Hair Loss Misdiagnosis

I am a 25 year old male with dark and curly hair. Some family background: My father has no hair loss, but has a high hairline. Possibly NW2/NW2A. My paternal and maternal grandfathers both experienced Male Pattern Hairloss around the age of 60. My maternal uncle is an NW2 but has no other hairloss. My younger brother (age 23) however while having a higher hairline than mine has definitely experienced noticeable frontal hairline recession in the last year. Around October of this year I became concerned with my hairline after getting a shorter than normal haircut. I usually wear my hair medium length and longer in the front which completely covers any visibility of my hairline. I expressed concern to my parents and a few close friends at the time and all of them said I had no noticeable hair loss, and if anything maybe had receded a tiny bit at the hairline. I did make an appointment with my PCP to check it out but ended up being scheduled to see another doctor at the last minute. I had never seen this physician before and she said that she could not give me an answer about hair loss because she had never met me before nor had she seen my hair. She ordered blood tests which all came bak normal. I went on with my life. During the months of December and January I experienced extreme emotional stress and more sleep deprivation than normal as a result of the new job I started around Christmas time. Around February I got another haircut, and shortly afterward felt extreme itching and burning at the back of my head right where the occipital bone meets the top of the neck. My rommate had a look and said that it looked very red and inflammed. I made an appointment with my PCP and met with him a few days later. I described my symptoms and my thoughts about possible hair loss. He had a look all over my head and asked if I had a history of thin hair or anything while also noting redness on below my occipital bone where I had experienced the itching. I said no because people have always told me I have had thick looking hair. His diagnosis was that I had “Age related hair loss” on my hairline and “possible” thinning on my vertex crown. He said he could not be sure. I asked if this meant I had a mature hairline or was undergoing male pattern baldness. According to him there was no way to tell either way until it gets worse/if it gets worse. He spoke to me about minoxidil and finasteride which I was already familiar with after extensive research online. However he said in my case it was much to early to start on either of these treatments. I left the office not feeling entirely convinced of his diagnosis. Later after going online and seeing examples on forums of men who were thinning at the crown and hairline I became very stressed and thought that if I possibly had thinning this may be a sign of mpb and should begin treatment immediately. I emailed my physician and asked him if it were possible to get a referral to a dermatologist for a second opinion. He said of course but that either way the treatment for hairloss would be finasteride/minoxidil and didn’t see the benefit of seeing a dermatologist. In fact he prescribed me Proscar and said I could begin using Minoxidil if I wanted to. This was a bit over a month ago and since that time I have been using both medications. However, since that time I have continued to have itching, bumps, and pain all over my scalp (even down my neck) and ears along with what seems to be a rash on my ears. Also, in speaking with my mother and others it came to my attention that I had apparently always had a cowlick near my crown and that it looked exactly the same as always which may have been what the doctor was talking about when he discussed my “possibly” thinning crown. That said I apparently do have a more noticeable line of thinning hair behind my head in between the vertex crown and my neck which the physician apparently didn’t notice. However after looking up pictures online I don’t really see any examples that look similar to the thinning pattern I have behind my head. I am going to continue using the medications advised my my pcp until my dermatologist appointment which is scheduled a little bit less than a month from now however I can’t help but feel a little wary in regards to the medical treatment/advice I’ve received up to this point.

My questions are:
Would Finasteride/Minoxidil have an effect on my hair if I didn’t in fact have MPB? I now find 1 or 2 hair strands when running my hands through my hair for a time. Sometimes more. However, I know that Minoxidil is said to cause an increase of shedding 1-3 months after initial usage.

2. How often do you find cases where patients where misdiagnosed in regards to their hairloss?

3. Is a line of thinning below the rim of the crown along with itching/pain in the scalp, ears, and eyebrows something you see in patients with genetic hairloss?

4. Do dermatologists often do miniaturization studies or hair bulk measurements? I know from reading many of your answers to questions that this is the most crucial part of measuring possible hairloss, and am worried my dermatologist will either not have the equipment to do those measurements or not know how to do them period. I live in Seattle and there are not a great deal of hair loss specialists nearby, and none of the HT surgeons I’ve looked up seem to be highly recommended.

The simple fact is I cannot diagnose your condition. If you think you were wrongly diagnosed, see another doctor. Genetic Male Pattern Balding is not a difficult diagnosis to make. Having a small microscope to look at your scalp helps for a miniaturization study but this is not always necessary. Propecia does not work for non balding patients and Norwood 2 is generally not considered balding as it more reflects the impact of a maturing hairline than genetic balding in most men.

Hair Loss Medication Side Effects

Hello Dr. Rassman
I have always thought about doing something for my loss of hair which is mainly in the front. I hear about all these products (propecia, procede, avacor) they all sound so great but it’s hard to trust on any of them since they don’t mention any possible side effects. I read about the gentleman who loss a lot of his hair when he used procede and I’ve heard that propecia may cause low sperm count. Are these side effects common? Is there any place where I can find such information? I guess most products (like medicine) have possible side effects. I just need to know how common this occurs. Thank you

I have no direct knowledge about ProCede. Avacor’s main active component appears to be minoxidil, which is cheaper if you buy it as generic minoxidil. Propecia does not reduce the sperm count, but can reduce the volume of the ejaculate that goes with the orgasm. Your sperm count should be as potent for getting your lady pregnant as before you took Propecia. The good news about Propecia is that it stays in your body less than a day (90% is out of your system in a day and effectively 99% is out in the second day). Keep priorities, do your research, and get a good examination by an expert doctor.

hair loss with male testosterone enhancement

I am 68 yrs old, very fit, weight lifter, and runner. I have been taking Cialis 60mg usually about 3 to 4 times a week. I also take male enhancement pills.Since I got serious about my sex drive and enjoy it almost daily, I have noticed my hair getting thinner.Could it be the Cialis, or male testosterone enhancements?

male testosterone enhancements of all kinds are known to cause hair loss

Hair loss from low Vitamin D or genes?

Now I am 18 male and from the last 5 years I am losing hair that’s why the front portion of my hair had become so thin that one could easily see my scalp, 2 months ago I came to know that I have vit D3 deficiency it was 11.78 ng/ml, now I am under treatment so anyone can tell me how much time it will take to regrow my hair?

If you Vitamin D levels are low and this is the cause of your hair loss, you can expect to see hair regrowth in a year or less; however, as a male, then the loss is most likely genetic (99% probability), Time will tell?


2019-03-19 07:21:25Hair loss from low Vitamin D or genes?

Hair Loss Lotions and Creams

dear Dr rassman
iam 26 years old and have been losing hair steadily since last few years. No one in my family is bald for that matter and now i guess my loss is pretty prominent. my question is do these hair loss creams really help.If so which one can be beneficial
thanks

There are only two medications that are known to work and to be safe for the treatment of hair loss. Propecia (finasteride) is a wonderful medication (oral pill once per day) for men only. Younger men or those with early hair loss in the back of the head often get reversal and hair regrowth. In most men, it prevents or slows the hair loss process. Rogaine (minoxidil) is the second medication and works in men and women, although it is not predictable. It is a topical medication and must be applied twice daily to get any effect.

There are hundreds of products sold over the counter and over the internet that make magnificent claims, but few if any of those claims can be backed up with any good science. Claims of FDA clearance are rampantly fraudulent. There are so many people looking for a magic cure and so many others looking to take advantage of them. Buyer beware!


2006-03-07 14:32:13Hair Loss Lotions and Creams

Hair Loss, Lasers, Drugs and Transplants

I am undergoing a hair loss treatment. This treatment involves lasers, basically a helmet that shines light on my head to deter DHT. I am somewhat skeptical, but it was the only option that was within my price range at the moment. I am 20 years old; my hair loss is not substantial. I am thinning on the top of my head and the most severe areas are in my hairline and the back of my head. I took this treatment to prevent my hair from thinning anymore. The thinning is not very obvious but I can tell it is still progressing. I wanted to know if transplanting hair from my own head would leave an area in the back of my head that hair will not grow on anymore. I also wanted to know if there are ways of getting transplants from other donors. Lastly, I want to know how much these treatments would cost and how effective the treatment I’m receiving is.

There is anecdotal evidence in Europe that hair lasers (Low Level Light Therapy / LLLT) increases hair growth. I’ve written about LLLT previously, here. Thinning of the hair in young men often starts off insidiously and gets slowly worse. At the beginning, you might actually lose 50% or more of your hair before you notice it. If you are a platinum blonde, you could lose 85% of your hair before it becomes noticable. The key is to make the diagnosis early and get on the only good, FDA approved DHT blocker that is out there: Propecia. This drug is the best and possibly the only real hope at this point to slow down, stop or reverse the hair loss. In young men, I have seen some wonderful reversals of hair loss. Transplants in a 20 year old without noticable hair loss is NOT something you should pursue at this time. When the donor area is harvested for hair transplants (the back of the head) it does not produce a bald area as you suggested in your question.

Laser treatments can be obtained from those who sell those services. We have a laser in our Los Angeles office, but do not sell the service at this time. I am told that the company that provides the service charges about $3000/year for treatment. Propecia costs range from $55/month to as high as $120/month depending upon the pharmacy you purchase it from. We sell it in our office at $53/month (very close to our cost). Transplants are sold by the graft. These surgical procedure generally cost a few thousand dollars per surgery, but they do last your lifetime. The more transplanted grafts you buy, the higher the fee.

Hair loss is now very rapid at 34, will dutasteride fix it?

I’ve seen a lot of your messages on reddit being very helpful for people combating baldness. If you have a moment I hope you could help me with a small question. In my mid 20’s I noticed my hairline begin to recede and went on Finastride. It seemed to work great. My hair recession slowed down significantly. However, when I turned 34. I began to notice my hair line was receding again. I’m aware that drugs like Finasride, more or less, just slow the process down. But I was alarmed at how quickly my hair seemed to be receding all of a sudden. It was like the drug simply stopped working. I panicked and with some research I found that Dutasteride was an alternative that’s been shown to be slightly more affective. So I switched, from 5MG of Fin(quartered) to 0.5 of Dutasteride. That was approximately 10 months ago and my hair continues to recede and thin, at what feels like an alarming pace. So here is my question. Have I made a huge mistake in switching? Will I lose all the hair that I kept on Finastride even though I’ve switched to Dutasteride? I thought that if Dutasteride worked it would keep the hair that Fin was holding back. Or perhaps there was no slowing these effects any longer, whether it was Dut or Fin? I don’t know what to do. Thank you for your time.

A hair transplant is a better option. Dutasteride will probably not reverse this problem at your age and with your history with finasteride.


2021-06-09 09:33:29Hair loss is now very rapid at 34, will dutasteride fix it?

Hair Loss in Young Teen Male

Dear Doctor,
I have this very close friend who is 15 years old. He is suffering from hair loss and has been since about the age of 11. I’ve talked to him about it many times and he says that the amount of hair he loses after showers is unbelievable. Even when he runs his fingers through his hair strands come out. I really would like to do what I can to help him, he has trouble talking to people so I’m basically the only one who can help. He also gets made fun of at school sometimes and no one likes to be teased. I’ve read up on different causes of hair loss but nothing really is directed to younger teens. Please help me help him.

Young men as young as 13 can have genetic hair loss. He needs to see a good doctor, get his hair and scalp mapped out for miniaturization and find out if he is genetically balding. Assuming it is genetic hair loss, then the drug that is best to hold on to his hair is Propecia. He must get help and get proper management; the price of premature balding is too grave a consequence for denying the problem.