Female Started Losing Her Hair at 13

/by William Rassman, M.D./4 /,

i am a 17 year old (almost 18) female and have been experiencing hair loss since i was about 13. i used to have thick curly hair and now its very thin, i have to wear it half up in a clip to keep the thinning spots hidden (even though my whole head is thinning). my father is going bald and his brother and father are completely bald. i do not have any thyroid or hormone problems nor do i have any iron problems. i have been to dermitologists and they perscribed me monoxidil which i used when i was approx. 14 and stopped after about a half a year to a year because i hated using it and my hair loss was not completely noticble. now at 17 its pretty bad and i began using the monoxidil again, i started about a month ago. no one can explain my hair thinning and why a lot of it falls out after i shower and brush it. at first when i was 13-14 i didnt care because it was not noticable, but now i cant take it, im in high school almost uniiveristy and i dont know what to do! its been happening for 5 years without slowing or stopping..is there anything you can offer that will help me? pleasee im desperate, all my friends have thick hair and i hate the fact that i dont and mine falls out and is noticibly thin.

You have done your research concerning female hair loss. Have the dermatologist biopsy your scalp to see if you have an inflammatory process occuring which cause your hair loss. Find out if there are there any miniaturized hairs in the donor area, which is in the back of your head, and how much miniaturization you have everwhere else on your scalp. Are there any noticeble spots on your head? Has your hair loss been stabilized or has it become more progressive? I am limited to what I can do over the internet. Be sure to get a good, caring doctor to help guide you through what you are now experiencing.

15 Year Old Male Wants a Lower Hairline

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

I read the article regarding the 15 year old with a high hairline. I have the same problem (I am male) but when I read your response, there was nothing saying what there is out there to fix the problem. Would you please let me if there is hope for myself. I comb my hair forward too, to cover it up but I am tired of having to do that. Please let me know. Thanks for your time, I will be looking forward to your response.

At 15 years old, you are too young for hair transplants or hairline lowering procedures, because you do not know what will happen with regard to balding in your future. Such surgery, although it might work well today, may make you look abnormal if you should join the balding men out there (almost half of the male population in adulthood). Are you sure that you have a high hairline and not a maturing hairline which normally develops between the ages of 17-29? You must be seen in person to map out your hairline and entire head to determine if you truly have hair loss, a congenital hair hairline, or just part of the maturing hairline process.

Is My Hair Loss from Nizoral?

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

Hi dr. Rassman. recently I was prescribed an antidandruff shampoo called nizoral 2% ketoconazole. I used it religiously and initially felt some relief. but i was only supposed to use it 2-3 times per week and instead i used it every day. now i have noticed tha ti have a bunch of white hairs or hairs that are both white and black on the same follicle or new brown hairs. I have also noticed that i have lost quite a bit of hair on one side in the front and increased itching/burning in that area. I am only 17 years old and am positively not suffering from male pattern baldness ( i have hair like growing down to my eyes). but I am wondering if you think that the hair i lost in front with nizoral will grow back or if i permanently damaged my scalp beyond repair. Also note that there is no pain anymore that i have discontinued use of it for a month. but the shedding associated with it only stopped a couple of weeks ago

Possibly, you are allergic to the chemical in nizoral (2% ketoconazole). If your hair loss is due to an allergic reaction to medication or “chemical irritation,” then it will likely return back in 6 to 8 months after the offending chemical has been removed. Check back with me if there is no regrowth after 6-8 months.

I Am 75 and My Hair Started Falling Out 2 Months Ago

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

I always had a very heavy head of hair and thick eyebrows until about two monts ago. one eyebrow is gone and the other is gone in places. the hair on the top of my head is getting very thin i am 75 years my father died after his 93rd birthday and he had a full head of hair as did my mother. what could be causing this?

Be sure that you are healthy and do not have some early manifestation of some progressing medical problem. Sometimes, hair loss is an early sign of something going wrong. If I assume that it is not a medical problem, then Propecia may work to stop the process, if the hair loss is genetic with very late on-set balding. I have seen this late on-set balding in some 60 and 70 year old men, although it is very rare to commence at your age.

Alopecia on Tyra Banks Show

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

hi my name is Tia and i am 14 for the last 2 weeks my hair has been falling out…then i watched the Tyra Banks show and this girl with alopecia was on…anyways it has been falling out alot like up to 45 pieces a day and i am really sacred i do not ant to go bald ….how do i tell what is wrong plz help me….

It is normal to lose 100-150 hairs each day for the average person. Unless you have some medical disease or have been losing a great deal of weight, you should not worry about it. I don’t watch the Tyra Banks Show, so I couldn’t specifically make references to things that were said on the program, but I did find this link about wigs shown during that episode.

21 Year Old Female with Thinning Hair

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

Im a 21 year old female and have been noticeing my hair getting thinner since december of ’04. I figured it was just shedding and did not relieze a more drastic hair loss until september of 05. I went to two different dermatologists and both said my sclap was fine and to take vitimans. I had bloodwork done and everything came back normal. My mom is 52 with very thick hair and has been double processing it since she was in the 8th grade and my fathers side does not have any hairloss problems either. Im very confused and am worried to loose even more. It started in the front of my head now its March of 06 and im now loosing alot more in the back as well. The doctors said it could be stress .. but i would like to get to the bottom of it before it gets any worse. Is there anything else it could be?

Without seeing your hair loss pattern, I cannot comment on the etiology of your hair loss. You may have genetic female hair loss that has symptoms similar to yours, or other conditions. As you indicated that you are in New York I recommend you see Dr. Robert Bernstein, a hair transplant doctor who happens to be a dermatologist on the Columbia Medical School faculty.

For more information, look up female hair loss in the search engine on the front page of this site and you can read the various questions and answers that will align to your questions. Remember, the more you know when you see a doctor, the more value you will get from the questions you pose and the doctor answers.

Why Did I Start Balding at Age 15?

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

Dear Dr. Rassman,
I am a twenty-seven year old man, and I began to lose my hair at age 15. I went to several doctors when I was younger but they all told me the hair loss was male pattern baldness and not the result of any health problem. I am already as bald as my father, who is thirty years older than me.
When someone begins to lose hair at the age I began to lose mine, will the baldness progress until all of my hair is gone? Will I ever be able to use a hair transplant system? And what the heck would cause my male pattern baldnes to start so early anyway?
Thanks.

Don AmecheAndrogenic hair loss or male pattern hair loss starts as males enter puberty, as their testosterone levels increase, bringing on voice changes and pubic hair and other male sex characteristics. Although it is usuual to start the genetic process at 15, the DHT is clearly working on young men of that age. There is an issue of ‘gene expression’, which means that the trigger for the gene may have started early on you. Unfortunately, some men have the gene that causes male pattern hair loss to trigger earlier, while others do not see this until later in life. For example, Don Ameche, a popular old-time movie star in the 1930s and 40s known for his perfect hairline and good looks, started to bald after the age of 50 (late onset trigger for gene expression) and was almost completely bald when he was in his mid 70s (and starred in the movie Cocoon in 1985).

Propecia for 40 Year Olds

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

Sir,
I am about to turn 40 and just started last month on Propecia. My balding pattern is 3A I believe; very recessed temples since I was 23 or 24 yrs old but very slow thinning of the front 1/3 since then. I have a very low widows peak and the real thinning of this center peak area just became noticeable in the last year or so. I’m assuming I would eventually go to a 4A pattern? I have read that Propecia does not help in the front 1/3 and expecially in older men. However, since the actually thinning out of this area on me has been so gradual and recent, I was wondering if you were aware of any exceptions to this. I’m ok with the recessed temples; I’m just hoping to maybe thicken back up the center area. Any experience where the little thin hairs underneath the more normal looking hairs in the front might respond? Also, I have practically no body hair except on my legs and even that has always been very light/thin. My brother is VERY hairy, 7 yrs younger, and is almost completely bald; think there’s a DHT correlation here? Thanks so much for your time and effort.

You are correct in terms of Propecia not being as effective in the frontal hair line as opposed to the crown area, but it just might halt the progression in the frontal hair loss. The older you are and the longer and more extensive the hair loss has been, the less likely it will be that the hair loss will reverse. Now with that said, on occasion I have seen hair growth in the frontal area if the hair loss has not be extensive. It may be worth a try and it may also slow the progression of thinning you are experiencing. Before starting any medication for hair loss, you should be evaluated by a hair transplant doctor to map your scalp for miniaturization and the pattern of hair loss at the microscopic level. Good measurements are the key to knowing where you have been and where you are going. Decisions in the future are easier to make if you know where you have been when you started the medication.

My Hair Doctor Told Me To Wait For Transplant

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

Hi Dr. Rassman,

I’m a 22 year old male. In the last two years I’ve noticed more hair falling out in the shower and if I run my hands through my hair, as well as a decrease in volume and more visible scalp. Although others haven’t said the same, I feel like I know my hair pretty well. I have mild temporal and frontal recession, a widow’s peak that was never there before, but most worryingly I noticed that individual hairs falling out are much thinner.

I saw a transplant/hair loss doctor and he took global photographs, but told me I have to wait. He said my small recession is just called ‘sculpting’ and that looking at my head you can’t see any pattern of loss.

My question: Why do I have to wait until its clear I’m losing my hair visibly to take action? My father has lost some of his hair (class III?), my mother has pretty severe hair loss, and one of my uncles as well (father’s side).

You always refer to miniturization, and I understand this process, but the doctor made no mention of mapping it in my case. Does every good hair doctor map for miniaturization? Is it right to pursue in my case?

What should I do?

Please respond, my hair is my confidence!

Thanks and all the best

Good measurements are the heart and soul of good science. That is why I map out the scalp in all of my patients. I generally do not like to transplant a 22 year old, but if you are in the early balding process you do need your scalp mapped out for miniaturization to understand what is happening to you. The science of measurement (metrics) is the back bone to diagnosis in your case. Where are you now with regard to miniaturization and where will you be in a year? If your hair is miniaturizing, why are not not taking Propecia? You need to have some good solid measurements to define where you are and where you are going. Then, with those good measurements over time, it will be easy to answer your questions. Please remember that what you do now will impact you for the rest of your life, so timing is critical.

College Students with Stresses

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

Hello doctor,
I am a 19 year old freshman at university. The transition seemed like a decent one. I didn’t feel like I was experiencing too much stress during the first month. However during the end of first simester when essays and midterms were coming up I started sleeping less, my face was covered with large zits that would not surface and then leave marks (some of which I still have 2-4 months later). During this period which started about 5 months ago, I was on an emotional rollercoaster too. I had almost no time to see my friends. My social life was quickly becoming extinct. I had no self-esteem because of my new-developed acne problem. It was bad. I think I have started to get the hang of the stress, now that winter is almost over everything seems a lot easier to deal with. But what I have been noticing for the last 2 months is a lot of thinning at the hairline. It was not so bad about a month ago but now my scalp is becomeing VERY visible to the point where I cannot use all the hair I have at the front to cover somewhat “balding” areas. There are no patches persay. It is ver diffuse, but also very noticable. I have had at least 3 people commnt on it. It is beggining to scare me. I have always had fine hair but my scalp has never been visible before. I started taking Vitamin B Complex about 2 months ago for the stress, and am now taking this product called samson’s secret which is full of nutrients that nurish the hair for about 5 weeks.
My question is, does this sound like a temporary thing such as telogen effluvium? And if so when should I be expecting to notice my hair back to normal? Also I am worried because final exams are coming up next month along with more essays worth an even larger percentage of my mark. I am doing amazing but that only makes my expectations of myself even higher, causing me to stress out lest I mess up and the GPA I have worked so hard to achieve and maintain falls. Does this mean that I am only setting myself up for more hairloss and a vicious cycle that will make it extremely hard for the hair to grow back?

I realize this is a rather long post, thank you so much for your time.

Stress definitely plays a part in hair loss. However if you have a component of genetic male pattern hair loss , hair will not grow back. If this become a big problem for you, you may consider making an appointment with a hair transplant surgeon who can map your scalp hair for miniaturization pattern and formulate a Master Plan for future hair loss.

You have many issues, and some of these things like self-esteem are inside your head as much as outside. For example, when I turned 60 four years ago, the changes in my body should have taken my self-esteem down to low levels, but I somehow managed to focus on the good things in my life. I have said many times, you are the director, writer and actor in your ‘life story’, so write it the way you want it to be. Direct it to work out that way (if hair loss is the issue then tackle it correctly). Act like the man you want to be and get your grades up, for that is clearly in your power. The world will not march to a down tune, only to an upbeat one.

Am I Too Young For Hair Transplants at Age 28?

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

I am a 28 year old man. I have been losing hair since my late teens. It has been mentioned to me as male pattern baldness by doctors I visited. Over the years, the baldness has become more visible and I now comb my hair staight down. I am getting increasing uncomfortable with my baldness. I am wondering what the best option for me would be. I recently visited HairClub and they said that I should not consider hair transplantation at such an early age as I might exhaust the donor area supply and would have permanent bald spots down the line when male pattern baldness takes full effect. Also, I am scared at the idea of having an incision on my head. What advantages does your organization have over a place like others (honestly I don’t even more of any other reputed transplantation shops)? Please provide advice as to the best course of action for me. Thanks

It does not sound like good advice you got. You need a diagnosis and a good doctor who will map out your scalp for miniaturization. With this done, at age 28 you may be able to predict much of your future hair loss. Then you and a good doctor will be able to develop a Master Plan, which will incorporate medications and transplants (if needed). I suspect that the person you visited wanted to sell you a hair system (also known as a wig), so the financial interests were driven by the salesman’s agenda. If you saw a doctor and he did not evaluate you as I said above, then he/she would be no more value to you than a used car salesman. If you are in California, come visit me. Otherwise, send me photographs and lets talk. I do offer telephone consultations as well.

I’ll Be Bald By 25 — How Can All I Get All My Hair Back?

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

Hello Doc,
I have a very vague question for you. Im a 20 year old male who is thinning very fast and probably will be completely bald by about 25 (Class 6). What would you have me to get all my hair back to the way it was in high school in the best method possible.
I understand i can’t get it back completely, but what would be the best possible recommendation from your standpoint. I have been on propecia a bit over a year now and I feel it has done nothing for me, and Im looking to buy minoxidil to help me, but I’m also considering Dutasteride. What do you say?

I want to have the body I had when I was 40, but at 60 I can’t get there. Reality is that everyone loses youth and I accept that for myself. You need to stop gambling and start being smart about your hair loss. Once your hair is mapped out for miniaturization, you can be checked for the change of miniaturization over time. If the Propecia does not work, then transplants with a Master Plan is the right way to go, but you need a good doctor first and foremost. Following the advice in this blog site will at least help you to become a smart buyer.

Teenager With Graying Pubic Hairs

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

I’m a fifteen-year-old girl. In may last year I noticed I had a few gray hairs. Then in July I noticed I was losing more hair than I normally do. This has continued right up untill I’m writing this. I have a few gray pubic hairs and under arm hairs. The mojority of hairs I have are still my natuaral colour, dark brown. My hair has become very thin and less shiney too. Most of my hair loss in at the front of my hair line, where I have two bald patches. I have not been suffering from any particuler stress and I can’t work our whats causing this.
Thanks

If you are experiencing unexplained hair loss in patches you may have a condition known as alopecia areata. It is impossible for me to diagnose you with an email. You should be evaluated by a good medical doctor (such a your primary care doctor or a dermatologist) for other medical causes of hair loss.

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).

Propecia’s Major Side Effects

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

Hi Dr., I am a 20 year old male who is goin bald and is considering a hair transplant. I was wondering what you recommened to maintain hair after a transplant, other than propecia because i have heard of major side effects. What is your opinion on rogaine and other topical treatments ?

I often receive questions on finasteride (Propecia) from patients like you quoting “adverse” or “major” side effects. All drugs have side effects (even Tylenol), but when used correctly under the supervision of a qualified medical doctor it serves its purpose. I often find people are misinformed from the mass amounts of uncorroborated information available on the internet or just word of mouth. It is the source of folk legends and superstition. It is one of the reasons why these medications can only be prescribed by a medical doctor.

Propecia has been well studied for male pattern hair loss in men. The following is taken directly from the Healthcare Professional Information Label for Propecia (finasteride 1mg).

Drug related adverse experience for healthy men taking Propecia during a 12 month period:

  945 men on
Propecia		 934 men on
placebo (sugar pill)
Decreased Libido 1.8 1.3
Erectile Dysfunction 1.3 0.7
Ejaculation Disorder 1.2 0.7

Rough translation: 1 in 100 (1%) patients had some form of sexual dysfunction. “Resolution occurred in men who discontinued therapy with Propecia due to these side effects and in most of those who continued therapy”.

There have been incidence of breast enlargement or tenderness (gynecomastia) reported. This occurred in 1 in 200 (0.5%) patients taking Proscar which contains 5mg finasteride (5 times the dose of Propecia) in a 12 month period. There is probably less than a 1 in 300 chance of gynecomastia from Propecia (which is 1mg rather than 5mg finasteride). This is also reversible.

Please note inb my practice experience there is a 1 in 10 chance of INCREASED libido (some may call this an “adverse” or “major” side effect for married men). I experienced this when I started taking it myself.

I believe the take home message for anyone who is serously concerned about their hair loss is to be make an appointment with a medical doctor (primary care doctor, dermatologist, or a hair transplant doctor) to discuss possible medical causes and its treatment options.

With regard to your second question, some doctors recommend the use of Rogaine (minoxidil) with a hair transplant on the belief that it accelerates the hair growth. I have used it on patients (half of the head with minoxidil and have without anything) and there was no difference with the use of minoxidil. The beauty of the hair transplant process, with the robust donor hair from the back and sides, is that no matter what you do or do not do with additional medications, the transplanted hair grows.

Propecia in 20 Year Old Male

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

I am a 20 yr old male who noticed a large amount of hair coming out while in the shower and during the day; I have also noticed visible miniaturization in the strands that fall out. I am about NW2 now, and I notice slightly less density on the very front of my hair line. At my age, are there side effects to taking Propecia? Are there any other courses of action?

Also, I am in Europe; do you know of my options here? (Is Propecia available/branded under a different name/does it require a proscription?)
Thanks!

The drug Propecia can be taken at any age. There are possible side effects, but they are rare and vary per person. Please review the many, many posts on this blog that discuss Propecia and side effects.

Some countries have not yet allowed the drug in, while others allow it to be sold under a doctor’s guidance and control. I am sure that if you ask your doctor for finasteride, you will find it in the 5mg dose and then would have to cut it into 1/4 dosages to treat hair loss.