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My father-in-law has the worst comb-over you can ever imagine. It runs from just above the ear on one side to the other side. My wife and I talk about it every time the family gets together. I can’t believe that anyone wants to look so foolish. How do he not see what is so clear for everyone around him? How can I tell him just to cut it short and join the bald man’s fraternity of normal looking balding men.

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These comb-over styles start when there is just a little thinning, and as the thinning gets worse, the side hairline creeps down ever so slightly year after year and the hair grows longer and longer on the parted side of the head. The man who is inadvertently migrating to the comb-over never notices the end look. He is watching it so slowly that he blocks any vision of the look everyone else can see. You can see it and everyone else can see it, but a classic case of denial is fully deployed in such people.

I have seen many men in my office that employ the comb-over that progressively works less well for them over time. Men like your father-in-law rarely come to the office. When I get to see them on the street or in airports , I want to go over and tell them what I can do for them to help them solve the problem – but that would not be ethical of me, like ambulance chasing. Your wife (his daughter) could approach him, but be sure that your mother-in-law sees this as a problem before the ‘talk’ or you could be heading off of a steep cliff.


I’m 22 and have been taking propecia since I’ve been about 19. It has definately slowed or stopped my hair loss, but I am still pretty unhappy with my hairline. I don’t think I would need a very large scale hair transplant at this point, my hair is only thin in the front, and I was wondering whether you thought it would be a very bad idea to get a transplant at my age and given the circumstances.

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For starters, please see Hair Transplants in Young Men.

As you see from this previous response, I do not have a problem transplanting a man of your age. It is important to read and understand the above link and we would have to develop a relationship. When both of us are comfortable with the analysis and the depth of understanding I require, then we can consider a hair transplant, provided it is indicated and not harmful to you.


I had a transplant and the hair that was transplanted became kinky. Does this happen often?

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No, change in hair character is not common, but it has been reported to me in about an estimated 1-2% of patients. It rarely gets very kinky, most of the time it just becomes more wavy. One patient that I do remember did get a kinky change to his hair after both transplants sessions. He loved it- his hair had never had any character before, so this was a most happy change for him.


I began to lose my hair in the frontal region of my head, shortly after beginning to take accutane. Is there any thing that will help?

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Hair loss from Accutane is a known side effect. First you must weigh the options of stopping the Accutane. Your doctor should be able to help you make the right decision. The lost hair may return, so you need some time to observe what happens. If the hair does not come back within 8-12 months, then you might need a complete evaluation with a doctor like me, who specializes in hair loss.

I have previously discussed Accutane on my blog, which can be found below:


My 17 year old son has premature balding. He already has a very predominant receding hairline. He is very self-conscious of it. My dad and my dad’s half-brother both had hair loss at an early age but I’m not sure that it was as young as my son. We ran some bloodwork to rule out any physical problems and all were negative. Is there anything that we can do to slow down or improve his hair loss? I was told that he is too young for Rogaine but are there any other options?

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Sometimes, hair loss occurs in very young people. As a male, he can take the drug Propecia which hopefully will stop the hair loss. First, get him examined by a competent doctor who will quantify the rate of miniaturization in his balding area. This is important, because when he starts on the drug Propecia we will want a starting point to determine if it is working and by how much. I would hold off on Rogaine until a good baseline is in hand and the rate of hair loss is documented. Please see my similar postings on age-related topics here: BaldingBlog – Age.


I had a brow lift and and a face lift. I lost a great deal of hair in the few months after the procedure. It is now 1 year since the surgery and I have had no return of the lost hair, and I have a very weakly defined hairline. The scar shows unless I comb my hair down in bangs. I would like wear my hair pulled back and show off the new younger me, as my face lift was very successful. Can you fix this?

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Hair loss is a known complication of brow lifts and face lifts. The brow lift may accelerate the aging process with thinning of the hair in front of the scar in those genetically at risk. The skin in front of the ears can be removed in a face lift, wiping out sideburns (more common in the 2nd and 3rd face lift than the first).

Hair transplants are the ideal solution for this problem. This is the most common hair restoration process I perform in women. As men do not have face lift procedures as often, I do not see as many men as women with this problem. But the same complication is still there if there is a brow lift and / or a face lift. It can be done in one procedure in most people, but it takes a great deal of transplanted grafts densly packed to get the results in a single session.


What do you think about all of the vitamins and other things sold in the health food stores that claim that they reduce or reverse hair loss?

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The word ‘claims’ in this usage, reflects the lack of scientific proofs for naturally produced substances sold in heatlh food stores. Many of the items sold are sold on their potential and a ‘hipe’ that is created by word of mouth. There is little regulation for natural food additives, so there is no way to determine the proof of the claims that are made. Some of the natural substances may have DHT blocking abilities, as claimed, but there is no proof of such activities.

It is common to find substances sold in health food stores that claim DHT blocking properties. There is no way to confirm or deny this, so it again becomes a ‘buyer beware’ issue, leaving the final action in the hand of those willing to spend the money on it. At least Propecia is a proven DHT blocker and we know that because it has been thoroughly investigated by the drug company to meet a high standard of FDA regulations. We also know about the side effects (very low) and long term use statistics. A large company behind this medication tells us that someone is accountable if things go wrong. I can not say that for most of what is sold in the health food stores.

For example, Saw Palmetto, is thought to be a natural DHT blocker, and there are various articles that purport to prove it is an effective DHT blocker. But, a recent article that I read in a well respected medical journal indicated that it was a very weak DHT blocker. Did you know that Saw Palmetto was added to the GI’s food in World War II battle zones to suppress the soldiers sex drive so that they would not get distracted? Now if you link these two (weak DHT action and sex drive suppressant), why would anyone want to take it?


I am a mature woman living in Florida. I have noticed that many of the ladies in the salons who are my age (over mmm.. let’s say 49), have thinning hair. Is there a bug going around that is causing women to lose hair? What can I do about it?

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Female genetic balding affects possibly half of post menopausel women. All you have to do is go to the salons in retirement communities and look at what is going on. The hair stylists have learned that the best way to treat female genetic balding is to lighten the color of the hair (have you noticed how many women over 50 are blonde?) and to style it ‘puffed up’ (this is a man’s description of the process, sorry for my myopic male view). For most women, there are few options. A word of caution may be worthwhile here. Take anything that is offered to you in the solutions arena with a grain of salt. Believe less that what you hear and be skeptical of fixes, particularly those without first hand experience by people you know.


I recently saw you on channel 4 news describing a new procedure of hair transplantation where there is no incision done.I have had procedures done going back 15yrs.Approximately 5500 of the old grafting frontal hairline and down the middle needs to be enhanced.I still have gaps and have lost more hair since my last procedure 8 yrs ago.Could you please tell me a little bit about the new procedure or where I can read up about it. I should also set up a consultation appt.

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You are referring to the news item from April on the FOX Procedure, also known as Follicular Unit Extraction or FUE. This is a technique that I introduced in the medical literature in the summer of 2001, and published in 2002 in an article titled Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation. The procedure essentially removes the follicular unit one by one without a traditional incision. More information can be found on FOX Procedure, FOX Megasession, and Medical Publications. is probably the most comprehensive hair restoration-related site in the world, with the greatest amount of original content and patient photographs, so please poke around the site to see exactly what we offer.

The FOX Procedure is an exciting new technique for minimally invasive hair transplant surgery, but it is not for everyone because:

  1. the costs are higher
  2. it is better for less bald people
  3. it is very difficult to perform and very few doctors are willing to step up and build the expertise
  4. not all patients are good candidates for this procedure because of the type of collagen that they have in their connective tissue (10% of people are in the category).

The procedure has the advantage of having almost no post-operative pain, and very fast healing with full activities within days of the surgery.

As you are local, I would recommend that you visit me in my Los Angeles office, which is only about 8 miles away.


Does wearing a baseball cap every day or using a wig increase a man’s chances of going bald?

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No, balding comes from within the scalp, from the genes that initiate each hair to grow. Even wearing a baseball hat for years and never taking it off and all you will have is a scaling, dirty full head of hair if your genetics are not ‘balding genetics’.


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