Month: January 2023

You should get a HAIRCHECK test to find out if you are losing hair and how much is lost (see here: https://baldingblog.com/haircheck-test-how-it-is-done-video/ . I always tell patients to be smart about hair loss and get Metrics on the degree of hair loss you have and hook up with a good doctor to manage it so that you keep your hairy look as you go through the genetic balding process.

[16][M][Help] Have a family history of Hair loss. None of my 3 brothers got to kept their hair. I would appreciate some advice regarding what i can do to slow down or stop hair loss. from tressless

Can hair be lost because of change in location/water?

I can not imagine that either the geographic location where you reside or the water you drink will cause hair loss, unless you are stressed or there is something in the water. Though I’d expect if there was contamination in the water, your neighbors would have similar hair loss. Stress from a recent move can possibly cause hair loss.

The Dermatologist told me I could take Rogaine for 4 years and I would keep almost all my hair for the rest of my life. I would even get better results when I use Finasteride with it. I’ve never heard about this 3/4 year cycle and then the hair loss magically stops, any idea what she meant? The appointment was very short, about 5 minutes.

Hair has a 3 year growth cycle. Drugs like finasteride impact both the length of this cycle as well as the quality of miniaturized hairs that are present during the growth cycle. Rogaine does not impact the growth cycle but does stimulate new hair growth in some people. For young men, finasteride is a better treatment for hair loss that minoxidil. It sounds like you did not get all of your questions answered.

I am wondering if the areas on the head which lose hair first in Male Pattern Hair Loss are the areas of the head which naturally release the most body heat (e.g. the temples/crown). Is there more blood flow near the skin surface in these areas?

Great thought, but no. Your hair loss pattern is genetic and it really has nothing to do with blood flow. If you lost hair and became bald (let’s say in the crown) then any hair loss will probably occur in the hairy area where the blood supply is more robust.

Dr. Rassman,
Thanks for taking the time to review my circumstance. i am 35 yrs old and have been thinning for the last 5-6 years. I currently use minoxidil and the lost has seemed to stop. A dermatologist said it was MPb after a brief exam. There are a couple of reasons why i disagree with this. first there is not one case of any member of my family even thinning much less losing their hair. second my hair doesnt look like a typical MPB patient. i have a real good hairline and decent coverage all over the top its just thin, much thinner than the sides which are quiet full. i also visited a Hair center to discuss some options and the interviewer was agreed that it didnt fit the normal profile. I am wondering if it is a hormonal issue. I took accutane when i was younger if that has any bearing. Also around the time i started losing my hair i started to sweat a bit more than usual Any help would be greatly appreciated

Genetic variations are wide and family patterns do not always show balding. Now with that said, I would want to see you to map out the miniaturization in the head and then determine if this is one of the variations we see in genetic hair loss. Accutane clearly does participate in the process and if you are genetically prone, it may contribute to the genetic hair loss.

Send me pictures as a start (my email address is on the Contact page). You clearly need a diagnosis. Let me know which city you are in and if you are not near one of our offices, I may be able to refer you to someone who can help make a diagnosis.

My original blog entry (found here) detailed a reader’s thinning hair, possibly due to taking Accutane when he was a young man. The following is my response to him along with one of his photos, which I was given permission to post.

—

Thanks for sending your pictures. I am using one of these for the Balding Blog to make good reading for our audience, showing only a top down view without anyone able to identify you. What I see in this photograph along with the other you sent, is that you seem to have miniaturization throughout the Norwood Class 6 pattern. The frontal hairline looks stronger than the area behind it (a good surprise), suggesting that the frontal line has different and stronger genetics than the hair behind it. I can not determine the amount of miniaturization that is there, but a good baseline is needed to determine change over time and any response to medications. Also, the donor area around the back and sides needs to be assessed to determine if you have a condition called Diffuse Patterned Alopecia, a diagnosis that is important to make prior to considering what to do about your problem.

With such an extensive area of thinning, your donor supply, skin laxity, and varying hair characteristics need to be determined before any treatment recommendation can be made. You may be a good candidate for Propecia and/or Rogaine. The pictures help, but I would think that you need to be managed by a competent doctor before going forward from here.

I am nearly 30 and have had diffuse loss at some point in my frontal third over the past decade. All in all though, it hasn’t really changed in years. It’s thinner than in my adolescence, but doesn’t really seem to be progressing much?