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Hello Dr. Rassman,

I am a 22 year old male with a widows’ peak that I would like removed. I also have bad acne if you take care of that at all. Please let me know costs, etc…


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Removing a widow’s peak is not easy and has side effects which include scarring, depigmentation, pitting, etc. That of course, depends upon the mechanism that you chose to remove the widow’s peak. FUE works, but may leave small depigmented areas, just like electrolysis might do. Laser hair removal may work but also runs the risk of depigmentation and the failure rates with laser hair removal and electrolysis is higher than 50% per hair treated.

With regard to acne, you need to see a good dermatologist. Costs are not appropriate to discuss at this time, because there is much to do to determine if you are a candidate for any of the treatments I discussed above. At 22, I am concerned about a focus to remove a widow’s peak.



The folks over at are having their annual Medical Weblog Awards, and I’m very excited to announce that Balding Blog is up for the Best New Medical Weblog award!

Thank you very much for your support!

UPDATE: Voting is now over.


I am down right angry about everyone targeting balding men as the butt of jokes. People do not understand that behind every bald man, is a feeling sensitive man and I wish that people will stop jabbing at us.

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In this week’s issue of The New Yorker magazine (January 9, 2006; pages 43-48), there is an excellent article about hair loss titled “The Power of Hair”, by Burkhard Bilger. There is a great quote in the article from an anonymous source that says, “The man who isn’t bald never thinks about baldness. The man who is losing hair never thinks about anything else.” It is full of wonderful stories about balding looking backward in time, and looking forward to genetic cures, cloning, and some of the recent work done on an experimental basis. The article is worth reading, concluding from a patient who had a hair transplant, “Having hair on your head, you feel like you’re still young. You feel like you’re alive. Nobody wants to look old, man. Nobody want to look old.”


Dear Dr. Rassman,
I am 22 years old and had a hair transplant last year when I was 21. Unfortunately, I am quickly thinning everywhere that I did not get the transplant and I am very dissapointed with the way I look. I wish I hadn’t jumped to this descision and had just accepted being bald. I read your articles on FUE’s to revise the scars on the back of the head. Is using laser hair removal as well as laser resurfacing practical for removing the hair and fixing the scars where the transplants were placed? Please respond as this issue is extremely troubling to me. Thanks.

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At 22 years old, it is easy to sell ourselves on a solution that seems easy. I always tell people that hair transplants are permanent and that is the good and bad news. For you in your present situation, it sounds like bad news. You may compound your situation, making it worse with things like laser hair removal, trying to undo the transplant with FUE and the like. Some of these things, depending our your specific situation, may work. FUE can take out the grafts, but it may not fix any skin dimpling you might have or wipe out the scar if you plan on shaving your head. Skin resurfacing sounds great, but it changes the texture of your skin, possibly making it worse than where you are now. You should see a real expert and with good guidance and good medication (like Propecia), you might want to consider another hair transplant (this time with a Master Plan) as an option to doing it right this time. Just how bald you will become is critical for the plan you need to make. I would personally love to work with you, as I have three sons in their 20s and early 30s and I seem to understand men of your age. Just be careful and do not make another bad decision without every piece of information you can put together in hand, and this time command what you learn. As I’ve said before, you are in the driver’s seat, so drive carefully.


Dear sir,
First of all i like to thank you you for helping the poor people who are feeling very sad over their hair loss. I am having continuous hair loss for the past 2 years. All of my hairs are becoming thinner and thinner day by day. i used all kinds of shampoo which don’t give me good results. i also have a dandruff problem. if i use oil it goes away, but comes back quickly after 2 or 3 days. please tell me what can i do for preventing more hair loss? please tell me not only which medication to use, but also tell me any useful shampoo which can give more help with medication. thank you.

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It is not good medical practice to diagnose and make treatment recommendations without the ability to see and evaluate your problem. Your symptoms are very general, like asking an auto mechanic: “What is wrong with my car? It does not sound right!” A good mechanic likes to see what the problems are, and to be able to evaluate everything about your car.

For me, I need to examine your scalp, looking for genetic balding and other diseases like psoriasis (which sometimes looks like plain dandruff). Make an appointment with a good doctor and do not treat yourself, for your problem may be more difficult than you think.


I am 29 years old and am losing hair. After the shower I can see lot of hair fallen around. In my diet, I dont include iron-rich food. Would it be a possible reason for hair loss? Can you suggest a good diet for preventing hair loss?

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Speak to your doctor and have your iron levels measured. This is an important step if you think that you have an iron deficiency, a common occurrence in women. Historically, women needed to eat meat to replace the iron they lose from menstruation which is why iron deficiency is not uncommon in women. A good general diet with red meat may be all that you need if your iron levels are bordering on the low level, otherwise, see you doctor and get his/her recommendation. If you have hair loss, then as I’ve suggested many times in this blog, you need a good examination for miniaturization to get the best diagnosis for cause.


I had a hair transplant completed two days ago. I was a IIIv. I recieved approx. 2200. I think everything seems to be ok but I am concerned about my post op care. Is it safe to take a bath or jacuzzi bath? I am also doing hyperbaric sessions. Tomorrow will be my fourth 90 minute session. Should I continue with the hyperbaric session? Lastly, what does a raised graft look like? I did sit in my jacuzzi bath for a while got out and the recipient sites looked sort of white. Thank you very much for your insight you are providing a great service.

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I generally tell my patients that they can run a marathon 5 days after the surgery, but any prolonged soaking of the head that has had donor wound harvesting may not be a good idea. If you had an FUE harvesting technique, then the rules change and you can safely soak in a hot tub (a clean one) or go surfing in 5-7 days (not in polluted waters of course). Providing that you do not soak your head, I do not see a problem with a series of short Jacuzzi baths at 5 days. Hyperbaric sessions are interesting. I would love to know if your hair continues to keep growing and avoids the surgical shock that usually makes the hair disappear for a few months after a transplant. Please let me know if all the hair is growing at 2 months.


I am a 27 year old, female of indian ethnicity. I always had extremely thick hair, but have noticed over the last 5-7 years, a dramatic reduction in my thickness (probably half the thickness it used to be). Admittedly my hair is probably still considered thick, but I am concerned that at the rate of my hair loss it could become dramatically worse, and want to prevent this from happening. My mother’s hair has dramatically thinned (you can see her scalp visibly) and I am hoping that is not what I am getting. I do notice slight regrowth but this does not seem sufficient to be replacing all my lost hair.

I notice that I lose a lot of hair in the shower, when I style my hair, and anytime I just pull my hair together, and also see that I lose strands of hair throughout the day (my floor perpetually has a lot of hair on it and my clothes usually grab a fair number of hairs as well). I have been perpetually on different antibiotics for acne for about the last 10 years (not sure if this is an influence).

I want to start using Rogaine for Women but am not sure if I am too young for this, and also dont want to use this unnecessarily. Can you please tell me if I can/should be using a product like this? Also, should I see a doctor regarding this (what type of doctor is best), and what tests should I be asking for? Any feedback you have would be appreciated.

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Self-diagnosis is difficult for me to recommend, because if you have a medical condition causing the hair loss, then you will not get a proper diagnosis. As I’ve said before, there many reasons for hair loss in women, including hypothyroidism, ezcema, alopecia areata, telogen effluvium, lupus, drugs, stress, crash diet, and infections. As you will see when reviewing the list of problems, hair loss in women is not as straight forward as in most men. Before starting more medications, you should get a metric (measurement) to get your scalp mapped out for miniaturization to determine if you have premature genetic balding for women.

A good dermatologist or family doctor can perform the basic blood tests and a dermatologist will be able to do biopsies when appropriate. Rogaine for Women may work if you do not have one of the medical conditions listed above.


I am a 27 year-old male from Toronto, Canada. I have a family history (faternal family and partenal family) of MPB. In the summer of 2005, my stylist informed that I was thinning at the top/front. I was in denial as I have used lots of gel or similar styling products and have been able to see my scalp. I later noticed the front thinning a little, but did not really care as it did not seem to be serious. In late December 2005, my uncle asked me if my hair was thinning (which he has always done b/c of the gel) and my aunt said that my hair was thinning from the crown….my sister said she noticed it as well. The next day I asked my barber not to use styling product and he said that would be good b/c of the thinning on the top (the first time he has mentioned it since the summer!!!). Needless to say I am no longer in denial BUT I WANT TO TAKE ACTION AS QUICK AS POSSIBLE.

I am going to speak with my family doctor about propecia/proscar. I have bought rogaine (2%) but will wait to use it, as I would like to see the doctors say and b/c of your advice to start out with one remedy so that I can know what is effective. I have also bought nizoral (2%). The rogaine seems like a pain to use. I am a very very busy young professional.

I have a few questions:

  1. do you have suggestions for a good doctor in Toronto, Ontario, Canada (preferably downtown core) where I can get miniaturization done?
  2. how long does the balding process take? I am concerned that I will lose a lot more hair before any medication kicks in. I would BE QUITE HAPPY IF I COULD MAINTAIN MY CURRENT HAIR for the next 8 – 10 years as I love my locks.
  3. Is avodart available in Canada?
  4. do you recommend any particular thickening shampoo and styling product? I want to avoid the revivogen and stuff like that.

Thank you for your help.

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  1. Check with the ISHRS for a doctor near you by using their physician search.
  2. The balding process varies with each person. The reality is that very bald men are usually on their way to that diagnosis well before their 29th birthday.
  3. If you do have genetic hair loss, Propecia or Proscar (broken down to 4 parts of a tablet) is more appropriate than Avodart at this time. That being said, I do not know of the availability of Avodart in Canada.
  4. I don’t believe that styling shampoos or any topical agents will help.

It sounds like genetic balding is the diagnosis, but I couldn’t properly determine that without an examination. As you know, we tend to follow our family patterns, which also includes the rate of balding. Find out who you take after, and you will have a better idea of what may happen if you do not go on such medications as Propecia.



I have been using Propecia for about 7 years. The results have been satisfactory. However, the other day, an overzealous hair stylist at XXX Sam’s gave me an extremely aggressive haircut. I mean, it felt like she was ripping my hair out by the roots when she would comb it or cut it. Do you think this haircut could have caused permanent hair loss in any potentially damaged areas of my scalp, or, with or without the help of Propecia, the hair will just grow back? Thanks!

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I had a patient who got mugged in downtown Los Angeles. The gang that robbed and mugged him, held him by his hair, and when they took all of his money and kicked him, broke his nose and cut his face, they pulled out most of the transplanted hair I had done in the front (1500 grafts). He insisted that the ambulance bring him to my office and he was the only person ever, who came to my office looking like he got out of a war zone. He did not care about his broken nose, his broken ribs, his cut face, or the many bruises on his body. He was crying for his hair that was then all gone.

I told him that he had to go to an emergency room to get himself fixed up and I assured him that his hair would come back. In just a few months, all of the hair came back. I doubt that anything that any person can do with a hair cut can match this story. To conclude, your hair should be fine.

With regard to your stylist, remember her like you remember an old discarded flame, what brought you and what sent you packing.


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