Month: January 2023

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Hair at Age 10, Blonde Hairs on Temples Are Gone Now at Age 20 (Photo)

You need to see an expert doctor like me, who can do a HAIR CHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/) on you to determine if you are going to go bald. This is a lot of recession in someone 20 years of age. Who do you take after in your family line? Blondes are the BEST candidates for hair transplants, but at your age, I would be hesitant to recommend it. You should absolutely be on the drug finasteride if you want to keep your hair. I find that blondes are the best hair transplant candidates because of the low contrast between hair and skin color. If hair is important to you, you will look at my comments seriously.


2019-09-12 12:25:49Hair at Age 10, Blonde Hairs on Temples Are Gone Now at Age 20 (Photo)

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Hair Assessment in Early Balding

Hi Doctor,

I am a 26 yr old male started thinning about 11 months ago sometime in december last year. My hair was really thick before so obviously I didnt realise I was thinning when it kicked in during the early stages.

Observations :
1. I notice about 18 -25 hair every morning on my pillow. Most of these hair are very fine and shorter than usual. Some of them have a white bulb at the end.
2. Even at work I notice about 4-5 hair falling on my desk/ keyboard everyday even when I gently rub my fingers on my scalp.
3. During a shower when I apply shampoo on my hair I get about 10 – 12 hair sticking on my hands/fingers even though I shampoo very gently. I wash my hair with shampoo and conditioner ( Clairol Herbal Essences/ Nizoral; was using Garnier Fructis earlier) about 5 times a week usually after a workout.
4. My Hair is thinning all over my scalp. Even on the back although since there is a higher density of hair so No scalp is visible.
5. Some of the common symptoms I have experienced in the past 8-9 months are itching, flaking/daindruff, A kind of burning sensation as if there is some heat generated from my body which is burning the hair roots on my scalp, and obvoiusly my hair is a lot thinner than a year back.
6. I do not see any receding of my hairline( thank god for that)but the area right behind my hairline/top has some noticeable bald spots where it seems like the hair thinned a lot and i have lost some hair.
7. Been on propecia for almost a month and do experience some pain in my balls of late (after ejaculation) however I dont think its reduced my sex drive or erections but I am determined to ride it out.
8. Overall When I examine my scalp minutely,I notice my hair still grows fast however the quality of hair is much more thinner than a year ago annd as a result a lot of scalp is noticeable. I probably have some hairloss too.
8. The worst part is I am not able to comb my hair like before and if I make it puff from the top/front My scalp is very visible from the front. I really woe the fact that I should have taken corrective measures early (when visible hair loss/thinning started about 10 months back but like most people I was in a denial mode and just would not digest the fact that I was loosing/thinning for good.

I have spent many sleepless nights on this issue in the past month and literally think bout it every 30 minutes.
I am a vegetarian and take about 100 grams of whey protein (courtesy GNC) per day for supplementation. I would say My professional life isnt that stressfull at all. The pics in the album were taken with a Kodak 4.0 MP digital camera under bright light.

1. I am applying Minoxidil twice a day but I am thinking bout changing it to once a day at night. I apply it mostly at the top and some on the vertex. Also its too flakey and makes it look like I have daindruff on my hair. Do you think this is a good move and is once a day 5% effective ?
2. From my pictures can you tell me whats my norwood scale ? I am thinning considerably from the top. The hair on the top of my scalp are very thin compared to last year. As a result They tend to clump together when I make them wet or when I apply hair gel. Sometimes in the morning when I gently rub a wet hand on to my scalp I get about 6-8 hair sticking into my hand. Will Propecia or Minoxidil make them thicker again ?
4. From the pictures how bad is my vertex ?
5. Realistically what are the chances I will retain my “Hair Glory” I had in Sept 2004 ? Or is it all downhill from now ?
6. Is there any way i can get the thickness measures with a densitometer in the North California area ?

Photo Album at [link removed for privacy]

Most of the pics in the first album were taken immediately out of the shower. these days I just stand under the shower and let the water wash the shampoo itself with out rinsing it off after applying. No towel dryng too. Notice how the thin hair clumps together from the force of the shower and my scalp is exposed. Or Am I balding on those areas ? looking at my current situation do you think I should continue using minoxidil 5% I started it 2 weeks back in panic I use it twice a day for now. Should I cut it back to once a day or totally eliminate it ?

I would appreciate your assessment of my situatiocn.
Best regards

Your photographs are consistent with genetic hair loss, but there is no substitute for a good examination as I have said many times in this blog. You should not be your own doctor. The miniaturization mapped on your head will allow the doctor to determine the pattern of the hair loss. The Propecia you are taking will probably stop much of what you are seeing, but you do need to have the examination for miniaturization, or you will not ever truly know if you are actually benefiting from the drug, or if the problem was just temporary and drugs were not necessary. You discussed your hair glory, wanting to go back. I can not (nor can anyone else) predict your response to Propecia, although I have seen some men return to their ‘hair glory’. Responses depend upon the time you have been losing hair, the genetics of each patient and the timing with regard to starting the Propecia with regard to when you actually started losing your hair. The quicker a young man starts Propecia, the greater the overall effect I generally see. As to your question about using Minoxidil while also using Propecia, I’ve talked about this a few times before: here, here, and here. I am in Southern and Northern California, and would be happy to perform such an examination on your free of charge. I can not make a doctor recommendation in the North Carolina area, but you could take a look at the physician search on ISHRS.org. Be sure to do your research before chosing a doctor.

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Hair Around My Ears Just Falls Out from Touching It

Hi, I am 25 and male.

I have for the past year or so been losing my hair round on the sides of my head to the point that you can now see the scalp through it. The hair round my ears falls out even if I gently touch it and the thinning is worst just above and behind my ears to the point there is almost a bald spot above/behind both.

Although I am in early stages of MPB (between II and III vertex) could you please advise whether this is anything more than MPB – as pretty soon I won’t even be able to shave my head without looking slightly odd? Thanks

Hair loss around the ears is not from male pattern baldness (MPB), as that area of the scalp is considered the permanent fringe area. That doesn’t mean you do not have MPB, but it should not affect the hairs around your ears. It seems you need a diagnosis and I cannot provide that here.


2010-11-23 10:47:18Hair Around My Ears Just Falls Out from Touching It

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Hair and the Effects of Flat Irons

Hi I am 29 years old, male. Do flat irons cause permanent hair loss? My hair dresser started using a flat iron on my hair 3 years ago, since my hair was wavy, he showed me how I can make it straight. About 2 months after using it (usually once or twice a week) I noticed that my hair was drying out. I stopped, only to use it once in a while. Today I find that my hair is receding on the sides and my crown is thinning. Is this from the use of the flat iron? I’ve stopped using it for about 6 months now but I still find that my hair falls out everytime I wash and style it. I researching on the net about the side effects of flat irons but never found any concrete proof about the consequences of using them. I hope I didn’t ruin my hair for good! What can I do?

Let’s think logically about this. When hair has grown beyond the scalp, it is no longer a living tissue. Only the hair organ below the skin is living. Hair is made of compressed fibers and a shingle type of structure made up of shed skin cells called cutin. These shed skin cells are in effect the same ‘stuff’ that produces the scales we see in dandruff and may reflect higher turnover of the skin on our scalps. As these shed cells are compressed above the fibers in the hair shaft, they form a layered array just like the shingles on a roof would form to keep out the water. But below the skin, the hair organ puts lipoproetin layers into these scales of cutin that give the hair the character that you have. The presence of fat on the outside of the hair shaft is what brings out ‘luster’ in the hair. Once the hair exits the skin as it grows , it enters the hostile environment of air, wind, weather, heat, etc… and it no longer is subject to what your body can do for it. As the hair exits the surface of the skin, the sebaceous glands secret a waxy sebum that may find its way onto the hair shaft, giving some people an oily hair.

When you iron your hair with heat, you do change the character of the hair and change the configuration of the varying layers of compacted cutin and the fibers that make up the structure of your hair. Heat takes away the luster (shine) from hair, burns away the waxy covering, may denature the lipoproteins on the surface of the hair shaft and it is this that protects the hair from the environment. Heat may damage the core of the fibers inside the hair as well. High heat applications can damage the hair so that it cracks, breaks, and even become fragile, producing broken ends from hair that breaks too easily. Take a look at this illustration of an enlarged hair shaft here (illustrated by Norm Nason). Note the layering of the cutin shingles. Look at the center of the shaft and see the fibers that form the backbone and the strength of the hair shaft. When these fibers are broken, or the shingled cutin is removed, damaged or burned, a pealing process may begin which would reflect the damage to the foundation of the hair shaft, and it can become permanent. When the hair is damaged, then gentle handling is critical to maintain and hold it on your head. You can, of course, cut it off and new hair coming from below the skin which should not grow out damaged, will eventually replace the weak hair. The hair exiting the skin is normal and undamaged so you can and should expect that once you cut off the damaged hair, the new hair will grow to whatever your normal should be. Good cosmetology can hydrate the hair and it might bring back some of its luster and strength. For those of you interested in high powered microscopic views of the hair system below the skin, see here.

So, if you have hair loss or thinning of new hair, it is possibly a new problem, and you need to have your hair analyzed by a doctor like me.


2008-02-08 10:03:10Hair and the Effects of Flat Irons

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Hair and self-confidence

I’m balding since i’m 23 and since then i never stopped looking at my hair in the mirror every time or looking at older pictures and my eyes goes to my hairs. Or also when i’m outside looking at peoples hair and comparing to mine or telling that guy has beautiful hair why not me.. Even now i’m 31 and i still do it it’s been more than 8 years that i do that. Fin saved me and got my hairline from 3 years ago (where my hair loss wasn’t so obvious) So i’m less sensitive to that but i’m still looking at other hairs and also mine every day

Your story is typical. Most men who see hair loss recognize for the first time that they are aging and nobody likes that reality. One of my sons noticed that his soccer skills have precipitously fallen down in the past few years and as he was always #1 in scoring, he now plays second class to the younger guys. We all, sooner or later, will recognize that we are getting older, sometimes it’s the hair, sometimes it’s the body’s performance, sometimes it is in the death of a friend way before his time. From the many celebrities (actors and musicians) I have worked with over the years, I found that their hair was critical to their art. Getting their hair back with drugs or a hair transplant gave them peace of mind so that they can focus on the things that are really important once their hair situation is a thing that they don’t have to deal with in the present.


2021-05-18 07:07:51Hair and self-confidence

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A transplant at 21, now at 22 he has more hair loss and needs a MASTER PLAN (photos)

The circles show where the hair loss has progressed since his hair transplant. I tell 21 year old men who want a limited hair transplant to wait until at least they are 25 or they will be back every year as the hair loss progresses as shown in these photos with the circle just one year after his hair transplant at 21 (not done by me, of course). By the time he is 25, he might have a lot more balding present (you can see some crown loss now showing up) and if he had a hair transplant every year from the age of 21, he would use up his donor hair. With patchy hair transplants done every year, the doctor makes money and the patient slowly develops an abnormal look without a plan. That is why I stress the need for a MASTER PLAN for hair loss on EVERY balding male who is thinking about hair transplants. Imagine at age 36, he might look like this: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/


2019-10-17 13:23:17A transplant at 21, now at 22 he has more hair loss and needs a MASTER PLAN (photos)

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4 hair transplants and now have massive hair loss, I’m worse off!

I had my fourth FUT around 11 months ago and I’ve seen zero improvement. Shock loss kicked in 3 months after the surgery and hasn’t stopped ever since. All kinds of hair (native/transplanted/vellus) are shedding. My body can’t tolerate finasteride so I bought a laser helmet which I’ve been using for 3 and a half months now. The scalp feels stiff. Will take up ketoconazole shampoo and vitamin d supplements soon. I keep cutting them shorter to get rid of the sick-ish ends with that weird wiry/coarse texture but it’s only getting worse. Visited my surgeon recently and he told me “it’s fine, you’re not bald” and dismissed me. He didn’t even examine my scalp. They rarely admit something went wrong in my experience. I am at a loss and feeling really depressed. Any help would be appreciated.

You should have, by now, developed a great relationship with your doctor after 4 hair transplant surgeries. He/she should not dismiss you. You should have developed a Personalized Master Plan for your hair loss with your surgeon when you started the hair transplants. What it happening to you now should have been anticipated as a worst case situation. Did you create a Personalized Master Plan with your surgeon? I would be happy to take a telephone consultation with you at info@newhair.com. Sounds like you need help and advice.


2020-01-31 06:29:484 hair transplants and now have massive hair loss, I’m worse off!

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3000 FUE grafts 1 week with ago with cracks on my head, why? (photo)

What you are seeing is terrible post-operative care which has allowed thick crusts to form on your head and then crack. An FUE is treated just like a regular hair transplant with regard to the recipient area while the donor area has open wounds which require daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish.

The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. IF any crust are present, use a Q-Tip and dip it into soapy water and roll it on the crusts. That will lift them off without dislodging them but never rub them, just roll the Q-Tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area are gone in 7-10 days with daily washing.

I don’t like the idea of anyone removing grafts that have scabs on them. We have published a paper in a formal medical journal (https://newhair.com/wp-content/uploads/2018/11/mp-2006-graft-anchoring.pdf) that states when a person pulls off a scab (crust) from a recipient area in less than 12 days, the risk of losing the graft is very high. Put a shampoo on your head and let it sit for 10-15 minutes, then gently work the crusts with your fingers. This will take days to get the crust off but you will not disturb the grafts.

I am also disturbed that 3000 grafts were placed in the frontal 3 inch zone of your scalp. Keep in mind that most people have only a bout 7000 grafts in their donor area and if your original donor density was low, then that number could be 4000 or even less. IF your hair is fine, things get even worse. You can contact me for more details on how to evaluate your long term planning if you wish.


2020-09-15 09:22:333000 FUE grafts 1 week with ago with cracks on my head, why? (photo)

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Habits – Are They Good Or Bad?

Did you know that 40% of our daily behavior is habitual freeing up our minds for other things. This was a cover story in the January 16th issue of New Scientists. Think, if you could only control your brain and put it into autopilot more often. The focus of the article is to tell us that we can train our brain. As I read the article I started to think how much time I spend driving in Los Angeles, and most is on autopilot. The answer to the question posed, it is both good and bad. Nail biting is a habit, is it bad? Brushing your teeth before bedtime or in the morning can be a habit as well as eating sweets at work. If you can retrain your brain towards against bad health habits, maybe you will live longer. The article warns that habit take a long time to make or break but there is no time like the present to start focusing on them.