Author: Dr. William Rassman

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Hair Loss InformationBalding and Hair Characteristic Genes? – Hair Loss Information – Balding Blog

Hello doctor. I was wondering, are the genes for balding and hair ‘type’ independent? For example, if a bald person has straight hair as does their son, is their son at a higher risk of losing their hair since they have the same hair type. I guess this could be similar for curly hair too.

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As far as I’m aware, hair characteristics and balding aren’t linked. For example, a son might have the same hair type as his father, but the son didn’t get the father’s balding pattern. There’s also nothing showing a link between hair color and baldness.

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Garlic Gel for Treating Alopecia Areata? – Hair Loss Information – Balding Blog

For those of us with Alopecia Areata, – this study may be beneficial to you guys. The study is quite positive. Please read the link below:

Link: Local Study on Garlic for Alopecia Areata

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GarlicNice find and thanks for sending. I don’t recall seeing too much about using garlic as an alopecia areata treatment.

This was a small study of 34 people presented last year at a conference in Australia. It does sound interesting, and I found another small alopecia areata study discussing the use of topical garlic gel in combination with betamethasone valerate, but I don’t know that the study mentioned in the link you sent was ever published in a peer reviewed journal. While the article is from the Philippine Dermatological Society site, it just mentions that the presentation was by one of their members…not that it was published in a medical journal.

I am glad there are new alopecia areata treatments being explored, regardless of how stinky they may be. And it’s worth noting that a few years ago the NY Times wrote about unlocking the secrets of garlic for use in medicine.

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Hair Loss InformationA Couple Months After My Transplant, My Scalp Was Exposed to the Sun – Hair Loss Information – Balding Blog

A week ago my grafts were exposed to the sun for approximately 10 mins. I didn’t burn but I did go slightly pink most noticeably on my right temple. To be honest I didn’t worry about it at all at first as from what I gathered from researching previous posts here your pretty much safe up to a first degree burn.

Over the last couple of days however I’ve lost a few newly sprouted transplanted hairs where the discolouration is on my scalp. In fact they emerged just before I was exposed to the sun so only 1 week old. I’m slightly concerned as I assume the only reason this would happen is if the follicles were going back into a resting phase or if they have died.

Is it possible sun exposure can cause follicles to shed but then regrow? I’m 9 weeks post op and had just experienced some early growth about week 7/8. Your opinion would be greatly valued.

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SunnyI wouldn’t think you have anything to worry about regarding your sun exposure. I don’t know why your newly emerged grafts disappeared, but 10 minutes in the sun will not harm the follicles and I doubt it will affect your scar. The ultraviolet light is what you want to avoid, so in the future I’d recommend applying sunscreen to your scalp (SPF 45 or higher).

If you are still worried, follow up with your doctor.

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Balding Time-Lapse Video – Hair Loss Information – Balding Blog

Hi Dr. Rassman

I just watched a timelapse video of a man age for 17 years, which shows the balding process really nicely. I noticed that his hairline recedes very slowly and gradually. But his crown thins all of the sudden at age 44. Can you explain why this happened?

Thanks

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This is a great video illustration! This man took multiple photos daily for nearly two decades. As to why he lost his hair in this way… it’s all in the genetics.

See the video below:

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Hair Loss InformationDoes One Side of the Hairline Recede Faster in a Maturing Hairline? – Hair Loss Information – Balding Blog

You mentioned one time in a post that it is common for on side of a balding hairline to recede faster than the other. Is this also common in a hairline that is just maturing? The right side of my hairline seems to have been stable for a while now, but the left side is catching up.

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Yes, it is very common to have one side recede faster than the other when forming mature hairline. But rest assured (as you are starting to notice)… the other side usually catches up.

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Hair Loss InformationMore Opinions About Finasteride and Prostate Cancer Risk – Hair Loss Information – Balding Blog

This post is in reference to an increased prostate cancer risk from finasteride and dutasteride (see here).

E. Antonio Mangubat, MD wrote an interesting metaphor to help some of his patients and colleagues understand the many discussions on cancer risks in association with taking finasteride. He writes:

“It is sad that the number of lives saved [who have not developed prostate cancer] has been discounted because of the words used …. [in the opinions drawn].

In my opinion their conclusion [New England Journal of Medicine] is like saying seat belts should not be used because it increases the chances of dying if the car ignites on fire. While the caution is true, the conclusion ignores the lives saved if the car does not incinerate.”

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We both agree that the conclusions in this NEJM article introduce a fear factor that people with hair loss will now have to consider cancer risks and even death from prostate cancer if they choose to take this drug. The study that is referenced was performed on 20,000+ men over 55 years old in a classic double blind methodology and it showed that the cancer risk was reduced by 25% for those men who took the drug when compared to the control group.

The fear was generated from the observations that there was a higher risk of high grade tumors in those men who took the drug, but there was no study of death rates on the men with higher grade tumors despite the high numbers of men studied. For those readers who are still confused, the pathologists who reviewed the ‘slides’ of the tumors felt that the tumors looked ‘meaner’ (my words), but if these meaner tumors did not kill the men who had that diagnosis made, then it seems almost meaningless, an exercise of intellectualization.

I am angry about these conclusions to two reasons: (1) I must notify patients of these recommendations since they come from the FDA and the NEJM journal, because this has now become the standard of care, and (2) patients who are balding and could be helped with a simple daily finasteride pill may be frightened into the hair transplant surgery route. Yes, I would make money from the transplant, but I prefer that patients simply take a pill rather than have surgery that could perhaps otherwise be avoided.

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Hair Loss InformationWhat is Hair Bonding? – Hair Loss Information – Balding Blog

What is hair bonding? Can it give a natural look?

Any treatment available to people over 60 years of age, with long standing baldness?

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You may be taking this term out of context. Glues that are used to attach hair systems (wigs) are said to be bonded to the scalp. These can cause damage to weak hair, leading to further loss. They may look natural, but they also could take a lot of work and money to maintain that natural appearance.

Hair loss treatments that I recommend include transplantation and medication. Your options depend on a variety of factors, but since I have no info about you (aside from age) I couldn’t begin to list what those options might be. But yes, generally there are treatments available even at 60 years old.

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Hair Loss InformationThick, Diffuse Hairs On An Otherwise Balding Scalp – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

First off, I would like to say you have an excellent site here and it has been the source of many of my answers while I suffered with my paranoia of hairloss.

I wanted to ask about a type of hairloss I noticed while talking to a person. The man exhibited diffuse baldness and was almost completely bald on top however all over the top of his head he had a few thick hairs that were buzzed down. All the hairs that I could see were all thick. Also, his hairline was completely unharmed. It was covered in thick hairs from left to right. I was wondering if this is normal MPB or not since from my understanding in the diffuse form of MPB, all the hairs slowly thin out on top of the head. I know it is normal to see some thick hairs among thin hairs in someone who’s going bald, but this guy had only thick hairs on top of his head.

Thank you for taking the time to read this.

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Some men who bald can have a persistent frontal hairline. Some never go bald in the front. These are a few exceptions to the classic Norwood patterns. You can also have thick (non miniaturized) hairs on balding areas. It is just that the proportion of thick to thin are different.

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Hair Loss InformationScar is Still Red a Year After Trichophytic Closure – Hair Loss Information – Balding Blog

I had a trichophytic closure performed on a scar just over a year ago. I think it is healing well but the area is still red not pink and some hairs have grown through accordingly but not nearly as much or what I was expecting especially after a year. Is it normal for the area to still be red? If the area is still pretty thin or still has bald areas can it still be improved? Thank you for your feedback.

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Some patients have persistent redness at the donor scar area, even after one year. Follow up with your doctor and get a formal opinion. Sometimes the redness may subside over time (1-2 years).

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Hair Loss InformationWhat If I Can’t Wrinkle My Brow? – Hair Loss Information – Balding Blog

Hi, I read your “Juvenile vs Mature Hairline” article I found it very informing. However, I am unable to wrinkle my forehead. Is there any other way to check if I’m getting a mature hairline or actually balding. I’m 19 by the way.

P. S. Is there a DIY way to identify miniturized hairs?

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Face measurementYes, you can also measure the distance from the tip of your chin to the tip of your nose (#1). Knowing that distance, you can look between your eyes at the top of the nose (in the hollow between your eyes) and go up to the forehead using the measurement you got in #1. That usually points to the location of the mid-line lowest point for the mature hairline. Note in the image at right, the white and red lines are the same length.

When I look to determine the mature hairline in my male patients, I usually do both measurements. The wrinkled brow is 100%, while the alternative measurement method discussed above usually runs an accuracy of about 90%.

As for mapping your own scalp for miniaturization, we wrote a 3 part series about that.