Month: October 2009

Hi Dr. Rassman,
here’s my question is it possible to have the same genetics for hair loss as say your father but not have it to the same degree. For example thinning in the crown but not as much, or recession but not as far back. I have this in families where it is obvious that brothers have the same genes but seem to have less progression of hair loss. I have even seen this where the older brother has more hair then a sibling two to three years younger.

The one-to-one relationship you are looking for does not exist. It is possible that you inherited the gene from your dad, but the expression of the gene might keep you from ever balding. That gene could be passed to your son and he might have your father’s hair loss pattern.

We do note that if you are balding like your father, then the gene may be similar and the pattern of balding you inherit may be the same as his.

Paid advertisements (not an endorsement):

I am 32 male, and have been losing hair slowly for 12 years. It has started increasing in the last couple of years. I started propecia about 7 months ago. I don’t believe I have seen results, hair still coming out slowly. I also have had dandruff, mostly because I don’t wash my scalp that well because do not want to force my hair out!! My question is after 7 months should I assume it will not work for me?? And if so what should I try?

I have answered this question many times. I believe Propecia (1mg finasteride) always works on balding men, but by “working” I mean reversing, slowing, or stopping hair loss… not necessarily regrowth. In other words, you may not see the true value of the action of the drug unless you take it for a few years and then stop it. Stopping it will show catch-up hair loss, and then you will know for sure that it was working before you stopped it. Of course, I wouldn’t recommend going this route, but it would be one way of proving the medication’s effectiveness.

If you make regular miniaturization analyses of the hair, you would have an objective metric to determine its value. There are some people who do not get great benefits after 2 years of finasteride use, and there are tests that can determine if you are going to be sensitive to this medication (see HairDX Genetic Test for Finasteride Response).

Paid advertisements (not an endorsement):

hello
is there a link between stress (psychological not physical) and hair loss? if yes, what is the mechanism of it?
thanks

There is clearly a link between hair loss and stress. We see it all of the time in people with hereditary hair loss. The hair loss can be brought on during the stress of the college student (for example) or during illness. I do not believe we understand the mechanism of it, though.

Paid advertisements (not an endorsement):

Dear Dr Rassman,

I searched the blog, but did not find answers to two specific questions.

1.)Is there a blood test one can have to determine the level of DHT in the body? What level of DHT would be considered above normal? If I want my DHT levels tested, what do I ask for? (I have an appointment with a dermatologist next month)

2.) Is Androgenic Alopecia the ONLY thing that causes miniaturization of the hair follicles? For example, could seborrheic dermatitis, or some other scalp or systemic illness, cause the follicles to shrink in a similar fashion?

Thanks so much for sharing your knowledge!
(male, 28)

The best way to get your DHT blood levels is to have your doctor send your blood to a lab that can do this test. Testosterone is broken down to DHT by an enzyme called 5-alpha-reductase type 2.

Miniaturization can be caused not only from genetic hair loss, but also it can be found in an unhealthy person and by certain medications you may be taking, such as tranquilizers. People who go through telogen effluvium can have miniaturization as well and the process can be reversed. More about miniaturization can be found here.