Month: January 2023

I have a question concerning today’s blog post. you mentioned that “exclamation point” hair is a sign of a disease but isn’t that what happens when miniaturization occurs in general? doesn’t the shaft get smaller, generally at the root first? that’s what’s happened to me. does this mean i have a disease? i doubt it. i got my thyroid checked when i first noticed hair loss and everything seems fine. i guess what i’m asking is, what’s the difference? thank you!

The term “exclamation point hair” is a term of medical art (see more info and a diagram at American Academy of Family Physicians). You are correct that as the miniaturization progresses (it would have to be rapid progression) one could theoretically see the reduction of shaft size, which is normally a very, very gradual process. It rarely can be picked up visually as you report.

I know that you’ve addressed this before in a post a few years ago, where you suggested that exclamation mark hairs were a sign of a more serious infection. However, I was wondering if you could provide a little more information as to if it is also a sign of Is it a sign of traditional male pattern baldness?

Particularly if the thinning is very gradual down the hair shaft, only detectable if you bend the fallen hair so as to compare the top of the hair with the bottom next to the bulb.

If they get thinner towards the bulb and less heavily pigmented is this an example of the process of miniaturization? If not, rather than an underlying infection, could it be due to a lack of vitamins, or telogen effluvium?

If this smaller diameter is noticeable on all the hairs that are being lost, even from the side and back of the head, or even body hair is that the case where it is more likely to be as you originally suggested an underlying infection?

Hairs that look like exclamation marks can be a sign of a variety of issues, but alopecia areata is chiefly among them and often points to this diagnosis. Other possibilities include lupus, thyroid disorders, and some allergies. I don’t mean to get you alarmed, so see a doctor for an examination to get to the bottom of the problem.

I’ve written about this before — Is Hair Normally Thinner Towards the Root?.

Hi,
My scalp produces too much sebum and there is a wax like build up around the hair follicles. As a result I am losing hair. My hair roots are not nourished properly and then fall out very easily. Surprisingly there is no sebum or wax build up on the sides and rear of the head and the hair is perfectly healthy in that area. Its the vertex part that is effected. Nothing seems to help. I am writing with a lot of hope…please suggest me something. I have started taking zinc sulphate and B6 and sebum production have reduced a bit. Thank you.

Sebum does not cause hair loss, contrary to what many people say, but the things we do to keep it down, does often cause hair loss. Shampoo regularly, possibly twice a day to keep the sebum down. Have your scalp mapped out to determine if your have miniaturization and genetic hair loss. Let’s be smart about how this is approached. Get a good doctor and get a diagnosis in your hand so that you know what has to be done.

Hi doc, Im 23 I have always had a naturally high forehead with thin blond hair but over the last year or so Ive noticed that my windows peak is more prominent than usual and the sides of it are ‘coming in’ a bit so I have a small strip at the front of my head and very high temples. I have been paranoid about my hairline since about 16 and recently it just seems it that its actually beggining to recede. Baldness does not run in my family btw! Im not sure if its my imagination but the hair on top my head does no longer feel as thick as the sides. My question is:

Are there any renowned H/T doctors in the UK i could look into? And also is the hair transplanted permanent or will that eventually fall out? Ive read somewhere that excersizing the muscles in your forehead and scalp can help reverse balding (something to do with circulation – ie: why do bald men have hair at the side and back – is it because eating everyday works these muscles?) Proffessionaly speaking – is there any evidence in that?

This is another great rumor about hair loss, ranking right up there with hats and naughty thoughts causing hair loss. Hair loss is caused by a combination of hormones (DHT mostly) and genetics (in combination with hormones even if it does not run in your family). Transplanted hair is permanent because it comes from an area of the scalp that is genetically pre-programmed to be resistant to the main hormone that causes hair loss, namely, DHT (DiHydroTestosterone). Therefore, with the possible exception of some rare disorders, it will not fall out.

Incidentally, there are muscles at the back of your neck and on the sides, but none to speak of on the actual scalp. Exercising the muscles in your forehead will give you wrinkles and a really strong eyebrow raise when you want it, but unfortunately will do nothing for your hair. There are surgical procedures that can lower the hairline. For doctors in this field all over the world, go to ISHRS.org, but keep in mind that each and every doctor needs to be evaluated by you very carefully. It is very important to do your own research.

Take a look at the information on pumpkin seed oil which can be used if you want to try to stay away from traditional medications like minoxidil and finasteride.

https://www.karger.com/Article/FullText/492035

Excellent Results in 30 Year Old Female Using Minoxidil Religiously for One Year. The pictures speak for themselves. Minoxidil is an excellent choice in women who are pre-menopausal and can’t take finasteride.

This article discusses microneedling and shows many photos of men before and after its use

https://www.hairliciously.com/blogs/news/the-best-before-after-microneedling-and-derma-roller-results-for-hair-growth

I get a good family history and try to match the patient’s hair loss pattern with his family history. Then I mark where the patient is in his hair loss process, usually deploying the HAIRCHECK instrument test (https://baldingblog.com/haircheck-test-how-it-is-done-video/). Then I discuss the various options that are age related. Many of the men under 25, who may be balding and wanting a hair transplant, I discuss the need to delay such decisions and offer the various treatment options such a minoxidil and/or finasteride. Then I see the patient yearly to find out the effectiveness of the treatment and may make adjustments. Once the man has passed 25-26, I may or may not discuss the hair transplant option. Throughout this process, I develop a relationship with the patient so we get to know each other and I learn and understand who he/she is, what their concerns are and acting like a doctor, do the things that good doctors do, that show concern about the course that the hair loss undergoes during this period, year to year.

I know this may sound ridiculous and maybe hypothetical, however i find it reasonable to ask. Hypothetically speaking, who ever the first person was on the planet to go bald, what scientific REASON did he? I know you may answer by saying they would have had DHT-sensitive cells,but that isnt really explaining what chemically or otherwise is making the follicles sensitive to DHT. People have DHT yet dont go bald, so what makes the cell sensitive to it? The usual answer i get given to why am bald is because the balding ‘Gene’ has been passed down. Well who ever was the first person to bald, What specific reason did his cells become sensitive to DHT?

This is a great question. For those readers who believe in evolution and not intelligent design, I gave one reasonable answer to why hair loss occurs in a previous post — Why Does the Back and Sides of the Head Not Lose Hair?

After having read Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution by Leonard Shlain (referenced in the above link), I became a believer, as it was the only explanation for balding I’ve ever found.

The book is available at Amazon.com.