Day: January 1, 2023

Hi, Dr. Rassman. Thanks for answering all of our questions.

My question is, How likely is it for someone to “settle in” to a level of hair loss (Norwood 3A, for example) and not see any more rapid loss for a period of time (years, for example)? Do some people get to a certain level of hair loss beyond a mature hairline and stay that way without medication? Or is your fate essentially sealed after you reach a certain level?

Let me clarify what I see as your misunderstanding. The Norwood chart is not to be seen as a progression of hair loss chart, but rather the final patterns seen in a large male population.

Some people do seem to go from a Norwood class 3 to a 4 and then to a 5 pattern, but you may just “settle in” to your Norwood 3A state, as an example. There is really no 100% certainty, but a good doctor with a good miniaturization study and examination can give you a better assessment of what hair may go with time. Here’s the Norwood chart so we’re all on the same page:

Your “fate” was sealed in your genetic code when you were conceived many, many years ago. Very few patients become a Norwood class 7 pattern, and even the balding patients who start as a class 5 may not go much further, even at the age of 100 or so. So for example, there’s no “point of no return” that says if you reach class 4 by this certain age, you’re guaranteed to be a class 7 later in life.

Just getting over some server problems today — thanks for being patient. Things are looking stable now after the system upgrade.

Was hooking up with a girl and realized she also had hairloss. I think once you become obsessed with hairloss you notice it so much. Noticed that her hair part was wider and thinner hairs around there. Can totally see more scalp than most women. She is still hot so idc. But my point is once you know about balding you easily notice it. So many people have hairloss.

Yes, that is very true. Ever since I entered this field of Hair Restoration Surgery 30 years ago, I look at other men and women to establish what is normal and what is not normal for hair loss. From all of these observations, I have learned (especially at airports when I see many people walk by and have little else to do) what normal hair loss patterns are found in the general population. From this, I drew interesting conclusions which I speak about at medical meetings as I have identified patterns of loss that are not the patterns confined to the Norwood Classification.

Supposedly, very little (if any) Finasteride comes across with semen, so I doubt that this is causing her problem. She should see her gynecologist. The levels present in the ejaculate of patients taking 1 mg appear to be negligible. From the literature I have read, there does not appear to be any need to stop 1 mg of Finasteride in those patients trying to conceive or in those whose partners want to be or are pregnant.

Finestride and semen from tressless

Bullied my whole life for being too ugly, when things were getting slightly better, I start going bald.. from tressless

Dear Doctor, I am a 41 y.o. male and suffer from androgenic alopecia, which I am currently treating (with poor results) with Finasteride 1.5 per day and minoxidil. Unfortunately, I also suffer from social anxiety and my doctor prescribed me selegiline 10 mg per day(Jumex). I have not taken this drug as I am afraid of the side effect on hair loss. Before I was on moclobemide 450mg, which I stopped due to mediocre results and concern of hair loss (which I thought got worse due to Moclobemide). I would kindly ask you:
1) Selegiline can worsen my hair loss? How likely is this to happen. Is it a rare occurrence or a common one?
2) How long after stop taking Moclobemide can I assume that that drug is not making my hair loss worse? Thank you for the great information you provide.

Selegiline and Moclobemide are medications to treat depression and anxiety. I do not have experience in the type of medications that you are using so I really cannot say much about its effect on hair.

You must understand the “big picture”. Male pattern hair loss (MPB) is genetic. Medications such as Propecia (finasteride) can help slow down the hair loss. It sometimes improves and regrows hair. But over the long term you will continue to lose hair. Genetics always win out. The side effects from medications is not really an issue as much as it is a genetic problem. Many people try to make sense of their hair loss issue by correlating it with their diet, drugs, or other non specific factors but they do not understand that the root cause of the hair loss is mainly the genetic fate that they were born with. At this point, there is no cure for hair loss.