Hair Thinning in a Young College Student

I’m 23 years old, male. I was concerned about my thinning hair and my forehead is also very high. I was wondering if my forehead could be lowered along with hair transplant in one session and also a general estimate of what it might cost. Could the surgery be financed?

Another concern that I have is whether my transplant area and donor area would be red and swollen for various number of days. How many days are we talking about here? Since I am a college student I am concerned if people will be able to tell I had a hair transplant surgery after I come home from the procedure. Will the transplanted hair and the hair from donor area shed very badly and leave me looking like I have thinner hair than I used to and how much pain should I expect?

Thanks for addressing my concerns.

Thinning hair in a 23 year old man is usually caused by genetic balding. You should see a good doctor to have your hair mapped for miniaturization and have your hair bulk analyzed to be sure that you have genetic balding. If this is the case, then the use of medications like Propecia will be critical to stopping or slowing the balding process from progressing.

The redness after a surgery depends on two factors — the color of your skin (white skin is more likely to turn red), and the general way your body reacts to a wound (scratch your forehead with your fingernail and then wait 5 minutes to see if it turns red). If and when you become a candidate for a hair transplant by presenting with a clear balding pattern, then you can at the time of the transplant, lower your hairline. Costs vary depending upon what has to be done. Financing is available.

Tags: hair transplant, propecia, finasteride, hairloss, hair loss

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Is Telogen Phase the Same Length for Balding and Non-Balding Men?

Dear DR, hi,

I found your blog by searching about duration of telogen phase on Men with male pattern baldness. I’ve a pretty simple question: is the telogen phase the same for Baldness suffering peoples and “normal” peoples?

I’m asking you that because ive checked your blog, and i saw tons of guys complaining about masturbation/working out incidence on MPB. Alot said they saw some changes in the daily shedding (in good or worse) after 3-5 days only… How is that possible? I though a “dead” hair fell 100 days after the beginning of the telogen cycle. So how can they check the result of abstinence OR over masturbation only after a couple of days? Do i misunderstood something? As nobody never corrected them about this point, do that means the telogen phase for MPB men is equal to less than 2 weeks and not 2-3 months like for others men?

In advance, thank you. Regards.

The duration of the telogen phase varies in everyone. The cycle can be longer when there is miniaturization present . If a hair dies (apoptosis), it can die within a follicular unit or miniaturize within a follicular unit. The telogen cycle, I believe, is significantly longer than 2 weeks. So, for example, if you have a high density and many three-hair follicular units, one hair may go into miniaturization and at some point in the follicular unit’s cycle, that hair can die off.

Tags: telogen, hairloss, hair loss

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When Should I Apply Minoxidil After I Take a Shower?

I have thinning hair on the top of my head. Should I apply minoxidil after a shower when the hair is still damp, or wait till it dries? If I apply when it is wet, it seems like more gets to the scalp since less gets absorbed by the hair and is easier to apply in between the hairs. But if the skin is nearly saturated with water, won’t less medicine get absorbed? The instructions don’t cover this.

I would use a towel to dry your hair and then apply minoxidil while the scalp circulation is increased from the warm water.

Tags: minoxidil, rogaine, shower, hairloss, hair loss

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I’ve Been Taking Finasteride for Years, So What Should My Next Step Be?

Cheers doctor. I live in the UK and there is not much information regarding hair loss as there is in America. I have been steadily going bald for the past 14 years and have been on proscar for some time. My doctor was reluctant to put me on proscar but finally gave in, bless him. Anyways, fast forward to now, I am 32 years old and have been seeing an increase in my hair loss in my temple area, hairline, and behind it. It is not that noticeable yet because nobody has really commented on the loss but I know in certain lighting it is very apparent and when I style my hair in different ways it is apparent.

What are the stages I should be taking at this point?

A. Continue with the medication or not take it anymore because I am losing hair regardless

B. Wait for my hair loss to continue until I have a more prominent bald spot and then go for a procedure

C. Go for a procedure now and try and stay on top of my balding

D. Get those micro dot tattoos on my thinning area

E. Do nothing and hope for the best

I always wondered about people who stay on top of their balding but the problem is when they start losing the hair behind their implants or their donor hair runs out, that is what is sort of preventing me from doing anything. Your comments and feedback would really be appreciated. Cheers.

There is no substitute for a good doctor to help you in this process. If you are really losing hair, then stopping Proscar (finasteride) could be a disaster that would lead to “catch-up” hair loss. I assume the Proscar you’re taking is cut into 4 or 5 pieces, and not the full table, which would be too much medication for treating hair loss.

You don’t need to necessarily wait for more prominent balding before you plan for surgery, but as hair loss is progressive, your pattern would need to be determined so that any surgery accounts for potential future balding. Having Scalp MicroPigmentation (SMP) is also a possibility, depending on the hairstyle you plan on having. I can’t really answer your questions without pictures at a minimum.

So really, your next step should be to sit down with a good doctor (you are fortunate to have both Drs. Bessam and Nilofer Farjo in the UK) and build a Master Plan with them.

Tags: proscar, propecia, finasteride, hairloss, hair loss, smp, hair transplant

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I Keep Seeing Stuff About TRX2 in the In-Flight Magazines When I Travel

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.

Tags: trx2, propecia, hairloss, hair loss

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In the News - Breast Cancer Patients Find Strength in Hair Loss

Snippet from the article:

Kim Irish had just started a new job and was in California for a training session. She had her tests and was waiting for the results but had asked the doctor not to call her so she could concentrate on the training.

She was set to return to Indianapolis when she got the call from the doctor confirming she had Stage 2 breast cancer. “I was standing in the security line at San Francisco airport when she called me, and I can still see the people in line around me,” she said.

Irish had a lumpectomy followed by four rounds of chemotherapy and 33 sessions of radiation. “My doctor told me my hair would start to fall out three weeks after my first chemo. The moment he said it would start — it started.”

Read the rest (and watch the video) at USAToday.com — Breast cancer patients find strength in hair loss

Fair warning: The video automatically loads when you click that link.

Tags: breast cancer, cancer, hairloss, hair loss

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I Was Diagnosed with PCOS Six Years Ago and I’m Losing My Hair!

I am 23 years old. I was diagnosed with PCOS when I was 17 and was placed on birth control pills. I started to take them regularly, but they started making me sick, so I quit taking them and didnt take them for several years. Just recently I went back the the practitioner who diagnosed me with this and she placed me on a slow-release iron tablet daily along with a new birth control that has iron in it.

I have started losing hair around the middle-back of my head mainly around the crown area. It looks like my part is getting a lot wider, and the part is spreading down to the back of my head. I used to have really thick curly hair but now it is getting thin around the top, and in some patchy areas.

At first, since I am a Registered Nurse, I thought stress was causing it. The last time I went to the doc, she said I was anemic with low iron levels, hence putting me in daily iron, so I thought my anemia was causing it. I’ve been on and off birth control, so I thought that could be another cause.

Am I too young to use a topical treatment such as Rogaine? or Sephren? Sephren is an oral and topical treatment for hair loss in women. What do you recommend? I feel like I am losing more and more hair by the day and it really stabs a knife into my self image and self confidence. I’m desperate for some answers. I wish someone would lead me in the right direction so I can start growing hair in those thinning spots. I don’t want to be bald by the time I’m 30. PLEASE HELP!!

Polycystic ovary syndrome (PCOS) causes hair loss in women who can also inherit the genes for balding/thinning. It is a very difficult condition to treat, as the treatment is often unsuccessful. Since you’re already under the care of a doctor, I’m not sure what I can offer. You need a good doctor/patient relationship.

Hormone therapy might help with the PCOS-related hair loss, though since you mentioned stress and anemia, those are other potential reasons for your thinning hair. I just have no way to know what is causing your loss, or whether it is a combination of things. You aren’t too young for minoxidil (also known as Rogaine, which is FDA approved to treat female hair loss), but the oral Sephren is just a vitamin supplement with no peer-reviewed published clinical evidence that it works.

There is a new cosmetic treatment that we’ve mentioned here called Scalp MicroPigmentation (SMP) which we offer to address the thinning problem in many women. One such patient can be found here.

Tags: rogaine, minoxidil, hair loss, hairloss, female hair loss

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I Used Minoxidil for a Couple Years, But Then Got Severe Dandruff and Hair Loss

I am 25 years old and have used minoxidil for two years but around a year back I got severe hair loss along with dandruff. Now the condition is worse than it was 3 years back, when I had started the treatment.

Hair loss is progressive, so having the loss increase over time is not unusual. Minoxidil doesn’t block the DHT that causes hair loss, and many people get increasing dandruff from its use.

If you decide to stop the medication, you should realize that this could rapidly cause hair loss, as many people build dependencies on this drug when it works well. Have you seen a dermatologist?

Tags: minoxidil, rogaine, hairloss, hair loss

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In the News - Survey Finds Baldness and Man-Boobs Are Men’s Biggest Concerns

Snippet from the article:

Men are fast catching up women when it comes to worrying about their appearance, according to new research.

A detailed look into the body confidence of 2,000 men and women documented a dramatic rise in appearance-related anxiety for both sexes. Results showed two-thirds of women feel under too much pressure to look good, claiming a rise in ‘perfect-looking’ women in the media has set unrealistic standards.

Men now spend over three hours a week on average stressing over their image and feel the level of expectation placed upon them is rising. In fact, results also showed a rise in men dressing for their body shape, discussing their image with partners. One in eight men is even dieting in secret. Baldness and ‘moobs’ emerged as men’s biggest concerns.

Read the rest — Men stressed about beer bellies, baldness and moobs

The survey revealed that men had the most anxiety about being overweight, followed by yellow teeth, going bald, and growing breasts.

Tags: hairloss, hair loss, survey

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Transplanting to the Hairline Corners Without Risk of It Looking Bad with Future Loss?

Hi Dr Rassman,

I am 30 years old and for the past four to five years have had some recession/thinning at the corners of my hairline. It is uneven (on the left side around a 6cm triangle shape in area) and on the right side around half that area. For years I’ve monitored the area (even went to see Dr Farjo two years ago who confirmed i had mild recession - not a mature hairline) and in terms of area of recession it has got no worse - maybe a little thinner in those areas but it has not spread.

The fact that I have a receded hairline REALLY bothers me because i have very dense hair in the middle and on top but it is thin on the sides making my hair very messy when i wake up etc. I would love to have it filled in slightly with a hair transplant to frame my face better and so I wouldn’t have to worry about styling it as soon as I wake. It consumes too much of my time/thoughts and I’d like to not have to worry about it so much. So here are my questions…

1) If my hair loss has been fairly stable for over three years is it likely that I won’t lose so much hair in future or does it not work like this? Dr farjo didn’t seem to think that I would not lose a great deal of hair in future but my dad is NW6 bald, My maternal grandfather was more NW3-4v in his later years with hair combed over.

2) If as I suspect it is just not possible to predict that I wont lose too much more hair in future, is there any way that I can have a hair transplant to the hairline corners without risking looking stupid in future if I do lose lots of hair behind it and can’t afford a future hair transplant or don’t have enough grafts left to cover it all (I have very fine hair by the way). What I mean is, is there any way for a HT surgeon to do a lower density transplant at the corners to stop it looking like the patient is looking like they have thick horns of hair left in future as they go more bald? By the way - I have ruled out the option of ever taking propecia as for me i can’t afford messing with my hormones (other health issues) and minoxidil never worked for me in this area (I sometimes wonder if it did more damage than good as it is when i used it years ago that the thinning progressed).

3. Finally… For someone with fine hair…what would be the density per square centimeter needed for a transplant at the hairline corners. I’d like to get an idea of how many grafts i might need if it is possible.

Thanks in advance for your help.

p.s. I realise my questions are quite specific and will of course go back to see a surgeon for an opinion but just can’t afford to at this moment hence my questions.

Dr. Farjo will give you good advice on these issues. If he thinks your hair loss won’t progress to your father’s pattern, I would plan for that. Ask you dad when he started to lose hair. I suspect he started earlier than you and accelerated more quickly.

That said, since we never know with 100% certainty what is going to happen to the hair loss over time, you need to make plans for now and then be able to maneuver to another step if the hair loss progresses. You should have a Master Plan created with Dr. Farjo if you have not done that yet.

Concerning a transplant to your hairline corners and having very fine hair, if you do opt for surgery, be sure to have it done right. Creating a thinning or balding look with this hair is not in your best long term interest.

Tags: hairloss, hair loss, hair transplant

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Do I Have DUPA or Alopecia Areata?

29 years old, male. Around 1 1/2 year ago I started thinning all over, except for 3/4 of the neck area (the last inch), but even there i am sure it is somewhat thinner. I probably lost 50% of volume. I shed 50+ hairs just in the shower. We can call it DUPA. Blood analysis are ok: ferritin, diabetes, thyroid, hepathogram.

Now, the thing is that some months ago I had Exclamation-mark hairs. I would see that most of the shorter and thinner hairs in the shower were even thinner at the root (say 30 or 40% thinner). The Average hair was 3 or 4 cm long (1 inch and a half) and this tapered hairs 1 to 3 cm (0.5 to 1 inch). I thought it was just miniaturizating really fast. But now i know they can be a sign of alopecia areata. I don’t have them anymore. Now the roots are thicker than the distal end as it should be in a normal hair. They disappeared after a diet (no dairy, sugar, flour) or by coincidence. I thought I was improving because of that and because the dandruff decreased. But i still shed many hairs and I am still getting worse (maybe at a smaller rate, only maybe).

Is it just DUPA? Can I have DUPA with Tapering hairs? Could be areata? If not, what else should I check for? Considering that i dont have Tapering hairs anymore (maybe some long ones, but it is really not the same), would a scalp biopsy help to know?

Diffuse unpatterned alopecia (DUPA) and alopecia areata are both very rare in men, but I can not tell you what is going on without seeing you. An examination is necessary, so you should see a good dermatologist in your area who should be able to tell the difference.

I wish I could provide more info, but this isn’t something that can or should be diagnosed just based on your description.

Tags: dupa, alopecia areata, hairloss, hair loss

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Did Taking an Acne Pill Cause Provillus to Stop Working?

I started with the 6 month trial offer of provillus after noticing a thinning hair line. I was skeptical at first with the knowledge that hair was still falling out while using the product because the product was pushing out dead hair to grow new strands. But about four weeks in I had great results with a filled in hair line. The product continued working so well for months and I decided to grow my hair out a little longer than my usual buzz cut.

I eventually stopped using the product as much,skipping applications certain times but not too often. One day I noticed my hair was the longest it’s been in a while so I decided to buzz it again to about a #2 short length. When I did this, that is when I noticed my hair line had began to thin again some where along the line, which I could not see under the longer hair. I then began to make sure I didn’t skip any more applications day or night.

During this week my results with the product began to change for the worst. My scalp began to get irritated and flakey with heavy dandruff and even small scabs appearing. I noticed that my hair was very weak and fragile at this point, and it began falling out the same way it did before I started provillus. *about a month prior to this bad result period, I began using an acne pill called acnepril to treat my acne symptoms.

So my question is: do you think my taking this acne treating pill has any correlation to why provillus stopped working for me? Or is there any other reason it may have stopped working??

As I do not professionally think that Provillus works any better than generic minoxidil (Provillus is just a boutique combination of minoxidil and some herbs), I can not tell you how your Provillus interacted with your acne medication. From what I just read about Acnepril, it is just a multivitamin.

If you’re serious about treating your hair loss and acne, I would consult with a dermatologist… not tinker with so called “all natural” herbals.

Tags: acnepril, provillus, minoxidil, hairloss, hair loss

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Have You Ever Seen a Case of Hair Loss Contained to a Just One Small Bald Spot?

Has a case ever occurred where a non uniform/asymmetrical form of hair loss had say thinning/hairloss centralized in a small area say 1inch x 2inch and the rest of your hair remained intact for the rest of your life?

Yes, there are inherited patterns like you mentioned and there are a variety of diseases like ringworm and alopecia areata that can do this. If that is a problem, see a dermatologist who can tell the difference for you upon an examination of your scalp and hair.

Tags: hairloss, hair loss, bald spot

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I’ve Got Stress, My Wife Finds Balding Men Sexually Repulsive, and Now I’m Worried I’m Losing Hair

Hi,

I am 36yr old male and have just had a baby as well as a herniated disc which incapacitated me for 3 months (this was on top of an interstate move and loss of my job). I received an epidural steroid injection to minimize the pain. I am now on the road to recovery, however my hair is falling out at an alarming rate, I would estimate a 30%-35% loss but have not noticed my hairline receding. I am noticing many hairs on my computer keyboard, pillow in the sink etc etc. I also have pretty bad dandruff at present.

I have always had VERY thick hair as does my father (he’s 74 now and still with a full head) but my uncle and grandfather on my mothers side are bald. I think i am noticing small re-growth hairs on my hairline but read that this is actually the hairline receding. I am very worried as my wife has always told me she finds balding or bald men kind of repulsive (sexually). I of course went to my docs who took bloods and found everything was normal so i asked for a referral to a dermatologist but the only clinic in Portland OR cant see me for 4 months. I find myself in a catch 22 cycle of worry, please help.

My questions are as follows….,

May i be experiencing stress related hair loss and if so will the hair that has fallen out grow back?

If i shave my head now will that affect regrowth if it indeed occurs or will it just speed up the process of my ‘losing everything’?

I have read that Rogaine does not work on the front of the scalp, is Propecia my ‘best bet’?

Best Regards

You might be experiencing stress related hair loss. If you have the genetics for losing hair, stress induced loss might become permanent. Otherwise, it should hopefully be a temporary hair loss. Try to get your stress under control and have some patience that your hair may regrow within a year.

If you shave your head, you will have a shaved head with the same amount of hair follicles which will grow out to the same status as you are now, unless you are losing hair. Shaving the head doesn’t speed up hair loss or induce hair growth.

Before you make a decision on going on any hair medication, do two things:

1. Send me photos of your head from various angles and with your hair pulled back and your eyebrows lifted high. Reference this post when sending.


2. Find a doctor in your area that can provide a hair bulk analysis with the HairCheck instrument which will absolutely let you know where you hair is being lost, if at all.

I wait anxiously to hear from you, as it sounds like you are coming into a personal crisis.

Tags: hairloss, hair loss, balding, stress

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Sebum Contains DHT, Which Is Why Women Don’t Go Bald?!

I receive oddly angry emails from time to time, and this one had the subject “WRONG!!!!” that appears to be in response to a post from 2007 — Does Sebum Build-Up Produce More DHT on Follicles?.

Actually the sebum in men contains DHT because it is caused by Testosterone in males…which is why women dont go bald..u should know that,

I think that you are confused. Here’s an article that discusses the relationship between dihydrotestosterone (DHT) production and sebum. Yes, the sebum contains DHT, but it is not the sebum that causes hair loss.

The androgens produced in the human body heavily impact sebum production (more about sebum can be found here). Women with conditions that cause ovarian cysts (PCOS) get balding just like men, but to a lesser degree.

Tags: sebum, hairloss, hair loss, dht, testosterone

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I Read That Balding Comes from a Mixture of Genes from Various Relatives

Hi Dr,

In school we studied how MPB is autosomal and sex influenced, not X-linked. I also read that balding is mixed penetrance. Does this mean there is a possibility that an individual can get a mixture of hair/balding, from various relatives? For example if ones father has no hair loss but his maternal grandfather does.

Thanks for your time.

You are correct. You can inherit balding from either family lines and the genes may not express in your father or mother, but it may express in one or both of their parents. You could be a victim of these genes when you are old enough.

Tags: hairloss, hair loss, genetics

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My Doctors Just Glance at My Hair and Say It’s OK, But I Know I Have Hair Loss!

Hi doc, I’m a big fan!!

I saw a post where you mentioned the importance of consulting a doctor before taking meds for hair loss but what is your take on people self diagnosing and self medicating? The doctors I go to don’t do miniaturization test or bulk analysis. Instead, they just glance at my hair and tell my hair is okay. But I am sure I’m having hair loss although my hair looks full.

I could find many miniaturized (thin and lifeless) hairs mostly among the MPB regions. They pull out easily. The density of hairs in the MPB regions is very less compared to the permanent zone. I could scratch my scalp and easily find fine unpigmented hairs with dandruff flakes. Also the MPB region alone is super oily.

I would classify myself as Norwood 1.5 with very minor crown loss. I have been researching online for more than five years. I already bought a strip of Proscar and am waiting to take it.

BTW I’m 25 years old from India. I wish I could come and consult at yours. Sorry for the boring post, but your opinion sure will mean world to me!

The ability to check for miniaturization is in an easily available electronic hand microscope. Place the microscope against a small pea size area of scalp, and look at it. Count the hairs that are thick and then those that are thin. Miniaturization is present when the percentage of thin hairs exceed 20% of the total.

An alternative would be to have one of your friends do it for you with a non-electronic hand microscope. There can be purchased in the US for about $7, but I am sure they are also available in India.

If you’re under a Norwood class 2, I wouldn’t consider that to be hair loss. That said, there could be a good reason for your doctors to not prescribe you the drug, and I would not suggest taking a finasteride (Propecia / Proscar cut into 4 pieces) without a prescription.

Tags: hairloss, hair loss, miniaturization

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Does Good Laxity Prevent Large Strip Scars?

Does having good laxity prevent large scars ? I see a lot of people with small scars, and a lot of people with large scars where the situation is so bad that many are implanting beard hair to cover those scars. I’m thinking about getting a second hair transplant, but I am afraid after the second transplant I might get a big scar which is hard to cover up. The doctor said I have above average laxity, but below average density. My density again is only 60 grafts per square centimeter. Can you give me some information about what causes a bad scar ?

Generally, people with very high laxity (loose scalp) may have a higher incidence of scars than those whose scalp is tight; however, the looser it is the more grafts can be extracted with any given hair density.

Scalp scars can be very easily treated, if they occur, with Scalp MicroPigmentation (SMP). An example patient can be seen here.

Tags: scarring, scars, hair transplant, hair restoraton

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In the News - Can Hair Loss Drugs Cause Injuries to Athletes?

Snippet from the article:

Arsene Wenger has warned that professional footballers looking to cure baldness with hair loss products could be putting their careers at risk.

The Arsenal manager made the shocking claim when discussing the nature of injuries in his weekly press conference ahead of Sunday’s game against Everton.

Wenger, who revolutionised the English game when importing new fitness and preparatory methods following his arrival at Arsenal in 1996, says some players are leaving themselves open to problems if they use products to reverse the process of balding.

And according to the Gunners boss, vanity could lead to injury.

Read the rest — Wenger warns stars over hair loss products

He says hair loss medications can lead to liver problems, though he doesn’t specifically say which medications he’s concerned about. As far as I’m aware, finasteride (Propecia) does not have any adverse effects on the liver.

Tags: hairloss, hair loss, soccer, football

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Stem Cell Breakthrough? Don’t Believe Everything You Read!

Snippet from the article:

Scientists have found a surprisingly simple way to turn mature cells back into a primitive state. Simply giving mouse blood cells an acid bath is enough to produce so-called pluripotent cells that can develop into any cell type in the body, they report in two new papers this week. The remarkable transformation contradicts many assumptions about cell biology and may ultimately lead to new ways to treat disease and injuries.

Scientists not involved in the work say the technique could be a game-changer if it pans out. “If this new approach is applicable to human cells, it would have great implications for regenerative medicine,” says Hongkui Deng, a stem cell researcher at Peking University in Beijing. “It’s quite surprising” that the technique “doesn’t involve any genetic manipulation,” says Rudolf Jaenisch, a developmental biologist at the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts.

Read the rest — Acid Treatment Could Provide Breakthrough Stem Cell Technique

But wait…. the above snippet is from an article that was published and appeared in many publications, but then the scientific community tried to replicate the study. Now there are many other publications that show how the attempts to replicate these results were unsuccessful. Read more about the investigation here.

For those interested in hair breakthroughs, this report could have been significant and prompted considerable excitement for creating stem cells that could be turned into hair cells, but without direct support by the greater scientific community, this was probably another blind end for stem cell development.

Tags: stem cells, breakthrough, investigation, acid treatment

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