When I’m Positioned in a Certain Way, I Can See My Scalp Under the Light – Hair Loss Information by Dr. William Rassman

Hey Dr. Rassman, I am a long time reader, first time writer. I was just wondering about how to tell if I am thinning. I am a 23 year old male that has always had fine hair, but recently my hair-stylist said he thought my hair was thinning. My family said he’s crazy, but when I look directly into the light I can see my scalp. But, I have to be positioned in a certain way. It is the worst on the crown around where I have a massive caulic. I am wondering If maybe I am just being paranoid, and my hair isnt thinning at all. I dont have insurance, so I can’t go to a dermatologist, please help. Also, when I style my hair is looks thinner than it used to. Maybe I just went through a shedding phase?

It could just be lighting in a person with fine hair. If you have to be positioned in a certain way, avoid that position. You could have some thinning in the crown as this is where the fine hair shows most. I haven’t seen your hair before or after, so I’m just making guesses as to what it could be.

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Thinning All Over Scalp When Going from Adolescent to Adult? – Hair Loss Information by Dr. William Rassman

Hi Doc,
I went to have a miniaturization study done, and the doctor noticed that I have miniaturization everywhere, even in the permanent hair zone of the scalp. He says that I am going through a thinning process as I go from an adolescent to an adult. How long can I expect this to go on?

If you are developing fine hair where it did not exist before as you go from an adolescent hair to an adult hair, then that is possibly your new norm. What did your doctor say about the cause, besides describing it to you?

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Frequent X-Rays and Hair Loss – Hair Loss Information by Dr. William Rassman

(female) I had about 30 x rays this year… A few months later a started to lose a lot of hair, evenly and patches. I am very young and have a bald spots on my head. My doctor said he doesn’t believe that x rays would be cause of hair loss. Blood test didn’t show any reasons for hair loss also. And it’s not a genetic thing for sure. Anybody, please…..
Thanks

I would agree with your doctor that clinical X-rays should not cause hair loss. Taking one thing out of your past year’s history (like frequent X-rays), does not paint a full picture of your heath issue with regard to your hair. In other words, I couldn’t begin to guess at the cause for your loss, but I don’t believe X-rays are the reason.

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Could My Hair Loss Treatments Be Doing More Harm than Good? – Hair Loss Information by Dr. William Rassman

HI, i started losing my hair when i was about 20 years old. I started using 5 mg finasteride cut into fours and rogaine to stop the hair loss. Since i started the treatment about three months ago ive notice a increase in hairloss more so than before. I read you answer to the shedding saying it was part of the treatment and actually meant the medication was working but in my case the shedding hasnt stopped. Is it possible that the medication is doing more bad than good? should i stop the meds to slow the hair loss and just stick with the rogaine?

I doubt the medication is causing more harm than good, but you need to follow up with the doctor who prescribed you the medication. There may be other factor such as undiagnosed illness (although rare) that is causing hair loss. Of course the great danger is that someone will actually have a significant medical problem driving the hair loss, something that few of my patients ever consider. This is not a proper platform for you to receive personal medical advice, as there may be more than meets the eye. It’s also outside of my legal limits.

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At What Point Will You Realize Propecia Is Not as Safe As You Thought? – Hair Loss Information by Dr. William Rassman

Doctor when I hear so many people writing in that they have slight pain when ejaculating or there semen is jelly like, or they are experiencing problems cognitively-at what point does one such as yourself stop and say hey maybe this drug Propecia is not as safe as I thought. You keep saying the side effects only apply to 1-2% of the people, however it seems to me that you are getting repeated complaints and concerns.

This is why I hve hesitated with a systemic drug like Propecia. I only hope Minoxodil (Rogaine) will not be a hazardous choice for the long term.

The last time I checked, nobody is forcing anyone to take medications to treat hair loss. If you do enough searching on the Internet, I agree that you will find many people complain about side effects associated with Propecia. For that matter, you will find many people complain about many other drugs as well, as ALL drugs have side effects to varying degrees. Keep in mind that the Internet, while a very useful tool, is not a source for accurate and factual information all the time.

I wonder… if you took the medication and didn’t have side effects, would you go to every forum you could to tell people? The most vocal and persistent on forums are the ones that have a gripe, valid or otherwise. In my practice, a large percent of my male patients take Propecia and I do not get “repeated complaints or concerns” — and I do not believe the patients I see are any more special than those on the Internet. Of those patients that I see that take Propecia, only a few have side effects and it does correlate with the 1 to 2% figure I often quote. For those patients who have side effects, they can choose to stay on the medication or stop the medication. There’s no gun pointed to their head, and it isn’t life or death. If you are hesitant, then don’t take the medication. It’s really very simple. By the way, minoxidil has many side effects including heart arrhythmias, blurring of vision, fainting spells and on and on.

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Transplanting Vellus and Terminal Hairs? – Hair Loss Information – Balding Blog

With follicular unit transplants, I’ve read that the unit can consist of 4 or 5 terminal hairs and 1 or 2 vellus hairs. Why transplant the vellus hairs along with the terminal hairs? I thought vellus hairs were what happened to terminal hairs after extensive miniturization? Do the vellus hairs serve a function in the transplant? Do they eventually become terminal hairs or something? I’m just a bit confused. Vellus hairs do not become terminal hairs that I know about, but maybe I am wrong and would have to study it over a prolonged period of time to determine it.

Thanks

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We don’t decide to transplant vellus hairs as they come along with the terminal hairs in a follicular unit. You can not separate the vellus hairs without damaging the terminal hairs. Why and for what purpose would you suggest doing it?

Watery Semen After 2 Months of Finasteride – Balding Blog

Hello!

I began losing my hair at around 16 years old, I’m 17 and a half now and I’ve been taking 1.25mg Finasteride (Proscar quartered) for about two and a half months, my doctor prescribed it to me. Up until recently everything seemed ok, I had a slightly lowered sex drive but nothing too bad. But a couple of days ago when I rubbed one out I experienced a very weak orgasm. I tried it again today and the same thing happened, the sensation was weak, and my semen was very watery also.

I am getting worried about this. I really don’t want to stop taking Finasteride if possible, because it has helped a huge amount to slow/stop my hair loss. So my question is, is it unusual to see sexual sides after already having been taking Finasteride for two and a half months, and should I stick with it and see if they go away? what are your thoughts on the matter?

Any help would be greatly appreciated.

Side effects you describe from Propecia occurs in 1 to 2% of men and it does correlate with the percentage of patients I see (who have been taking Propecia for many years). You need to meet with the doctor who prescribed it. Ask yourself if you can live with this side effect. Side effects may not be permanent and you have full control to the decisions on the use of the medication. Discuss these options with your doctor who prescribed you the medication.




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Sore Nipples from Propecia, Heart Palpitations from Minoxidil – Hair Loss Information by Dr. William Rassman

Hi

Thanks for the truly great website.

I’ve just started on Propecia and developed sore nipples and from reading your posts guess I should stop using it. Minoxidil gave me palpitations so I cannot use that either.

My question is this. Until today by using Propecia I thought there was a glimmer of hope of not losing my hair. Now that hope has gone, are there any other medications / treatments that I can take that will really make a difference? It seems that everything else out there is useless… In other words what would you recommend somebody who cannot use Finesteride and Minoxidil do to keep their hair?

Apologies if this question has been asked before.

Unfortunately Propecia and Rogaine are the only two medical drug treatments currently available for male pattern hair loss. Your other option is hair transplant surgery. If I were you, I would continue to take the Propecia for a period of 3 months, then try a half pill and then a quarter pill 1 month apart. If it continues to cause you breast and nipple pain, I might consider packing it in. In the end, there are no easy answers and sometimes we are limited to what we can do in medicine. Discuss this with your doctor, particularly if you are considering stopping any medication.

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Is Hair Loss from Stress Going to Be Diffuse? – Hair Loss Information by Dr. William Rassman

Hi Mr. Rassman! Many off us now that chronic stress is bad for the overall health, one of the potential effects of stressors is an increased hairloss, maybe not such a big problem if you dont have androgenetic alopecia but if you do this temporary increased hairloss can potentially do more damage to the already weakening follicles! So my questions is:

1. In the connection to stress what is exactly happening chemically in the hair follicles that is leading to increased hairloss/premature entering of the anagen follicles to telogen?

2. And finally, hairloss that is connected to severe stress follows a diffuse pattern or am i wrong?

I do not have the answer to your question. Extreme stress (both emotional or physical) can cause hair loss and for men with genetic hair loss, it will follow a pattern of loss (not become diffuse). In women, this is often not the case as they are more likely to develop a diffuse form of thinning (without a specific pattern). I do not know the exact biochemical science behind hair loss caused by stress. As it is often said, medicine is mostly a descriptive science. Many times, we don’t know exact mechanisms.

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