Month: January 2023

Dear doctor,

I am a 22 years old male with very little family history of male pattern baldness. Yet a few months ago (I think last may or april) I started to experience some drastic hair loss. I was literally shedding all over my clothes, the tub, the kitchen floor… As I grew really desperate I went to visit a dermatologist who told me I was going through telogen effluvium. I actually changed my diet at the beginning of the year by becoming a vegetarian, so I figured it made sense that my hair would undergo a moment of weakness. I took various vitamins for two months or so and things seemed to get better until october.

I have always been very sensitive to the changing of season, hair-wise, so it didn’t worry me at first, but now I find it weird that this is still going on to the present day. But what confuses me the most is the nature of my sheds. I had already noticed that I would lose hair that were a lot shorter than the others (my hair is mid-long), although they seemed to have the same thickness. This could all be a result of effluvium. However, I started to find these days hairs that were thinner than what they should be… Some of them have a normal length but are just pretty thin and fuzzy. Others are also really small… I have no visible recession of my hairline (yet ?). I can tell my hair still fall from all over my head, even in the areas never affected by AGA. But I am scared to death, are those tiny sheds a definite sign of MPB ?

I hope you will answer my message. Sorry if I made a few mistakes. Regards.

You should get baseline measurements on your hair bulk to determine the significance of the shedding, and quantify just how much hair you are losing over time.

As for a seasonal shedding, I’ve had a few reports emailed to me from readers over the years about this, but there is no medical explanation that I know of for it. Humans have asynchronous hair growth, which means that we do not shed in seasons, but do so relatively uniformly over the year.

When I wake up – I look in the mirror and it’s obvious that my hair is much thinner on one side of my head. I can create a big parting on this side because the hair is so thin and can’t do so if I try on the other side. I’m 27 and have slightly receded temples and the temple recession is slightly worse on this side but I don’t understand why it’s thin all the way to the back of my head on this side?

Is this common with male pattern baldness? My dad is bald but I have been quite stressed over the last year and don’t want to take propecia if it’s something other than MPB.

Thanks.

It is common to see more thinning on one side in cases of genetic male pattern baldness (MPB), but rest assured that the other side generally catches up. I do not know if you have MPB, but if you believe you are losing hair you should see a doctor and get a diagnosis.

I love your site.

I have a strange question for you. For the last few months I have been sleeping with my hand kind of positioned as a pillow, if that makes sense. I also sleep on one side and it just so happens my hair has thinned out just in this area. Between the ear and my temple right at the front edge. This is exactly where my hand is when I sleep. Could this be caused from this. I have changed my sleeping pattern, will the hair grow back. Thanks

I have never seen this before and only have had one person that I can recall even writing to me about a similar situation (Ergonomic Pillow and Hair Loss), and except for people who have trichotillomania and pull on their hair even in their sleep.

You should be examined by a good doctor. A miniaturization study should be done to see just what is happening. If your hair is miniaturized and you are rubbing on it, it might come out.

Hey Doc,
Firstly, what an amazing job you guys do with this whole set up: Dr Rassman your blog has provided so much insight for those of us scared about hair loss.

I’m a 22 year old male student. To combat my hair loss problem, last year I used Minox 5% (Rogaine) for about 1month, but due to the subsequent irritation it caused, I ceased use.

The area that I applied this to is now dead, straw like hair, and so much thinner than other parts of my hair. I have read about minoxidil dependant hair, do you think this could be the case for such a short application period? A trichologist I consulted over here, dismissed that as being unlikely, as 1month was too short a time frame. He emphasised to me that stopping minox would return hair to the ‘base level’.

The thing is, my hair loss has accelerated greatly in the past 10months: I touch my hair and it falls out. My scalp is clearly visible on top. What cuts me up inside, is that I think I brought this upon myself by trying minoxidil.

Do you think propecia would be of any use in this situation, if stopping minoxidil has damaged my hair? – I understand that the mechanisms are different. I am merely speculating as to why I’m losing hair so much, so quickly, but I am keen to give finasteride a go. Any feedback would be greatly welcomed.

Kind Regards

You are describing what might be genetic hair loss as well as some side effects from the minoxidil on your hair texture. I doubt your current hair loss has anything to do with minoxidil use and any new hair that grows out from the scalp should be as it was before the minoxidil use. Here’s your scenario as I see it — You started using minoxidil because you were losing hair… minoxidil caused irritation and hair texture issues, so you stopped using it… then your hair loss continued, because hair loss is progressive. I don’t think it’s clear that minoxidil accelerated the loss, though.

At 22 years old with early balding, Propecia is a good idea to help slow the loss down (if it is genetic hair loss), but you will likely not see results unless you take it daily for at least 9 to 12 months. It’s a prescription drug, so talk to your doctor if you’re interested in that. You should also have a good doctor examine your hair and perform a miniaturization mapping so that you can see the progressive nature of your loss over time.

In your opinion, if there is no miniaturization does that mean there is no hair loss? I recently had my hair mapped for miniaturization by Dr. Pak in San Jose, CA. He found no miniaturization beyond what is normal. It is possible that I have experienced a telogen effluvium, I mistakenly took a testosterone booster for a month about 8 months back, I also had 4 surgeries this past summer. I know for a fact that my hair has changed some in the past year, but I don’t show any miniaturization upon examination. Should I be worried?

In the interest of patient confidentiality, I will keep the answers generic. If you have specific questions or concerns you can call our office at 800-NEW-HAIR (800-639-4247) for a personal consultation / discussion.

Having no significant miniaturization should indicate that your hair loss state at that point in time was stable. You may have lost your hair in prior months and may have even experienced telogen effluvium, but there is no way to tell with a miniaturization study, which just shows hairs that are in the process of being lost.

If you take testosterone or anabolic steroids, you could “kick start” the genetic balding process, but as stated above, if you do not show signs of miniaturization at this point, it indicates things are stable. Most people will undergo changes in hair texture with age, but frankly there is no way to tell. I would recommend watching the hair over time with repeat miniaturization studies in the hope that your hair will become more full.

I’m a 37 year old male who has a full head of hair, however my hair has always been very fine and frizzy/slightly curly. As a result, I shampoo it daily and I’ve always applied gel and then used a blow dryer daily to straighten it too.

In the last few years, my hair has gotten much more fine, and overall it is less thick than it used to be and much more prone to static, especially if i let it dry naturally and don’t use product/blow dry. It’s clearly changed in thickness during my mid thirties, however I don’t seem to be receding dramatically or anything like that. Does this the fact that my hair has gotten much more fine mean that I might be beginning to go bald and is it likely that this process will continue? Do I need to take steps now to prevent it getting more fine?

Thanks for the help!

Great site.

Some people will see a change in the hair shaft diameter towards finer as they get older. That could explain what you are telling me. You want to be sure, however, that the finer hair is uniform all over the head (including the sides and back). The lack of uniformity could suggest a problem, so we generally like to map out the hair throughout the entire scalp for miniaturization to determine if you have some condition that is causing it. If uniformity is seen, then using styling agents to thicken the hair shaft is the way to go.