Author: Dr. William Rassman

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Family Genetics, Measuring the Mature Hairline – Hair Loss Information – Balding Blog

Hello,

Thank you for taking the time to write this blog. I have two questions. First, how much truth is there in the genetics for hair loss comes from your mother’s father? If not completely, what role do your father’s genetics play?

Secondly, not to be too literal in what you’ve stated regarding measuring the mature hairline, but when you say it should rise about 1.5 to 2 times higher, does that mean from a center point used in measuring the midpoint of the hairline? I’ve included pics (feel free to publish), including one where I’m holding a ruler to show how I’ve been measuring my corners. My hairline is about 5/8″ from the midpoint and about 1 1/8″. What is that, about a Norwood 2?

Thank you for all the work you do.

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Thanks for allowing us to post your photos. Click them to enlarge.

Hair loss genes may be passed on from mother, father, or both. I realize many people believe it follows more from the mother’s side, but that is not an absolute fact. I’d say if anything, it favors the maternal side only 52% of the time, compared to the paternal side in 48% of cases. Statistically it is insignificant.

Your frontal pattern shows early erosion and a movement in the direction of a mature hairline, as the leading edge is thinning and the corners are a good one inch from the frontalis muscle in the corners. I would assume that you are under 29 years old. Everyone’s hairline is different and there is no absolute math or measurement to say precisely where your hairline should be, but for a mature hairline the picture here shows its location well.

And yeah, Norwood class 2 sounds about right. Unless you’re seeing loss on other areas of the scalp, I wouldn’t be concerned about your hair loss at this point.

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Hydroxyzine Caused My Hair Loss to Stop – Hair Loss Information – Balding Blog

Hey Dr. Rassman
I am a 23 year old male, with no family history of MPB, who was diagnosed with MPB in October of 2009 and was immediately prescribed Propecia. However the Propecia didnt really seem to have any effect on my hair loss. That is however until I was prescribed Hydroxyzine for unrelated skin autoimmune condition in May of this year. Immediately upon taking Hydroxyzine I began to notice I wasnt losing any hair when I showered or when I put hair product in.

So my question to you is what type of effect, if any, could the Hyrdoxyzine be having? Also is it possible that my hairloss is actually caused by an autoimmune condition rather than MPB? And if so, how do I get the real cause of my hairloss properly diagnosed? Thank you for your time

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I do not know how hydroxyzine is connected to hair loss issues. Hydroxyzine is an antihistamine, much like diphenhydramine (commonly known as Benadryl). The fact that you notice some association with hair may be a coincidence. I believe what you are experiencing is almost certainly true, but I do not have a medical explanation. Have you discussed this with the doctor that diagnosed you with MPB?

Just to be clear to everyone, hydroxyzine is NOT used for MPB or hair loss issues.

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Is the White Coating On My Hair Causing Hair Loss? – Hair Loss Information – Balding Blog

I am a healthy 21 year old female. When my hair falls out, each strand has a white coating *surrounding* the white bulb. This ‘coating’ is usually white, also (sometimes it’s off-yellow). It’s a hard substance. You can scrape it off, and then you’ll see the normal white bulb.

Please help! What is this and what can be done? I am afraid it is causing hairloss.

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The white coating is likely sebum, and this is normal. It isn’t causing hair loss. It is a regular part of hair anatomy that acts as the body’s own conditioner, of sorts.

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Itchy Scalp from Finasteride? – Balding Blog

hi Dr Rassman, I’ve been taking Finasteride since Apr 09 and would have to say, I haven’t seen any improvement. If anything, its gotten thinner, along with a case of scalp itch (no dandruff) in and around my hairline. Is that a known side affect of the drug? I’ve seen people suggest it could be new hair growing? That would be nice, but i’d rather see it than feel it. I don’t even like being in pictures any more. I’m seeing a dermatologist in a couple of weeks, but would really appreciate your thoughts.

Itchy scalp isn’t a side effect of Propecia (finasteride) as far as I’m aware. Perhaps you’ve got something unrelated going on that your dermatologist should be able to diagnose.

I’m not sure what area of your scalp that you’re looking at or where you’re losing hair, but Propecia does not generally regrow hair in the frontal areas (it can happen, but it’s rare). It might be slowing the loss down, but not stopping it completely. You’ve been taking the medication for over a year and a half, so hopefully your prescribing physician will have some better insight into whether there has been any success for you while taking Propecia.




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Hair Loss in the Crown – Genetics or Dreadlocks? – Hair Loss Information – Balding Blog

Hey, I’m 22 and worried about hair loss. I noticed my hair thinning out in the crown area when I had dreadlocks, which I have since cut off after seeing a dermatologist. I don’t experience a great deal of hair loss, but the crown area has thinned out a bit and is more noticeable in bright lights.

I have purchased minoxodil (which the dermatologist said was optional) but am yet to start using it as I wanted to watch my progress in case if I didn’t actually need it. Advice?

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DreadlocksI don’t know anything about your hair loss history, but early crown hair loss is typical of male pattern baldness, which means it may be caused by your genetics. The loss you’re seeing could be unrelated to the dreadlocks. Then again, the dreadlocks wouldn’t be helping the situation, as you’re running the risk of developing traction alopecia.

Minoxidil does work for some in the crown, but I’ve found that Propecia for young men with early loss (particularly in the crown) works even better. Both Propecia and minoxidil are optional (they are for treating a cosmetic issue, not to save your life), but if you want to save your hair, the option you’ll want to try becomes clear. I assume you want to treat your thinning crown, or you wouldn’t have written to the BaldingBlog.

So if your dermatologist saw early crown loss, I’m a little surprised you weren’t prescribed Propecia… though again, I’m not your doctor and don’t know about your hair loss history. Perhaps there’s something else that I’m not aware of at play.

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Hair Loss InformationWhat Caused My Transplanted Hair to Thin 6 Months After My Surgery? – Hair Loss Information – Balding Blog

I’m 6 months into my hair transplant and it seems to be getting thinner from about 2 months ago. I was under a great deal of stress a few months back. Could that cause a thinning of the newly transplanted hair. I use Rogaine and Avodart every day. The doctor said it was ok to use on the new hair. At the 4 month mark it really looked promising. However it has definitely thinned since then. Any suggestions on the cause?

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Hair transplant surgery is highly variable in terms of the individual patient, as well as the techniques used by clinics and doctors. Many people who have a hair transplant will actually lose some of their original hair and that may be the cause of what you are seeing.

The general estimate is that it can take 4-8 months to see results, and usually the majority of the results are visible by the 8th-12th month. I’d follow up with the doctor that did your surgery.

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Hair Loss InformationWill Hair Regrow After a Bout of Typhoid? – Hair Loss Information – Balding Blog

Hi Doc
My Sister had Thypoid for a month and she suffered hair loss due to Thypoid. Does the hairloss due to Thypoid is reversible ?

Thanks

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Hair loss in itself is likely not a direct result of typhoid, but the hair loss is likely from the stress on the body from the disease. This stress related hair loss can be caused by a variety of illnesses. Your sister should gain her hair back over the course of a year or so.

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Hair Loss InformationCB-03-01 Anti-Androgen – Is It a Future Hair Loss Treatment? – Hair Loss Information – Balding Blog

Hello, Doc. I found a study about a future topical antiandrogen that appears to fight baldness.

This is the link: Cosmo reports exciting results in P.O.C. alopecia study

Do you see this treatment as a potential option in a not so distant future?

Thanks for keeping us informed through this great blog.

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CosmoIf you understand a basic fact about hair loss, it’s really quite simple: Blocking the impact of androgens at the hair level will favorably impact hair loss. It could be a promising direction, but at this time good data is not in hand, so an anti-androgen cream is not a proven solution for the hair loss problem.

The link you sent is for a press release from Cosmo Pharmaceuticals of Italy, which boasts “exciting results” to get readers interested, but in reality this is just announcing that a proof of concept trial has concluded for something called CB-03-01 on 40 men and 30 women over the course of a month.

The studies and products you and I find on the Internet are usually not new or groundbreaking, though they might sound promising. Both doctors and patients hope the next great hair loss treatment is right around the corner, but we will have to wait for good science to be presented to us before getting too excited about this as a future option. There’s a lot of hurdles it would need to cross before making it to market.

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Does Seborrheic Dermatitis Rule Out a Hair Transplant? – Hair Loss Information – Balding Blog

I have been on propecia due to MPB for about 2 1/2 months. In addition, I also have seborrheic dermatitis. I believe I am going through a shed however I can’t be sure as my seborrheic dermatitis has flaired up over the last month so I cannot totally tell which my accelerated hair loss is from. My questions are:

  1. When you shed from propecia, does shedding also occur in the hairline? If so, does this hair grow back?
  2. Hair lost due to the seborrheic dermatitis, does it regrow? I haven’t been scratching or picking at it, but hair has fallen out of parts of my scalp affected by it.
  3. Does having this condition make you a bad candidate for a hair transplant?

Thank you very much

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  1. When you lose hair at the hairline, the hairs rarely grow back (even if you take Propecia). Propecia mainly slows down the shedding process.
  2. Seborrheic dermatitis is a skin condition, not a hair condition, so it shouldn’t cause hair loss. However, it might accelerate underlying MPB or you could be seeing loss if you are picking at your hair. Picking at seborrhea can produce traction alopecia, which can be permanent.
  3. I have performed hair transplant surgery on many patients with seborrheic dermatitis and there is no issue. Sometimes if it is severe, I will use a short course of topical steroids to calm it down.