Is it normal for a hair under an inch long to be noticably thinner towards the root? i see hairs that fall out that look kinda like an exclamation mark, thick at top and thin at the root. my hair is around 2cm long.
The exclamation point hair you’re describing usually points to a variety of conditions, such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis (see Exclamation point hair). Normally hair is uniform in width.
Hi Mr. Rassman! Many off us now that chronic stress is bad for the overall health, one of the potential effects of stressors is an increased hairloss, maybe not such a big problem if you dont have androgenetic alopecia but if you do this temporary increased hairloss can potentially do more damage to the already weakening follicles! So my questions is:
1. In the connection to stress what is exactly happening chemically in the hair follicles that is leading to increased hairloss/premature entering of the anagen follicles to telogen?
2. And finally, hairloss that is connected to severe stress follows a diffuse pattern or am i wrong?
I do not have the answer to your question. Extreme stress (both emotional or physical) can cause hair loss and for men with genetic hair loss, it will follow a pattern of loss (not become diffuse). In women, this is often not the case as they are more likely to develop a diffuse form of thinning (without a specific pattern). I do not know the exact biochemical science behind hair loss caused by stress. As it is often said, medicine is mostly a descriptive science. Many times, we don’t know exact mechanisms.
2008-12-02 12:35:162008-12-01 10:06:11Is Hair Loss from Stress Going to Be Diffuse?
If the hair loss is stress induced and you have the genes for hair loss, then the answer may be no, it may not be reversible.
2020-01-20 04:00:432020-01-20 11:20:39Is Hair Loss Due to Stress Reversible?
Doc
Do you think we will ever see a day when someone with complete male pattern baldness (I.e. Horse shoe shaped) will be able to get a full head of hair? It seems like hair cloning has fallen off the radar. Is anyone/company still pursuing this? Do doctors and researchers still believe that we will be able to make it work? Will we see a solution in the near future? If so how long? There must be industry discussions and gossip about where we are with it. It seems like we have been waiting for ages
There are private companies that are still working on hair cloning. It has not fallen off the radar, but the progress has been slow. I can’t put a timeline on when it’ll be a reality available to the public, but I hope it will be available within my lifetime.
2012-10-03 08:37:452012-10-02 11:03:16Is Hair Cloning Advancing At All?
If you are considering putting hair back where you lost it by having a hair transplant, the big decision is to take the step of finding a caring, competent doctor working with an experienced team, followed by scheduling a hair transplant. For most men, scheduling a hair transplant is the greatest step, in other words, to fix a problem with a surgical solution.
Fortunately, the hair transplant procedure has been made absolutely undetectable today, contrary to the 1990s, when everyone could see a hair transplanted patient and know it was not normal. Today, normalcy is the rule in the hands of an excellent hair transplant surgeon who has developed an excellent surgical team that has been fine-tuned over many years.
Most cosmetic surgeries only require the skills of a single surgeon, but all hair transplant surgeries require the skills of a great surgeon who built a great team to work with. A great surgeon with a poor team will produce poor results. A bad surgeon with a great team will also produce poor results. Why am I saying this when everyone thinks that the surgeon is the key to a good hair transplant? It is because a good hair transplant requires a skilled surgical team that understands quality control systems, similar to great manufacturing operations. When the team produces 2,000 grafts, it is a team effort that works under strict quality systems rules.
Once you take the plunge in deciding if you should go for a hair transplant, the next step is to find the best doctor with the best team that knows how to work together. Then, you need to decide if you should want a strip surgery (FUT) or FUE.
The FUT procedure (Follicular Unit Transplant) harvests a batch of hair by cutting a strip from the back of the head. The strip of hair is then dissected into their natural family groups with a large team of technicians working with high powered microscopes. Both I and my wife and daughter-in-law had strip surgeries, and we have undetectable scars.
On the other hand, the FUE procedure (Follicular Unit Excision) is a hair transplant procedure that harvests the hair follicles in singular hair groupings. FUE is a great procedure that I pioneered. But contrary to most young men’s belief that FUE is better than a strip procedure (FUT) because it does not scar, this is not the case. Many doctors would like you to believe that FUE is a scarless surgery, but take a look at the type of scars a large FUE session can create. Scars are a complication when FUE is performed on a person with low donor density and is unable to support a large number of FUE grafts. Many patients found out the hard way by getting 3,000-6,000 FUE grafts without having an assessment of their donor density performed prior to their surgery. As a result, over-harvesting has become far more common than you might expect. I love doing FUE and half of all of the surgeries we do today are FUE hair transplants, but for those of you who are reading this post, please note that anything done well in moderation may be good/ . Likewise, FUE done in moderations is a great surgical hair transplant procedure. However, when done in excess, the patient pays the price with ugly scarring that may never have been anticipated. Certainly, the unfortunate man in the photo below had no idea that his FUE was a massively scar-producing surgery because his doctor over-harvested grafts.
2018-03-02 06:28:272018-06-22 11:39:06Is FUE Worth Doing?
I have followed this site for a few years now and I am so impressed. First off, your integrity seems to be apparent in how you run this site. There is none of the cheap salsmanship common to some of the hair replacement surgeons with whom I have spoken. You provide so much disclosure that it is obvious that you truly want educated patients. It seems to me that the medical hair replacement industry was crying for someone like you.
With that, I am happy to share with you my story and ask you my questions. I am a 45 yr old male who began losing his hair at 19. I was told early on by a few surgeons that I was an excellent candidate for hair transplantation because my donor hair was so good (it was rated a 9 out of a possible 10). I believe that I am a Norwood 6 but I know that I have long lost all the hair that I was to lose. I have had 13 hair transplant procedures with Dr. X [editor’s note: name removed] and 2 scalp reductions with another doctor. The procedures were performed between 1989 and 2001. In total, I had 1679 “large” grafts, 379 “medium” grafts, and 321 “single” grafts. My hair provides decent coverage for someone who by this time would have been left with only what I call “clown fringe” (I am sure the visual will resonate with you) but I do use a concealer (Fullmore) to hide some small patches of my crown which show, and some of the scarring. My goal is to surgically get more coverage – or at least more uniformity in my existing coverage – so that I can stop using the concealer. I would like a good evaluation on what surgical options may be open to me, as I have already had so much work already performed and donor hair is not so plentiful. These are my questions:
- Do you ever do any work in NYC/LI?
- If the answer to #1 is no, can you recommend any good and caring surgeons in the NY/LI area?
- It seems like FUE2 would be a natural choice for someone who has had so much work performed already and where so much donor hair might not be harvestable in one strip. Is this a correct assumption?
- Is it possible to do many smaller strips so as to increase yield for someone who has had so much work performed already? Does it matter from where the strips are taken? I think that I may have some donor hair on the high sides.
- I have not heard of too many people having as much work as I have had. Does the work I describe sound like it is so much? Are you aware of many people who have had more work?
- I have been using a concealer for 15 years – just during the week and just during the day. Are there any health affects of such prolonged use?
- How does the cost of the FUE2 compare with the normal strip method?
Any of these questions which you can answer would be appreciated.
Keep up the site.
The problem with your situation is donor scarring and your donor area must be a mess. It’s difficult to make any real advisable points without first seeing what I’m dealing with, but you might be able to excise the highly scarred donor area (probably using a balloon expander) if that is bothersome to you. Good luck.
Hello Doctor,
I came across this article regarding Follica – Hairloss Cure: Could Follica Be A New Breakthrough In Baldness Prevention Products?What are your thoughts about this? Is it something you are looking forward to?
Would you peel your scalp skin back? As the article states: …“sounds mildly terrifying: they start with a process called ‘skin-peturbation’ where the top layers of the scalp are peeled back.”
There’s a long way to go before Follica would be able to be taken to market, so I’m not going to get excited about it yet. I’ve seen a lot of promising “cures” go nowhere over the years. We shall see.
You may slightly notice if hair loss has stopped or slowed down. The drug will be having an impact. The only way to find out what is happening is to stop the drug, and if you do, you may shed a great deal of hair that may not return. Therefore, stopping Finasteride may not be a good idea. This is a difficult place to be, but you almost always must stay on the drug, and in up to two years, you will almost certainly get value from it.
Hello. I have been balding for around 4 years (started when i was 17 unfortunately) and I have searched for solutions for my hair loss endlessly to no reward. I have used multiple shampoos, different types of minoxidil (spectra-DNC and more recently rogaine foam- had to stop rogaine foam because it seemed as if i was shedding ridiculous amounts for way to long ~1 month) and still nothing.
I feel like have no where else to go besides into the realm of anti-hormone therapy. By that I mean finasteride (propecia) or Saw Palmetto pills. My question now is, is the herbal route (saw palmetto) that much different than the pharmaceutical route (finasteride)? They both inhibit 5-alpha reductase leading to lower levels of DHT so what makes one drug better than the other?
Another question I had was, after testosterone is inhibited from becoming DHT, what happens with the extra testosterone? Does aromatase convert it to estrogen (-> leading to gynecomastia)? Does it have the same effect as steroids whereby exogenous testosterone leads to smaller testicles and decreased sperm count?
Thank you.
For starters, peer-reviewed clinical studies about saw palmetto as a DHT blocker do not exist, making it difficult to make any comparison. It’s a catch 22, I know — it’s a natural herb so it won’t be able to have any patent protection, thus no company will put up the funding to get a good study done. Still, Propecia (finasteride) does have such studies, meaning there is real data to look at and make judgments on. If you don’t want to go the pharma route and would rather go with saw palmetto, that is entirely up to you. I don’t think the results will be there with saw palmetto, however.
Much of what you state has bits of truth to it, but it’s not a complete picture nor is it really helping you understand things. Hormonal pathways are very complicated and you cannot narrow things down to explain things to suit your needs. I am not going to explain all the biochemical pathway of testosterone to DHT to aromatase, etc. It’s a bit too abstract for this site, and honestly I don’t want to teach a course in college biochemistry.
So lets start from the beginning… and by that I mean, what are your goals? If your goal is to find a cure for hair loss, then you will not find it. There is no cure for hair loss. If your goal is to slow down male pattern hair loss then the only thing that I know of that really works is finasteride and topical minoxidil. These medications do not stop hair loss per se, but will help slow down the loss before your genetic predisposition eventually wins over (this could be many years). Everyone responds to the medication differently, and ALL medication have side effects.
Propecia’s side effects have be beaten to death on various web forums, much of it being false or blown out of proportion. Take note, Propecia is not the only medication that has side effects. Just look up any common medication on the Internet and I am sure you will find loads of false (as well as true) information and their horror stories. My guess is that Propecia is a sensitive topic to most, because words such as “erectile dysfunction” and “decreased libido” are key issues for any male patient. If you look up medications like Prozac or drugs used to treat high blood pressure, you will also find “erectile dysfunction” as one of the many side effects.
The patients who are considering Propecia should be aware that side effects exist, but in reality (from my personal medical practice with actual patients I see at my office) the incidence of “erectile dysfunction” is as stated in the medical literature — 1 to 2%. Those patients with these issues can stop the medication and the side effects reverse within a week. The incidence of gynecomastia is about 1 in 300 to 1 in 500 (I am not sure of the exact published number), but I only remember one patient reporting sensitive breasts about 3 years ago. He stopped the medication and he was fine afterward.
One last thing I wanted to point out — Propecia does not give you small testicles or decreased sperm count.
2010-10-25 14:58:002010-10-22 15:30:47Is Finasteride Really That Much Different than Saw Palmetto?
Hi Dr. Rassman,
I saw my Dermatologist recently and after a quick scan of my hair, he prescribed me Proscar for early stages of MPB. I’m 28 now. I started taking 1/4ths and after 3 months decided to cut
it into 1/8ths to stay below 1mg per day.About a month in, I noticed a few things with my vision. I noticed a couple of floaters, I was more sensitive to light especially at night with headlights and street lights and my eyes
were more dry. A trip to the eye doctor revealed no issues, but the effects still persist periodically.In your experiences, have you had any patients report any changes to their eyes/vision? I’ve read some posts on message boards with the same issues but don’t find them reliable.
Many thanks! and this is a great board!
First, I commend you in having the skill to break such a small pill into 8 equal pieces.
Second, I doubt finasteride is the cause of your eye problem. I’ve not had any reports of this from any patient I’ve prescribed finasteride to and I haven’t seen anything in the medical literature about vision issues from finasteride. It is unclear if you were seen by a optometrist or an ophthalmologist (the latter is a physician who specializes in eye problems). Seeing “floaters†may be benign, but it may also herald other medical issues.
2007-07-25 14:32:432007-07-25 14:32:44Is Finasteride Making My Eyes Sensitive to Light?
