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Does hair age?

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Of course hair shows the effect of aging and it will often change as we get older. Look at the huge crop of large diameter hairs in the ponytail of a twenty two year old women and think of the meager, thin hair of some 80 year old women. Hair often gets smaller in diameter and fewer in number as we age.

The process of getting finer shafts (or lower densities of the hair) with age occurs insidiously over many years, starting in some people in their early 20s (male and female) and progressively becoming more frequent with each decade. We just notice the changes when we look at an isolated 80 year old in a nursing home and we think ‘Old’. The medical profession calls this type of thinning ‘senile alopecia’ (doctors have to use some Latin to create a medical mystique to it). Most people will notice that their adult hair changes in character as their age advances. This change in character may be from wavy to straight, or from thick gorilla hair to a see through appearance where the scalp can be seen in reasonably bright light (htat may never have been the case in that same person when they were 20). I would suspect that the thinning of hair densities occurs in fully 1/3rd of the adult population (male and female) at some time during their lifetime and I see this process in some men who are in their early 20s, which we now call ‘diffuse unpatterned alopecia’, yet another abuse of the latin language of olden days.

By Drs. Jim Arnold and William Rassman


Dr. Rassman,
I am 23, and have had diffuse thinning for the past three years. I am currently taking propecia and minox and have been for 15 months. During that period, I have not noticed any significant regrowth, but the appearence of my hair has seemed to maintain to some degree. I am also a law student and in December I had my first set of finals. During that time, I can honestly say that I was more stressed then I have ever been in my life. Since december, I have noticed that my hair has appeared to thin significantly.It used to be thin only in the back, now I can see a thinning pattern in the front. Additionally, in the month since finals ended my libido and sex drive have significantly increased. I do not know whether that increase is due to my lack of stress, however I am speculating that the propecia has stopped working for me. I was wonding if these are typical effects if it does stop working; i.e increased thinning and greater sex drive or perhaps I can attribute both the my level of stress and current lack there of. Any help would be greatly appreciated. If propecia has stopped working for me, then I really don’t know what else I could do

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Stress impacts everything in our lives. Your hair loss and thinning is certainly (assuming you have genetic hair loss) being made worse by stress. Propecia sounds like it has slowed or stopped the present hair loss, but as male genetic hair loss is a progressive process, it is only a matter of time until you notice more thinning/recession. The sex drive issue relates to many things. Men can find sex to be a good outlet for frustration and hiding from problems. Propecia can initially cause an increased sex drive due to the increase in testosterone levels, but the sex drive of a man your age should already be high, so perhaps your body is just learning to deal with the stress better. Could it be that your normal sex drive is what you are now experiencing?

With regard to your thinning and possible genetic hair loss, you should get your hair mapped out for miniaturization to determine if the hair loss is genetic and to what degree it is progressing. You need a Master Plan for your future hair loss. As you are in Los Angeles, I would be pleased to see you myself at no charge in my LA office. If you are interested, please call my office at 800-NEW-HAIR to set up a free consultation with me.


Hello Dr. Rassman
Again, thank you thank you thank you for spending the time to provide this blog. It is an oasis in the desert of misinformation on MPB. I have a quick question:

Can products like toppik / couvre and / or hairsprays accelerate hair loss? Are there any negative repurcussions to using such products? I havent noticed any accelerated hairloss but I use toppik and hairspray everyday and wondered if they could be damaging my hair in any way?

Aside from my concern, I strongley recomend toppik to anyone with thinning hair. I’ve found it really helps for cover up / concealing purposes.

Thanks Again

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I totally agree. Toppik (color-matched keratin protein fibers) and hair spray (glue, basically) are excellent additions to any hair loss sufferer’s cosmetic arsenal. I also highly recommend trying different styles to maximize the hair that you have (one of the reasons women’s hair loss is underdiagnosed is because they take the time and try different tricks to camoflage it well). As for these adjuncts causing hair loss the answer is “No” – there is no evidence that these affect your loss in any way. Chemical hair loss CAN occur with chronically chemicaly treated hair, but these two products do not fall into this category so you can continue to use them without fear.


Hello Dr. Rassman.

My son began to lose patches of hair since he was 18 months old. Doctors say that can be due to stress or Alopecia Areata. His father was diagnosed with that a few years ago and he was also told that his own father had it too when he was stressed. My son’s grandfather and father recovered their hair, but they didn’t begin so young. I am extremely concerned about this. My son has also dark lines under his eyes and is a very picky eater. The only thing he loves is milk. My son began losing hair in his top right side, it spread down then it happened in the left side, after that he lost a couple of patches on the back of his head, and now, he lost a big patch in the middle of the frontal part and the last is on the top of his head… Please give me your advice. Thank you very much.

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Alopecia Areata is found in family lines, like yours. The treatment of this disease must be done by experts who specialize in this. Check with a good Dermatologist for the appropriate referral. I have little to offer you via the internet for this problem.


When I was younger, I always had very thick hair. Never a concern at all. Recently, I ran my fingers through my hair and noticed that I could see my scalp quite easily by pulling the hair vertically or to the side. I usually have a very short haircut, not military style but certainly less than an inch in length. I’ve been paying more attention to my hair lately because I’ve been growing it out, and that’s really the only reason I’ve noticed. It seems like the hair on the side is thinning more…I’m not really noticing a maturation pattern where it’s receding, just thinning.

My uncle on my mother’s side is almost entirely bald, my father has a bald spot on the back of his head and thin hair…so genetic predisposition is possible/probable. I’m wondering what I should do at this point. I may be over-reacting but I’d like to find out. I use gel/comb my hair regularly, but I’ve never seen hair fall out. I can run my hand through my hair several times without seeing any hair fall off.

I’ve also started wearing a hat recently, which is reasonably tight…and may only be coincidence. I’m just not sure what to do/who to see.

Thanks for your help/site…it’s much appreciated.

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To determine if you are balding, you need to have your head mapped out for miniaturization which will show if your have developed or are developing a pattern of thinning that will eventually lead to frank balding. Any topicals you place for combing your hair may make it look fuller, but it will not change the process that is going on. Propecia is the best medication to slow or stop the hair loss and some times it even reverses it, but first you need a diagnosis. The hat will not make a difference in the hair loss, unless is is very tight and causes pulling of the hair.


First, I would like to appreciate your online service, for freely accepting questions and comments and for your valuable answers. Thank You.

I have had my hair transplant about 12weeks ago of approx. 1,650 grafts. My donor area took quite some time to heal, approx. 9-10weeks, before the occasional swelling in a few spots which have now completely subsided. During the first 10 days I had some grafts fall out, which I was told was normal, over the next few weeks I lost more of these transplanted grafts as has been considered normal procedure after a hair transplant. I have had to deal with pimples/puss modules in the transplanted region occasionally and again I read that this is normal. I have used Neospirin ointment to treat these modules and it has helped quite a bit. I am also taking finasteride 1mg for about 17weeks (started 5weeks prior to the procedure as recommended by the Doctor). It is now 12 weeks, and my questions are:

  1. Is it possible that not all the transplanted hair has fallen out? Because when I touch the transplanted region with the palm of my hand, I still feel a few spikes here and there. Just today I noticed a couple of hairs with scab attached at the bottom fall out. Should i be concerned that even after 12 weeks not all of the transplanted hairs have fallen out?
  2. As I do not see much new hair in the transplanted area as yet after 12 weeks, should I be concerned, when I have been reading that by 2-3 months the new hair would start appearing.
  3. I am considered type VI and 35yrs of age. Even with taking Finasteride, I seem to lose at least 50-75 hair everyday after the two daily showers. Do HOT water showers have a negative impact?

Your valuable comments are much appreciated. Thank You

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I am fairly sure that you are not losing hair transplants, but what you are seeing may reflect poor cleansing of the recipient area where the scabs stayed on too long. Without seeing you, I am assuming that what you are seeing is the hair from within the old grafts that is coming out (the hair that should have fallen out earlier). The ‘root’ of the transplanted graft is secure in a couple of days after a transplant until the scabs are all off. Rarely will a transplanted graft come out after the scabs are gone (in our hands in just a few days the wounds lock the hair graft into position because of the small needles we use). We have researched this extensively, and found that they can not be pulled out the earlier of (1) after 10-12 days, even if you try to pull them out, or (2) the disappearance of the scabs (usually a couple of days in our practice). In patients who do not comply with our washing protocol, the scabs may last for weeks.

Hair roots start taking hold and growing hair in 10-20 weeks after the transplant procedure, so I would not worry at this stage in the transplant growth cycle.

Hot showers will not cause hair loss, but if you are losing hair, then there may be a shock effect from the original surgery which should be about over shortly. You need to ask your doctor to map out your remaining hair for miniaturization to determine if your class 6 pattern will progress to a more advanced pattern. That should have been in the discussion when you and your doctor made a Master Plan for what was about to happen to you with a hair transplant.


Dear Doctor,
I have this very close friend who is 15 years old. He is suffering from hair loss and has been since about the age of 11. I’ve talked to him about it many times and he says that the amount of hair he loses after showers is unbelievable. Even when he runs his fingers through his hair strands come out. I really would like to do what I can to help him, he has trouble talking to people so I’m basically the only one who can help. He also gets made fun of at school sometimes and no one likes to be teased. I’ve read up on different causes of hair loss but nothing really is directed to younger teens. Please help me help him.

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Young men as young as 13 can have genetic hair loss. He needs to see a good doctor, get his hair and scalp mapped out for miniaturization and find out if he is genetically balding. Assuming it is genetic hair loss, then the drug that is best to hold on to his hair is Propecia. He must get help and get proper management; the price of premature balding is too grave a consequence for denying the problem.


I am a 33 year old male and am convinced that I am losing my hair at the front of my head. I have thick hair, but it is certainly thinner, i.e. I seem to have less hairs per square cm. I can also see my scalp at the front, which I could not around 1 year ago. When I comb my hair, or wash it I notice hair in my hands or in the comb. I would say that the number of hairs is around 5 or 6. This is also something pretty new to me. What I would like to know is, am i going bald and how can I determine the rate? Also I take Xanax in small doses and what like to know if this has an effect. Would Rogaine help for frontal hair loss?Finally, how long should I wait before I have a hair transplant. I don’t want to go bald before I do. Thanks.

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Xanax can cause hair loss, but I would think that if you are thinner in the frontal area, then you may be having genetic male patterned hair loss. As I have said many times in this blog, a diagnosis includes an examination for miniaturization, which would be evaluated throughout the head to determine what your genetic pattern might be. At 33 years old, your pattern should be evident when your scalp hair is mapped out. I am ingorning your 6 hairs per day loss as that is low and probably a wrong estimate, but the thinning of the hair in the front is more of a concern for me. If you have male pattern balding, the hair in the front will be heavily miniaturized and will show up nicely on magnification imaging. If that is the correct assessment, then Propecia may help slow or stop the hair loss.


Dear Dr. Rassman–

I understand that after one stops taking Propecia for some amount of time, X, one will lose all the hair they have gained and kept as a result of using Propecia in what you term “catch up hairloss.” I also understand that this may result in what appears to be a large amount of hairloss. However, what is that amount of time, X, referenced above? That is, how long must one be off Propecia to lose all benefits of having taken the drug? For instance, I have been using the drug for 14 months–if I stop today, when will I lose all the hair I have gained and when will catch up hairloss begin–next week, next month, within 9 months? Sometimes, I forget to take the medication and skip a day or two–is this lethal to my regimen of measures taken to maintain my hair count?

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The time it takes to play catch-up is about 3-6 months. Forgetting to take the pill a day or two might have a marginal effect on you.


Is DHT the cause of all genetic hair loss? I ask because I have DUPA similar to my mothers type of hairloss which is hairloss all over with not balding pattern. Whats the best way to attack this, thanks.

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The answer is different for each sex.

Male: DHT is the cause for almost 100% of genetic male pattern hair loss. There are other genetic diseases and other weaker male hormones made in the adrenal glands that can cause hair loss. Other diseases include the various alopecias (e.g. areata and totalis) and unique diseases that are generally not found in the United States. We know that if your testicles are cut off (this was done in mental institutions in the U.S. many years ago when we did not understand mental diseases) hair loss can be prevented. When these men were given testosterone, they lost all of their hair in months, as was typical for the family pattern.

Female: Women have some male hormones just like men have some female hormones. When these ‘male’ hormones are produced in high amounts in some women (example would be tumors that secrete such hormones), we have observed the impact of these hormones as they contribute to hair loss in genetically prone women. With women, our understanding is not quite as good as with men, because in men we have recognized the role of a single hormone (DHT) as the major cause of most hair loss. You need to have a complete medical workup for hair loss before assuming that this is a genetic process. There are many conditions that cause hair loss in women and it is dangerous to assume that it is genetic unless you take the right tests to rule them out.


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