Month: January 2023

I have noticed that I’ve been losing my hair since I was about 18 years old. For the past few years , I’ve been using finasteride, nizoral, and minoxidil. It worked for a couple years but now I’m noticing that my hair has been falling at a very fast rate. I currently live in Seoul, South Korea, and I have been thinking about having a hair transplant but I’m afraid of having one at a young age.
Do you have any advice?

There are things you need to be clear of:
1) Losing hair is not fun but it may be something you may have to face. More than 50% of men face some degree of genetic hair loss. If you are worried, find a doctor who can give you a diagnosis and a Master Plan for how to possibly address the hair loss.
2) You don’t have to have a hair transplant. Losing hair does not automatically mean you need to have surgery. There may be other options such as medication or scalp micropigmentation.
3) As you live ins Seoul Korea, you can always visit my colleague Dr. Jino Kim of New Hair Institute in Seoul Korea.

Doc, I’ve recently taken notice that along with my frontal hair loss, I’ve been losing way more hair from the back side of my head. Since that is the permanent zone, could this have an effect on any future hair transplants? I’ve been on Proscar cut into quarters taken daily since January. And can hair length increase or influenece hairloss (as mine is just about shoulder length)? Thanks

I must sound like a broken record. To make a diagnosis, you need to have your hair mapped out for miniaturization to determine what is actually happening. If you are losing hair from the ‘permanent’ zone and you are a male, then you may have Diffuse Unpatterned Alopecia (DUPA) (see Follicular Transplantation: Patient Evaluation and Surgical Planning?). If you are a female, then this is not unusual, especially if you have genetic female hair loss. Get to a good doctor and find out what it is and then what to do about it.

So I’ve been losing a ton of hair for around the last year. My hair has thinned out dramatically, and receded in the front a little but I have no balding areas just diffuse thinning. I have been using Rogaine and Finesteride and have seen some thickening at the crown but no benefit everywhere else. I have had a CMP done to check for any deficiencies and it was negative. I went to a hair loss clinic yesterday and they scoped my scalp and told me I had a normal amount of follicles and no miniaturization (the hallmark of male pattern baldness). When I asked why I was losing so much hair they couldn’t really help me. One person told me that I should rinse and shampoo my hair everyday because accumulated rogaine can cause hair to become brittle but other than that they just said they couldn’t help me. Does anyone have any ideas? I’m worried the finesteride won’t help either because it specifically inhibits DHT.

If you went to a clinic, you should have seen a doctor skilled in this field. I would have examined you, performed a HAIRCHECK, a miniaturization analysis and quantified your donor supply. I would have told you what to expect short and long term.

Hair loss in women is not uncommon after any hair or facial surgery. When hair loss occurs after a hairline advancement surgery, the scar which usually abuts the hairline is separated from the hairline so that it stands out. A hair transplant is a way to fix this.

When you lose hair due to illness, do you lose hair from all over your scalp or just on top? Is the location of the hair loss different than it would be with genetic factors?

Stress such as an illness can produce hair loss. This is explained because illness requires that your body conserves its resources to fight off the illness. Hair is a high metabolic organ, consuming considerable amounts of nutrients, blood supply, cardiac output, etc.. The body diverts is support activities and abandons those organ systems of low importance. Hair qualifies for that sacrifice. I might expect hair loss to be a generalized loss over your entire scalp, possibly including some body hair as well. That being said, the illness or the stress may have set off a genetic “switch” that probably kick started male pattern hair loss process when the gene is carried by the patient.

I am having issues with finasteride and have been very depressed about it. I was wondering if you could answer some questions. Over the past two years, I’ve been taking finasteride and I would say that it worked moderately. I was still losing hair but the shedding was slowing down. I didn’t have too many sides but I had a bit of ED. My erections were weaker and I didn’t have morning wood. Suddenly, starting a few months back, it seems like I have lost tremendous ground. My shedding is very intense and I’m getting thinner by the day. I also got my morning wood back and it’s very intense. I talked to my dermatologist but she doesn’t know whats happening. Do you have any recommendations for dutasteride or any idea of what is happening? I would appreciate any help! I feel like I’ll be bald by the end of the year and I’m only 22, so this is absolutely killing me. Thanks!

I discuss often that a tug of war exists between the drug finasteride and the genetic balding process. Like any tug of war, the stronger side wins. If your genetic balding creates a stronger pull than the drug finasteride, you will lose hair. There is no solution for many people in this situation. Dutasteride is only slightly more effective, but it has sterility risks which may not be worth taking.

You are starting to see shock loss, which is a loss of the native hair that often follows a hair transplant. This is prevented by the use of Finasteride. The small arrow points to the area which had hair before the hair transplant.

I have been losing my hair around the crown and in the front for past three to four years. However, now I am starting to lose hair in the back of my head I have never seen this happen before and I do not know why?? I have a very stressful job but am only 25. Please help!!!

I don’t know what you would like me to do to help you. Losing hair in the back of the head (below the crown) is unusual, and my advice is that if you are concerned about your hair loss and want to be proactive about it, go see your primary care doctor or a hair transplant surgeon (who will not necessarily do a hair transplant) for a good diagnosis of what is going on. There may be treatments (not only surgery, but medications) that may help with your situation.