Month: January 2023

I’m a 27 year old male. About 3 year ago, at the age of 24, I went to work abroad for a year. At the time of leaving home I had a full head of hair.

When I was abroad my diet deteriorated. During this time my hair became very unhealthy. It became brittle and it stared to fall out. I returned home 2 years ago and my diet has returned to normal. My hair’s condition has improved and it has stopped falling out.

Though it has improved, progress is very slow and it has not returned to its former condition.

Could you help me, please?

A normal diet should not have any significant impact on hair loss. If you were malnourished during your travels abroad, it may have had some impact. However, once you start the hair loss process, I have found that it is difficult to stop the hair loss process. Some have explained this phenomenon by analogizing to a light switch that is turned on, but can’t be turned off. You should have your scalp hair mapped for miniaturization to see it there is a pattern to this hair loss. You have a component of genetic hair loss which may not be related to the diet issue.

Yea doc said just not to use it. My father used minoxidil as well and he got lots of side effects just as I did. Very disappointing considering there’s barely any other options

If that was topical, he and you might be one of the 60% of men who will not respond to topical but will respond to the oral.

Thank you for writing this blog, it is a wonderful resource for so many people. My question is regarding Saw Palmetto. I had my serum DHT levels checked, then began a regimen of Saw Palmetto extract for two weeks and had my DHT tested again. The results showed that my DHT dropped from 62 to 22 during that period.

This is a pretty significant drop in DHT but I am wondering if there is more to the story from a hair loss perspective. Does an overall drop in serum DHT mean that it should have a similar effect to Finasteride in stopping hair loss or is there something else to the equation?

It is hard to believe only two weeks on a herb (saw palmetto) can have a significant decrease in DHT levels. I do not believe even finasteride can have that effect. I simply do not know the significance with respect to how it can be interpreted for hair loss treatment.

Please note that the human body and its functions are not as simple to just quantify with a blood test and hormone levels. For example, testosterone level may vary in your bloodstream throughout the day! It may be high in the morning and low at night, and this may even vary from individual to individual depending on their work habits, exercise habits, sleep habits, etc, etc. So DHT levels can vary as well. The conclusion or associations that you are trying to make is unclear.

DHT may be implicated in male pattern hair loss, but as we have said over and over again, just lowering your DHT level is not “THE” answer to MPB. Sorry to be a party pooper.

I just got my first box of finasteride 1 mg today. I wanted to get minoxidil 5% as well, but I need a prescription for that where I live. However, my dermatologist said the action of finasteride and minoxidil isn’t synergic, and that I won’t get better results by adding topical minoxidil to oral finasteride. That’s the opposite of everything I’ve heard so far. Men do combine oral finasteride and topical minoxidil 5% exactly to get better results, don’t they?

I don’t agree with your dermatologist. These two medications have different modes of action so taking them in combination, especially for the crown, is more effective.

Hi Dr. Rassman,
I went to see a dermatologist today about my diffuse hair loss, and I asked him if the thinner hairs that are falling out now (as opposed to the thicker hairs that fell out before) necessarily pinpointed miniaturization. He said that a telogen hair is supposed to be miniaturized compared with a anagen hair. Now, I’ve done quite a bit of research on this topic, and I’ve never heard that a telogen hair was supposed to be miniaturized. Can you give some insight into why he might say this? Thanks so much!

I agree with you. Telogen hairs, when they fall out, are normal width. I have no idea why your dermatologist would say otherwise.

My hair started frontal thinning 6 months ago and now i am almost completely bald up front. i have two questions.

1. does it make sense it fell out so fast?
2. i’ve been visiting a dermatologist and he said it was a form alopecia and he injected it with steroids. not to insult his credentials but it doesn’t look like any of the alopecia pictures i seen online and my hairline is starting to look like my dads could it be a misdiagnosis.

Really, you didn’t supply any information to work with here. If you are a male, injecting steroids in male pattern balding could be very damaging. If you are a female, it may not be as damaging as with a male, but I am not familiar with the benefits unless your doctor thinks that you have some autoimmune form of alopecia.

Alopecia is just another word for “hair loss” — so unless there is a defined form of alopecia (such as alopecia areata), I’m not sure what your doctor diagnosed you with. You should go back to that doctor and find out what your condition is and be sure to ask as many questions as you need to. Open communication between doctor and patient is a really beneficial thing to both parties.