I have a question regarding exclamation point hair. Or more specifically thinned proximal shafts (Picture linked at the end). Age:18,Gender:Male

Online sources say that exclamation point happens when you lose hair in patches or in non traditional MPB ways but I am suffering diffuse style MPB (pattern) and the hair that falls off is really thin at the root with a white bulb thick at the top. I also have seborrheic dermatitis. I was prescribed 2% nizoral which then caused me to lose almost 50% of my hair in the span of one year (or maybe it was meant to happen?). Could nizoral cause scalp inflammation that leads to MPB?

The online source of “exclamation point” hair shaft from Am Fam Physician. 2009 Aug 15;80(4):356-362 is describing Alopecia Areata which is a disease process where your body’s immune system “attacks” your own hair causing hair loss.
Male Pattern Balding is a genetically inherited condition where men lose hair in a typical “pattern”.
Seborrheic dermatitis is an inflammatory condition which causes scaly patches on the scalp/skin which may cause hair loss from the inflammatory process.
Nizoral is a shampoo with antifungal properties that is used to TREAT Seborrheic Dermatitis. Some people may have an allergic reaction to this and a rare side effect is hair loss.

All of the above are separate and unrelated causes for hair loss and it is understandable you are searching for a unifying answer.

The simple answer is that Male Pattern Balding is genetic and unrelated to Nizoral, Seborrheic Dermatitis, or Alopecia Areata.

For a more complete answer you need to follow up with your doctor to find out the cause of your hair loss especially if you are having side effects with the medication you were prescribed.

I saw a website from a ‘company’ in the field of hair restoration, where the doctors were advertising several types of lasers for the treatment of hair loss saying that their devices are FDA approved. Does this mean that these devices have been tested by the FDA and actually work?

We addressed the subject of FDA regulation with hair lasers many years ago here and here. The FDA never really approves such a device confirming that it grows hair, but in this case they cleared it to be safe for sale. It is unfortunate that some doctors seem to promote the idea that such devices are ‘approved’ by the FDA for certain hair loss treatments. The FDA does not actually test these devices on its claims of growing hair, but place the burden on the seller or manufacturer to demonstrate safety and effectiveness. In this situation, the FDA clearance for use of terminology for Low Level Light Laser Therapy seems to have faltered.

I am taking Red Bull along with my work out program. I keep losing hair and I saw from your blog site that working out will not cause hair loss. With that in mind, I want to know if using energy drinks can help my body grow hair. I drink a great deal of Red Bull, but I have not seen value for my hair regrowth.

What in the world would make you thing Red Bull may help your body grow hair? I am missing the logic!
Red Bull contains: caffeine, niacin, pantothenic acid, vitamins B6 and B12. There is nothing special about it from a hair follicle point of view.

Energy drinks like Red Bull will not grow your hair back as you have already noticed. When taken in excess amounts, this particular brand can be dangerous, especially if you are a diabetic. There was been one report in the medical literature that presented a patient who drank about 100 ounces of Red Bull per day (5 20 ounce servings). In this particular patient, he developed renal failure (kidney failure) which fortunately did reverse when the Red Bull was stopped. Red Bull contain caffeine as well as other ingredients such as vitamins, sugar, amino acids, and herbs and when taken in moderate doses, it is probably safe, but 100 ounces a day for 3 consecutive weeks, did seem to bring on the kidney problem, a condition that could be life threatening. Just one report may not really do this side effect justice. Using energy drinks in moderation like anything you consume, makes sense.

Snippet from the article:

Laser light therapy has been proven to improve hair health, but cold laser therapy has only been available at specialist clinics. Theradome lets people use this advanced technology at home, and contains high efficiency lasers that produce virtually no heat but allow the maximum amount of light to be delivered, the company claim. However, the technology comes at a price as the helmet costs $795 (£473 plus shipping).

The article continues…

Dr Bessam Farjo, Medical Director of the Institute of Trichologists, said: ‘I do believe that laser technology has validity, but I’m sceptical of the specific claims made by Theradome GB that this particular headgear has the ability to increase the hair shaft diameter by 200 per cent. I have not seen any scientific evidence to support this.

‘It’s great to see businesses putting resources to the development of this technology, but more scientific results are needed to back-up the huge claims that Theradome is making.’

Read the rest — The helmet that can cure BALDNESS (allegedly): $800 headgear uses lasers on the scalp to stimulate hair growth and thickness

I’m going to go with Dr. Farjo on this one — I’m skeptical until I see actual proof, as the claims that it can double the size of existing hairs are pretty wild.

Conclusion from the study:

In four randomized, double-blind, sham-controlled trials of MPHL and FPHL, we detected a statistically significant increase in terminal hair density after 26 weeks of lasercomb treatment compared with sham treatment. Such improvement was independent of the sex and age of the subject, and independent of the laser comb model when similar laser dose rates were delivered. A higher percentage of lasercomb-treated subjects reported overall improvement of hair loss condition and thickness and fullness of hair in self-assessment, though the results did not always reach statistical significance. Increase in terminal hair count was comparable to the short-term trials of 5% Minoxidil Topical solution and 1 mg/day Finasteride, but less efficacious than longer term (≥1 year) trials. Further clinical trials are needed to define the optimal duration of treatment, the duration of response, and the use of the lasercomb in other alopecia conditions.

Read the rest — Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss

I have not been a fan of this modality, though I am now inclined to be more open minded in using this after reading the study published in the American Journal of Clinical Dermatology.

This study was still quite small (128 men and 141 women) and I can not tell which patients would be the ideal candidates for this treatment. I would suspect that it may have value for those who have advanced miniaturization in their hair, but not for those that are completely bald.

Snippet from the article:

Researchers from the Republic of Korea’s Pusan National University have confirmed that pumpkin seed oil increases hair growth among balding men.

The medical researchers tested the pumpkin seed oil on 76 male patients with moderate androgenic alopecia – male pattern hair loss. None of the patients had tried any previous medication, supplement or topical therapy for at least three months prior to the beginning of the study. The researchers recruited 90 patients, but excluded those with high liver enzyme levels.

The patients were divided into two groups and half were given a placebo. The treatment consisted of giving the patients 400 milligrams of the pumpkin seed oil per day in capsules. They were given two capsules before breakfast and two capsules before dinner.

Read the rest — Pumpkin Seed Oil Found to Help Reverse Balding

Although this is a small study, the results are encouraging. The rule in research of this kind is to get another group to validate the results by repeating the study. I can not advise anyone to start immediately taking pumpkin seed oil pills, but this is clearly your call as it is not a prescription matter.

You can read the study abstract here.

I am 17 years old and experiencing heavy signs of MPB, receding hairline, receding temples, Shedding and thinning. I understand that DHT is what causes hair loss in men, but DHT is also known to be the primary catalyst for penile growth. I am currently still growing (bones) and developing sexually (penis growth facial/pubic hair Etc).

My question is will DHT blocking shampoos block DHT in the body, specifically the DHT responsible for penis growth? Or do the shampoos only block DHT locally in the scalp? I don’t want this shampoo to interfere with DHT pathways and the metabolizing of testosterone into DHT (DHT attaching to androgen receptors etc).

I realize there are numerous factors that influence penile growth but I don’t want to hinder my penis growth at such an age, resulting in a less developed penis than what my genetic blueprint has set out for me. Thank your for your time, its highly appreciated.

The DHT shampoo i had in mind contains Ketoconazole DHT inhibitor, saw palmetto, emu oil, biotin & salicylic acid

DHT blocking shampoos probably don’t work to treat hair loss, and certainly not systemically. Some people claim that ketoconazole shampoo regrows hair, but it’s just a good antifungal treatment as far as I’m concerned.

Moreover, I don’t believe that these shampoos will impact the size of your penis. At 17 years old, you’ve likely completed puberty by now (or close to it).

Hello Sir,
My wife is suffering from thinning hair from last 3 years, now one can see the scalp in front. However, she has got good long hair and the hair density is reasonably good at the back. But it is thinning in front which is really a matter of concern. Earlier she used lot of Richfeel products but none of them was helpful. Richfeel, is one of the company from India specialized in curing hair related issues.

Currently, one of the local dermatologist has suggested her Ducray’s Neoptide along with novophane plus tablets. I hope that this will work. It has been 45 days she is using those. I hope it wont have negative impact which lead to further hair loss.

I am really worried and am ready to take her to any part of this world to get the best hair of her dreams. Please suggest me the best treatment for her, do you think hair transplant is too early and that should be the last option to be considered. She is 27 now. I have also got her laser comb from hairmax, will it be helpful in any case.

I am so worried, because she is only 27 and I am really afraid that in 10 years time she will lose all her hair.

One good hope I can see is that she has got long hair and hope that with advance oil and medication she could easily grow her or make her hair thick on front side. Moreover, her mother has also got thin hair but not so thin like my wife. In fact my wife’s mother hair were good when she was 27 but my wife problem of hair loss has become serious now at this early age. Is it heredity that she is losing hair so early. Is it curable?? I hope there are no side effect of the medicines and lotions, especially in women we have to see when it comes to pregnancy and fertility related issues.

Please guide me.

We’ve written briefly about the Richfeel Anagrow product before, which apparently contains plant stem cells. Unfortunately, that is not going to do anything to actually treat your wife’s (or anyone’s) genetic hair loss problems. It’s garbage with no science backing up what they claim. You said that this company specializes in “curing hair related issues”, but there is no cure for hair loss.

I can tell that you’re trying to help your wife, but you’re throwing money at a problem that is not as simple to fix as you’re hoping. The LaserComb is unlikely to do much, if anything, for her hair loss. The only FDA approved medication for treating female hair loss is minoxidil (Rogaine/Regaine), and the collection of oils and lasers are more than likely just going to provide no results, wasted time, and poorly spent money. Female hair loss can be tricky to treat, as there are a variety of possible causes in addition to genetics. See a partial list here.

There’s no way for me to know if your wife is a candidate for hair transplantation without an examination first, but depending on the hair loss pattern, she might be a candidate for Scalp MicroPigmentation (SMP). First though, your wife should go to an actual medical doctor (a trichologist is NOT a doctor) to find out the reason for her hair loss. It could be a vitamin deficiency or related to some other medication she is taking. Once a cause is determined, then a treatment path can be planned.

Hello Doctor(s),

My question is simple: Is DHT topical? In other words, is DHT a residue or some other topical “film” that builds up on the scalp? Many hair loss magic shampoos and creams claim to remove daily toxins and buildup including DHT. Regardless of the validity of their claims (I know there is little good science in most of these products), is DHT topical and cleansable whatsoever and if so in theory would a topical cleanser help against MPB?

Many thanks for the time and energies devoted to providing such invaluable information! Cheers

DHT (dihydrotestosterone) is found throughout the body, as it is a breakdown product from testosterone. It can not be cleaned off of the skin or hair to stop hair loss.

I know there are shampoos and creams sold that claim to remove DHT from the scalp, but I haven’t seen any good proof that these do anything to actually treat hair loss.

What is TRX2? I’ve never even heard about it prior to seeing it mentioned in two in-flight magazines on my travels this year; yet it boasts on it’s website that it is Europe’s number one best selling hair loss medication. How does it differ from propecia? Does it really have no side effects whatsoever as the in-flight article claims? I’m sensing there is a catch. Is it more expensive than propecia; why have I never heard of it before?

The way it differs from Propecia (finasteride) is that Propecia is an FDA approved hair loss medication with peer reviewed studies of efficacy and safety, while TRX2 is some sort of dietary supplement without any FDA approval. The ingredients in it should not work at all in curing or treating balding, though I’m sure it does allow the maker of the product to become quite rich.

We’ve written about TRX2 before here and here. I’m not impressed by the product, though their marketing efforts seem to be working to their advantage.