Month: January 2023

You’ve said before that balding comes from both sides with a tiny bit more weight on your mother’s side. When looking through a family tree for traits and patterns of hair loss (which I’m sure every visitor to this site has done over and over), how far back or in to your extended family should you look (cousins, uncles, great uncles, etc.), or can it spring up out of anywhere? I understand there are many environmental factors as well, but I ask because I have some unique traits I can’t attribute to anyone I have photos of in the past two generations or my second cousins even.

Genetic hair loss will likely be visible somewhere in your family tree, but I really cannot give you a definitive way to predict if you have the hair loss gene just by looking at your family members. The best way to know is look in the mirror… or see a doctor for a miniaturization study and/or hair bulk analysis.

The genes can be determined by genetic testing to 70% accuracy (see HairDX), but the test doesn’t tell you at what point the genes will be expressed, if at all.

I’m 21 and I’ve used minoxidil in the past (foam and liquid), but it was just too much of a hassle to apply consistently so I never saw any gains. Has anyone here used oral minoxidil with good results?

Oral minoxidil can be effective for male patterned hair loss. For many years, poorer countries have been using it successfully for male patterned hair loss before finasteride was released in their country. In India, for example, many people couldn’t afford Propecia and genetic finasteride wasn’t available so oral minoxidil was the only drug for hair loss.

I’m sitting at about a Norwood 1.25 or so right now, and was wondering if I could restore it to at least a 1 reliably with only min since I caught it early. I’m also horrified of the dreaded shed making it appear worse, will this be lessened since I caught it early?

The younger you are, the better the chance that finasteride might work on the hairline. This does not mean restoring the juvenile hairline and reversing the mature hairline, but I am referring to real hairline recession in men under 22 years old. Although, I have seen this happen in older men under 30 less frequently.

For the long term, finasteride has been very effective at holding back the balding or slowing it down. Some of my patients who were on it for more than 10 years, tried and stopped it and they all reported significant hair loss within 3 months of stopping the drug.

I have a fraternal twin who at 21 hasn’t started thinning yet while I have some minor loss.

We have had quite a few identical twins. I wrote about such a case here: https://baldingblog.com/transplanting-identical-twins/ Fraternal twins are not the same as they may have inherited different balding patterns.

I often tell my young male patients to see who in their family line (mothers fathers or fathers and uncles) and that might help them if they can identify their hair loss history with one of them (uncles, brothers, fathers, grandfathers, etc.. I will almost always do a HAIRCHECK (https://baldingblog.com/haircheck-test-how-it-is-done-video/) test as well to see if I can predict what is going to happen to the young male patient

How do they know that Sebhoraic Dermititus and Psoriosis do not cause hair loss? You wrote on your blog once that it can cause reversible hair loss indirectly by the inflammation accelerating telogen effluvium. Can the inflammation in someone that does not have telogen effluvium do this? Many (not all) of my outer brows fall out by just touching them gently. I have sebhoraic dermititus, is this accelerated a normal symptom of the condition or does this mean I also might have telogen effluvium?

• Seborrheic dermatitis causes scaly, itchy, red skin and dandruff. It is a skin condition. It is not a hair condition.
• Telogen effluvium is diffuse hair shedding which is triggered by some form of stress that makes the hair go into the shedding (telogen) cycle. Hairs usually grow back in 6 to 12 months.

I suppose any inflammation or trauma or stress can cause hair loss, but these types of hair loss are generally reversible and do not occur in everyone… just some susceptible people. I suppose extreme seborrheic dermatitis can trigger telogen effluvium, but it would be rare. It may cause some hair loss from scratching producing traction alopecia (not as drastic as telogen effluvium).

We generally believe that for some period of time, the hair follicle stem cells in a balding man still are present. We occasionally see reversal of the balding in younger men. With our new experimental medications, I will probe this and eventually publish my findings.