Month: January 2023

A good photo to show your recession should be a frontal view with your hair pulled back and your eyebrows lifted high so that the creases on the forehead show up. This will show the anatomical landmarks to measure where your hairline belongs and more about what the shape should be. A normal hairline is one finger breadth above the highest crease of the furrowed brow. Anything higher is recession. I can only guess that this man doesn’t have recession because the frontal hairline is flat, which is an evolutionary step towards a mature hairline, but if he supplied me the photos as I outlined above, I could be more definitive.

“I’m seeing a few hundred hairs in the shower drain every day. I really don’t think I am balding, but I came to ses you because I wanted to be sure that if I was balding, you could transplant my hair and keep it looking good.”

This comment reflected the comments, one way or the other, of many men who visit me, but this particular day, this 26 year old actor who just finished his first role in a major movie came to me with the above comment. He looked like a typical hairy 26 year old male and I thought that after I measured his hair bulk, that I would reassure him that he was not balding. Much to my surprise, the numbers from the tests surprised me but shock him. The tests indicated that he already lost 50% of his hair bulk in the front of his head just behind his hairline, and 40% in the top (between his ears) and crown (back) of his head. He came apart emotionally. “This can’t happen to me”, he said. “I am going to hit it big time in Hollywood, I have an interview coming up for my second film, now a leading man, and I just can’t go bald”.

I tried to calm him down. At 26, he could go on the drug finasteride and probably stop most of his hair loss, so that was the ‘good news’ I told him. But despite my reassurance, he had difficulty letting go of the idea that his career was going to be ruined. “They won’t take me on if they knew”, he said. Again, I tried to reassure him that the drug might very well buy him years on keeping his hair, but he would not, could not focus on what I said. Over and over again he said “It over, my life is over”.

Hair loss is devastating for many young men and they don’t have to be heading to the top of the Hollywood scene to feel the way this man did. Although the drug often turns out to be effective in 26 year old men, the reality is that some day he will have to face balding. Although preventive hair transplants are a terrible and improper decision for him now, if and when he starts losing his hair, this may become an option. He left very unhappy and even unwilling to consider taking the drug finasteride. I asked him to return to see me, but he was from out-of-town and not easily accessible, but I called him a week later anyway and he promised to see me in 4 months on his return to Los Angeles. I wonder if he will deny what I told him or if he will think this matter through and make the logical decision to try to slow down the balding process and fill the prescription I gave him.

Did my dermatologist prescribe Finasteride too liberally ? Context : 27 y/o. Father and his 4 brothers have full heads of hair. Mother’s side : 3 out of 4 bald uncles. They were bald in their early twenties. I went to the derm two weeks ago. He didn’t look closely at me or do a hair count. He was like “yep, looks like MPB alright” and gave me a prescription for Fin (1mg). First pic is Aug 2017. Rest of the pics are from the last 2-3 months.

I would have performed a HAIRCHECK and a miniaturization study before committing you to a lifetime of finasteride. Too many men go on the drug not knowing for sure if they are balding. I like to make the diagnosis with instruments first, then use these instruments to establish a ‘metric’ which I can follow yearly to see the effectiveness of the finasteride yearly. That is the value I believe doctors should add to this treatment process.

I have a few follow up questions:

I am from Canada and am not sure if the local dermatologists will have this device. Are there any comparable alternatives?

If hair miniaturization and loss is caused by stress, even though I may have the hair loss gene, would decreasing stress stop or slow down the hair loss? (I am curious about this because through the observation of hair loss in my family, significant hair loss is nonexistent aside from one uncle on my dad’s side.)

Given my current description of hair loss, would you recommend medication such as finasteride and/or minoxidil or do you think a change in lifestyle should be the first line of defense?

Thank you in advance.

You do need to see a specialist to find out if you are losing hair. You have what appears to be a juvenile hairline in transition to a mature hairline. This is not balding. What I would do is perform a HAIRCHECK test to see if you are really losing hair. If you are, I would recommend finasteride and then follow your progress over a year to see if the hair loss was reversed by repeating the HAIRCHECK test. However, if you are not balding according to the HAIRCHECK test, then I would not recommend finasteride. Finasteride will not stop the movement from a juvenile to a mature hairline. (see: https://baldingblog.com/value-haircheck-bulk-measurements-two-patients-seen-today/)

To find out if you are really losing hair, get a HAIRCHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/ ) and this will actually measure the loss and then you can follow what happens over time with treatment.

Hello doctors, thank you so much for taking the time to do this, I really appreciate it.

Let me start off saying that I am a male and 19 years old. My question is about family hair types and the balding gene. My father is bald (looks like NW6 or NW5V). When he was younger, he told me he had hair that was like mine in that it was wavy/not naturally straight. Now this is my question, does this mean I inherited his hair gene since my hair is like his? Does this also mean I will go bald because of this, or is this the wrong way to think about the genetics?

I read your other posts about a gene being inherited but not expressed, but I would really like to know in your professional opinion that if my hair is like my dad’s(in terms of style only, his colour was black but mine is brownish)did I get his gene for hair and hair loss?

Thank you so much.

I really have no clue as to how you will bald or when or if you will even bald at all. It’s just not an easy thing to predict based on what you’ve told me. Male pattern baldness is genetically inherited, but just because you and your father have similar hair characteristics, does not necessarily mean you will have the same hair loss pattern. The only real way to tell is by time. In time, you’ll know if you’re destined to follow your father’s balding pattern.

The next best thing is an examination by a qualified physician with a miniaturization study. With that, you should be able to get an idea of early thinning (if any) and slow it down with medication. Then with follow-up studies of your scalp, you’ll be able to see how the hair loss is progressing and the doctor should be able to make an educated guess as to where you’ll end up.

The amount of brainfog i got from dutasteride is killing me I was using a pill a day for the last 15 months and i have brainfog… It didn’t go away for the last 15 days, am committing suicide? I am in my house with brainfog in my stupid dumb head quarantined…

Stop the drug! Those are bad side effects. See your doctor

Looks like you have early growth. If it doesn’t fall out in the next 10 days, you will see hair sooner than most people. This happens in 1″20 men who get a hair transplant and it is great when it happens.