Month: January 2023

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I’ve Seen 2 Doctors About My Hair and Think Both Are Wrong

I’m a 25 year old male and my frontal hairline began receding rapidly about 9 months ago. From reading your blog and my own observations I assumed it was male pattern baldness kicking in earlier than I would have liked.

I have now seen two doctors (One family doctor and one dermatologist) who have both told me that It would grow back by itself as they both said it was due to stress (About a year ago my dad passed away right after I moved to a new city and I had to start a new job the day after the service). The family doctor briefly looked over my hair and the dermatologist asked me my family history (No balding on my mom’s side, and my dad started balding in his early 40s) and did a pull test (No miniturization test)

The problem I’m having is that from reading your blog it seems like they’re both incorrect. There is obviously miniturization at my hairlines which to my understanding means there its is MPB which could have been triggered by the event.

Does my hair growing back by itself like they both said sound at all realistic? Should I try yet another doctor?

Thanks for your time.

I agree with you that a mapping of your scalp for miniaturization will make the diagnosis for you. The pull test that your dermatologist did will check out conditions like telogen effluvium (see article at eMedicine), which if positive might indicate that the process will reverse, but people with genetic hair loss will not have a positive hair pull test. See another doctor who can make the correct diagnosis for you.

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I’ve Noticed My Hairline Recede and Thin

Hello, I am a 23 year old African American male my hair has thinned drastically over this last past year. In 2007, I had a full head of hair. Later that year, I noticed my hair line slowly recede, but my hair remained full. Currently, my hair is thin and I have a nearly bald spot in the front of my head. Can you please recommend any treatments? Are there specialists I can see? Can this be the result of stress or does it signal some other sort of health issue? Thank you very much for your assistance and have a wonderful day.

Stress loss isn’t usually limited to the hairline. It sounds like you’ve got genetic male pattern baldness. Treatments include Rogaine (minoxidil) and Propecia (finasteride), though they aren’t known to work that well in the hairline. The Propecia could prevent further loss, however. You can try to find a doctor in your area by checking the physician search at ISHRS.org… and though the listings are for hair transplant surgeons, I’m not suggesting you should rush into surgery. These doctors are knowledgeable about hair loss in general, so either try them or a dermatologist.

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I’ve Lost Leg Hair

(male)
I have lost all of the hair on the outside of my legs from the knee down. I do not have any medical conditions that should affect this. Thank you

I do not know enough about you — like your age, for starters. If you know you have nothing wrong with you, then what value can I have? I think you need to link with a good doctor and then let him/her tell you that you have no medical conditions, and/or possibly identify something that is wrong.


2007-05-08 10:23:19I’ve Lost Leg Hair

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I’ve Lost Hair Since Starting Keppra (Epilepsy Medication)

(female)
I have lost my natural curl and half the amount of hair that I had as a side effect of Keppra. I would like to know since I have taken myself off it, will my hair grow back with the natural curl that I lost?

Hair loss is a known rare side effect of Keppra (levetiracetam), but I can’t say for sure if your hair will regrow now that you’ve taken yourself off of it. You’d have to wait out about a year to see if it regrows.

You were taking Keppra for an important medical reason (like seizures), and you should not be taking yourself off of medications without speaking to your doctor. I can’t even say for sure if Keppra was the cause of your hair loss.

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I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia.

Hi Dr. Rassman. I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia. Do you prescribe both, and if so have you noticed a difference in your patients responses?

Some patients have reported reduced effectiveness when they switch from propecia to the genetics but there are a few manufacturers of the generics and I have not kept a record of which is which.


2019-04-08 13:31:25I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia.

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I’ve Heard of Everything Before, but Getting Your Hair Back With a Blood Pressure Type Cuff on Your Head, Mmmm? (Very Long Video)

The theory is that tight scalps cause hair loss. There is no evidence whatsoever that this is true. The goal of this video is to sell you a device to loosen up your scalp. I don’t believe any of this but still will present it to you for the purposes of always presenting contrary opinions.

https://www.youtube.com/embed/sq5QYSNL_Ds?fbclid=IwAR0nXulCoyXy4Er3V6XrwwS1tTDx8rVEpU8SRgvyP_C1ApTgxLBF943_Ldc


2019-11-05 10:04:57I’ve Heard of Everything Before, but Getting Your Hair Back With a Blood Pressure Type Cuff on Your Head, Mmmm? (Very Long Video)

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I’ve Had Significant Diffuse Hair Loss On My Entire Scalp and Face

I’ve experienced significant diffuse hair thinning/hair loss over my entire scalp and facial hair about 8 months ago.

Could this be anything else besides Androgenic Alopecia? I’m 41 and was slowly losing hair only on top since I was 20. Been on finasteride for 7 years. Should I see a dermatologist first?

You should just see your primary doctor to make sure you do not have any other medical causes of hair loss.

Androgenic alopecia is also known as male pattern baldness (MPB). As the name implies, there is usually a “pattern” to the balding. Diffuse hair thinning all over your scalp, including in the donor area, would not be MPB… but could point to something like alopecia areata.

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I’ve Had Sexual Side Effects Since Switching to Generic Finasteride 2 Years Ago

Hey Dr. Rassman,

Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)

However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:

1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.

2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?

Thanks

Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.

While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.

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I’ve Had No Hair Loss Over the Past Year and a Half — Is Now the Time for a Transplant?

Doctors,

I have been taking proscar, religiously, cutting it up into quarters for the past 5 years. I have had moderate success in keeping what I have, but not any new hair growth. My temples have still receded and a little bit of the front part of my hairline has receded. However, in the past year and a half there hasn’t been any hair loss whatsoever. I am 29 years old, if I haven’t seen any hair loss in the amount of time I mentioned does that mean I have reached my final hair loss pattern and I will no longer experience hair loss, and I can go for a transplant procedure?

The last thing I want to do, go for a procedure and then all my native hair falls out and I am left with only transplanted hair. That is why I am sometimes confused as to how long one should wait to get a transplant and how would one know what the “final” pattern is at such a young age like mine.

The real question is: Is this your final hair loss pattern? You can guess at this, but at 29 years old, that might be difficult. Well-delineated patterns often show the final pattern. That means if you are (for example) a Norwood class 3 pattern, the area where the hair is should not have any miniaturization when looked at under a video microscope, and the hair behind it should not have bulk reductions as measured by a HairCheck instrument.

If you had clean borders and no loss of hair bulk behind your existing pattern then you could assume (not 100%) that for the moment, the hair loss should have stopped. The problem is that many people who see it stop may find that it picks up again years later. With the combination of what I discussed here with the continuation of the finasteride treatment, you may be one of the lucky few. If you are in Southern California, I would be happy to do these tests for you in my Los Angeles office.

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I’ve Had Diffuse Shedding Since Starting SSRI?

Had a slight thinning of hairline and a diffuse shed since starting an ssri. i have heard this is due to high prolactin caused by the ssri medication. could the thinning/receding hairline be the result of the medication?

While some medications can cause hair loss, medication is generally the last consideration among the list of other causes of hair loss. You may just have genetic hair loss that can cause thinning in the hairline. There is a reason why we call it male pattern baldness. Genetic balding has a pattern to it — like a receding hairline.

It’s even possible that you have a combination of things going on, with your genetics causing your hairline recession and the SSRI causing a diffuse shed elsewhere on your scalp. Many SSRIs are known to have hair loss as a rare side effect, but you really need to speak to your prescribing doctor about the medication and any issues you may be having because of it. I’ve written about this before here.

I simply don’t know enough about your case history, including your age, how long you’ve been taking the SSRI, family history of hair loss, etc.