total balness? Thank you so much for your help.

Senile alopecia often refers to generalized thinning or alopecia. With women, the female hair loss that we see on over 50% of post menopausal women, is a diffuse alopecia. We see this condition in 1% of men in their 20s. If the medical causes are not there and blood testing has cleared your mom of the the various causes of hair loss, then female genetic hair loss is probably the diagnosis. When it is referred to as senile alopecia, it generally means that the victim is elderly. It’s bad terminology. In the case of your beautiful 84 year old mother, simply put, she may be outliving some of her hair. Also see NHI Frequently Asked Questions.

Tags: hair loss, hairloss, female, woman, women, senile alopecia, alopecia, senior

I’m 14 and Think I Have Traction Alopecia

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

Hi. I’m 14 years old (female) and I think I have Traction Alopecia. My hair is thinning on the top of my head but the rest of my hair is okay. I have been wearing my hair in a ponytail since the 4th grade and now I’m going into 9th. Do you think my hair is going to grow back? what do I do? Also I noticed this about a month ago and stopped wearing it in a ponytail. But will It ever be the same again? Please Help!!!

First, be sure not to continue using a tight pony tail. It is tight pulling, not the pony tail itself, that causes traction alopecia. Second, get a good doctor to look at the hair count and the degree of miniaturization in the area of your concern. With traction alopecia, the count should be down. The good news is that it will probably get better provided you take away the ‘insult’ to your hair. Wait about 6 months for reversal if that is traction alopecia.

Tags: hairloss, hair loss, traction alopecia, alopecia

5 Year Old Daughter Has a Scalp Scar — Too Young for Transplant?

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

My five-year-old recently had something fall on her head, and it cut her and left a scar. It is on the front of her head, so it is fairly nodicible. I could part her hair differently, but I know this will probably bother her when she gets a little older. I was wondering if there is anything you can do to help. Is there any was of restoring hair where the scar is? Is my daughter to young for a small hair restoration procedure? Please help, I know I should have been watching her closer to prevent it.

Hair transplants are great at covering up scalp scars from accidents. It would be a fairly easy procedure depending on the size and the location of the scar. However, at 5 years old, your daughter may not tolerate the discomfort of the anesthesia and comply with the healing process. As it is a cosmetic procedure, it is my opinion that she should wait until she has a better appreciation of what is involved in such a procedure and drives the process herself.

Tags: hair loss, hairloss, scar, toddler

My Transplanted Hairline Was Too Low

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

im 22 and had 500 grafts done in my receding temples about 6 months ago. i experienced severe MPB at 18-19 and hairloss had been stable since then. the hairline was carefully marked by myself before the surgery so i cannot blame the doc, but now i feel it could have been 1/2 further up. the hair are very fine and not very dense, just as i wanted them on temples(not too dense, just enough to cover). in the future can these be moved 1.2 up??

Not really. It is very difficult to move transplanted hair. I tell patients that transplanted hair is always permanent and that is why it should be done right the first time. If removal was to be attempted, it would have to be done with a Follicular Unit Extraction (FUE) technique. You can have a brow lift which will give you a higher hairline, moving the transplanted hair upwards, but that is fairly radical surgery for someone of your age.

I am disturbed that some doctor would transplant a 22 year old and that the hairline would be placed low. The fact that there were only 500 grafts also disturbs me, because it indicates that the balding is not severe. Were you on Propecia? If not, then there is clear malpractice here. You need an expert to assess your situation.

A hair transplant is for life. That is why I constantly emphasize the Master Plan in hair restoration. To achieve the maximum cosmetic benefit from hair restoration surgery, a personalized Master Plan should combine the best information available with a realistic assessment of what your future hair loss may be. It is an integral part of the patient-doctor relationship.

Tags: hair transplant, hairline, hairloss, hair loss

15 Year Old Losing Hair From Sides and Back of Head

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

For the past year I have been noticing my hair loss, and it is getting to the point where I can’t hide it. The part that scares me is that I am only a 15 years old male. Could this be male patterned baldness at 15? It is not just falling off the top of my head but also falling out the sides and the back. Is any of this normal?

While it may be normal (but rare) to be affected with male pattern hair loss at the age of 15, it should not affect the sides and the back of your head. You may consider visiting a medical doctor who can evaluate you for any treatable medical causes for hair loss, because your hair loss may be secondary to a medical issue. If you had a ‘typical’ case of genetic hair loss, there will be patterns of miniaturization seen in the distribution patterns typical of those defined in the Norwood chart. Mapping your head and scalp for miniaturization will show this if that is the case. Otherwise there are rare conditions such as alopecia areata or diffuse unpatterned alopecia (DUPA) which are generally not easily treatable conditions.

Tags: teen, hairloss, hair loss

Desperate at 23 — Is a Hair Transplant Worthwhile to Me?

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

Letter from a person in Europe:

I am 23 years old and i am suffering from hairloss male pattern with a receeding hairline. I am contemplating a procredure and I want you to tell if it it is worthwhile. They assert to be the best in the industry. Can i trust them?. Have you heard of them?

Going through such a horrible condition at such a young age, as you can imagine is truly stressful. My personal doctor says nothing can be done and i have seen dertmotologists who say nothing can be done either. So i am taking things to the extreme.

Thanks

I have reviewed your pictures today. You appear to be a Norwood Class 3V pattern. At the age of 23, I would rather that you start taking Propecia (finasteride) before you do anything. If you have a transplant without that drug, you will accelerate your hair loss and if you think you are miserable now, it will be worse if you became much balder immediately after a hair transplant. The issue always is: Where is your balding going and what is the Master Plan for what you will have to manage over the years in front of you? With the genetic balding that you are showing in the photos you sent to me, anybody that would recommend transplants without giving you at least 8 months of finasteride, would be in my opinion incompetent and immoral. There is no doubt that a transplant on you now will leave you more bald, not less so; PLEASE do not start transplants without 8 months of oral finasteride. Get your hair mapped out for miniaturization to anticipate your pattern of eventual hair loss and then get a competent doctor who will put a plan for your long term (you have years to live and I do not believe you want to live it as a bald man). I have seen too many unhappy men your age who go for a transplant out of desperation and then use up the valuable donor hair without any plan and no way to ever look normal again. Do you get what I am saying?

Tags: hairloss, hair loss, propecia, finasteride

I Started Losing My Hair at 40

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

I’m 40, male and have always had a very health head of hair. I am in good health. In the last 3 or 4 months my hair has started to fall out (pretty much all over my head) but primarily on the entire top of my head. Does hair loss not usually start at a younger age? The loss has been pretty significant and I’m fearful that it will be all gone in the next few months. What can I do?

I have heard that a high fever (had one a few months ago) could have an impact.

Also, my scalp has been itchy – Nizoral has not helped.

My grandfather and great grandfather (mothers side) were partially bald.

Thank you

Assuming that the hair loss is very short-term (it may not really be that way), then for a man with short-term hair loss, Propecia has a good chance of reversing it. I believe that this is the case on a man of any age. Your bout of high fever could have been a precipitating cause. The causes of hair loss in most men are:

  1. genetic
  2. hormones
  3. stress
  4. time

The fever, if severe, is a real stress producer.

Tags: hairloss, hair loss, fever, stress

Concerned 22 Year Old Getting a Hair Transplant

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

I am a 22 year old man who recently signed up for a hair transplant. While I really don’t have a spot on my head that is bald, I can tell that the day will be coming when they will be. My question is how noticable is the donor area damage directly following the procedure? If I return to work in a few days will people be able to tell? I am so nervous about the procedure. I have visions of the procedure going well and having a nice head of hair for several more years. I also have visions of being scarred and worse off than when I started. Please write back as soon as possible, I look forward to any advice and answers you may be able to give. Thank you for your time.

Please think this through. Are you on Propecia? If you aren’t on Propecia because your doctor did not put you on it, he is not a good doctor and you should run for the hills, not for a hair transplant. Assuming that you have no visual balding, then doing hair transplants on a non-balding 22 year old for prevention purposes is malpractice. You are in control of this. Send me some good quality photos and let’s talk this through.

Why the rush?

Tags: hair transplant, hairloss, hair loss, propecia

Gray Hair in Young Man

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

I am 23 years old and have a worsening problem with grey hair. At 18, a few strands of hair slowly started to turn grey from the tips (not the roots). The graying would spread to the rest of the hair till it was completely grey. Over the past 5 yrs the grey hairs have increased and I now have about 30 grey strands all in the same area, in an area of about a few square inches. I don’t have grey hair anywhere else on my head and do not know how to stop it. I have been taking multivitamins and get plenty of exercise as well. Also, it seems odd that the grey hair is all concentrated in one area. Please advise me as to what you feel could be causing this and what I should do to treat it.
Thank you.

People gray in sections of the scalp before it spreads to other areas. I have seen people who had a single patch of gray hair in an otherwise normal head of hair that is dark. This could be in people who are very, very young (children have it at times). This is a genetic variation when it occurs. Other than the use of hair dye, there is nothing that can be done. You call this a problem and from a social point of view it clearly can be, but from a medical point of view, the hair at this point on your scalp is completely normal. If you do not like what is happening to you, you can use a variety of safe hair dyes to solve the problem.

Tags: gray hair, grey hair, dye, hair color

My Daughter’s Hair Won’t Grow

/by William Rassman, M.D./56 /,

My 5 year old daughter’s hair will not grow! I have tried almost everything and it still seems to be the same length since her birth–very short, course hair. I have recently resorted to extensions (braids) in an effort to give her hair a break from everyday styling, but nothing appears to work.

Could she have a medical problem?

Hair on the scalp grows in cycles. They 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.

I do not know why your daughter’s hair has not grown in 5 years. There is a peculiar genetic condition that impacts children of her age causing hair loss and balding. There may be variants of this condition worth exploring. You should discuss this issue with her Pediatrician and determine if she has any medical conditions that may be contributing to such slow hair growth. The use of hair extensions may cause the hair she has to fall out from the traction it causes. If her hair is not growing as you reported, then she may become bald at the point the ‘extensions’ are attached.

Tags: traction alopecia, child, hairloss, hair loss, hair growth, slow