Author: Dr. William Rassman

Posted on

Can Propecia Keep Frontal Hair? – Hair Loss Information – Balding Blog

Hello Doctor.

I’m 18 and my hairline, while naturally high, has been receding, especially at the temples. It is thankfully not noticeable at the crown yet. I’m in my school show and am forced to have a combover which is slightly embarrassing because it clearly displays my receding temples (although they have always been high) plus my hair is wavy/curly, so that just makes it look worse. Fortunately i don’t normally do a combover and just have it all combed towards the front… but anyway, im seeing a dermatologist on Tuesday. I’ve read that if caught early enough MPB can be slowed or and even halted when DHT is blocked, and that Propecia can do this. I just had a question about it.

I know its not proven to regrow frontal hair, however can it help KEEP the hair that is still currently there? And perhaps thicken the amount still left so it looks healthier? Also, what should i be sure to discuss with the dermatologist on Tuesday? To make sure i receive the best benefit as possible (no surgery please!) Thank you for your time!

Block Quote

Propecia does not usually regrow frontal hair, as you know. It may slow the recession a bit, but in general Propecia is not known to work well in the front (especially the corners). That being said, if you have genetic balding (your dermatologist can determine whether it’s MPB or a maturing hairline), I’d still get a prescription for Propecia since it may help slow your balding process down.

Posted on

Scalp Tattooing that Looks Like Hair? – Hair Loss Information – Balding Blog

Hi Dr Rassman,
Since I like the close cropped look and I am probably a Norwood 4 leaning towards 5, I am considering getting cosmetic hair tattoos to the scalp. What do you think about this place? The results look great in the photos, but I’ll ask to see some patients in person of course (thanks for putting that in my head!). Here’s the place. They are in the UK, but I’ve got family there and have been wanting to visit anyway.

HIS Hair Clinic

Block Quote

TattooI would definitely want to see some real patients up close before deciding on tattoos like this. As I’ve written before, I have seen scalp tattoos that try to mimic hair, but what I’ve seen has been unimpressive and some even seem to have a greenish tint as well (maybe it is the ink or the artist — I have no idea, as I am not a tattoo expert). I understand tattoo technology has evolved, but drawing what looks like hair on the scalp can be tricky.

The photos presented by the clinic you linked to are quite nice, I will admit. I’m sure these results look fine from a distance, but I wonder if you’re sitting across from someone at dinner would it look like someone drew on their scalp with a pen? If the light hits your head wouldn’t it still shine like a bald head? Over time, tattoos with fine lines will blur… so how will that change on the scalp? I know there’s at least one scalp tattoo place that posts comments on this site from time to time, so perhaps they can post below to inform us about that.

I do recall one patient who did draw (non-permanent) individual hairs on his bald head to mimic a close shaved look, but it took many hours, special artistry, and skill. He eventually went on the have a hair transplant procedure.

Posted on

Thickness of Hairs – Hair Loss Information – Balding Blog

First off i just want to congratulate you on your blog. You’re doing a splendid job. It helped me tons in these two years of my battle with MPB.

My question relates to thickness of the hairs. You had mentioned previously in several posts that the thickness of hairs is standard for each hair in the non balding areas (the horse shoe pattern hair remaining that will probably outlive us). However i did a test and plucked some of these hairs in this region and not all of them have the same thickness. I didn’t use a microscope or anything but it it is quite clear to the naked eye. I am also sure that i am not thinning in these areas because my MPB is very very early and just in the corners of the hairline and none of my family members went past NW 3-4.

So to sum it up is it possible that some hairs on the head might be thinner than others? Is this normal? thank you

Block Quote

Yes, you are correct! Hair thickness varies all over the head as each hair is going through its cycle of growth/rest/fall (anagen/catagen/telogen). For non-balding men and women, you should have about 90% of hairs in a growth phase with relatively thicker hair and about 10% should be in a relatively thinner state. Then there are vellus hairs which are found in the follicular units. These vellus hairs are always thin and that is normal. So it is perfectly natural to have thinner hair in the back of the scalp (permanent, non-balding zone). If you are balding, this ratio will be dramatically different. Keep in mind this is a relative comparison with respect to your own hair at different areas of your scalp. This is in essence the miniaturization study that we have been advocating.

When technology catches up to us, we will have an instrument to accurately map all the hairs and its states on our scalp. As an aside, you should know that this horseshoe rim of hair is often impacted in women and in men who develop DUPA (diffuse unpatterned alopecia).

Posted on

Does Propecia Work for the Vast Majority of Men Under 30? – Hair Loss Information – Balding Blog

Dr. Rassman,

Do you agree with the following statement: At least 50 percent of men in their 20’s today who have little or no hair on their head should not be bald.

Propecia doesn’t last forever, some can’t afford it, others will choose not to take it, and it won’t work effectively on some group of men. But for the vast majority of men, it works and it seems like most men under 30 who are visibly bald missed the chance to buy themselves a few important years by not taking Propecia.

Agreed?

Block Quote

The statistics indicate that men over 50 years old have a frequency of some degree of balding in half of the Caucasian male population. That does not mean than the same statistic will be found in men under 30, as some men start balding in ages beyond 30. The full value of Propecia for those that see benefits changes over time (opinion backed up by the Merck study). The choices are always yours.

The other side of the coin is that Propecia works best when hair loss is earlier. If you start hair loss at 22 years old, then you are a better candidate for value (slowing, stopping, or reversing hair loss) than if you were 32 and had hair loss for the preceding 10 years. Also, if you start balding at 35 and start taking Propecia at 36, you will have a better value in its use than if you were balding since you were 22 (14 years of balding) in that same situation.

Posted on

Hair Loss InformationLooking at Family Hairlines to Determine MPB? – Hair Loss Information – Balding Blog

Hello,

I have a question regarding hairlines. Does the similarity of hairlines bewteen family members serve as a tool in determing the possiblity of MPB? Or does hairline similarity have nothing to do with MPB? Thanks.

Block Quote

Since the balding gene can come from either side of the family, you couldn’t make a determination about hair loss just by looking at hairlines. It’s not that simple, but if you have started to bald at 25 years old and someone in your family says, “Wow, your hair looks like mine at 25 years old!“, then it would be safe to assume that your pattern might follow his pattern both in scope and in timing. So, ask around and speak to the men in your family.

Posted on

My Newly Transplanted Hairs are Falling Out! – Hair Loss Information – Balding Blog

Three months ago I got a hair transplant and over that time the hairs that were put in fell out. Is this transplant going to fail?

Block Quote

Normally the hairs that are transplanted do fall out in the first few months and then they get replaced by your body at about 3-5 months with new hair. If the transplant is a success, you should see 80-90% of the results in 8 months. Patience is your friend at this point!

Posted on

Hair Loss from SSRIs – Hair Loss Information – Balding Blog

Hi, I would like to request clarification on something. I saw a post where you mentioned Sertraline causes hair loss as well as Zoloft. I also saw on some posts where SSRI’s are said to cause hair loss. The questions is how common is this? I have seen different sources use different percentages to represent how rare or often this can occur. I ask this because online it appears as a significant amount of people have voiced their concerns about Sertraline or Zoloft possibly contributing to their hair loss. However, there have to be many people who simply will never come to these forums because they are not affected. Also, how long does the hair loss take? Some posts mentioned period from 2-8 days, while some people blame the meds after they have used them for 4-6 years.

I have been told by several physicians that hair loss with SSRI’s is simply an alergic reaction which is rare. Do you agree with that? Thank you for your help.

Block Quote

PillsHair loss from SSRI (selective serotonin reuptake inhibitor) drugs are relatively uncommon, but they can occur. First and foremost you need to find out if there is a pattern to your hair loss. Is the hair loss everywhere or just confined to the front/top (in a pattern)? If the hair loss is happening in a pattern like those shown here, then it is most likely not from the drug. Hair loss from drugs will often impact the donor area, which is what we generally refer to as “permanent” hair not susceptible to genetic factors.

Most doctors (and even the doctors that treat hair loss, such as myself) do not know the exact mechanism of why some people lose hair from certain medications. We must believe the patient when they say that they are noticing some correlation with the timing of starting these medications and the hair thinning, but these things are often very difficult to narrow down. It is just not that simple, as the patient may also have underlying genetic hair loss as well. Remember that more than 50% of the population have some form of genetic balding which has nothing to do with SSRIs or other medications! I do not think hair loss from SSRIs (or other medication in general) is an allergic reaction, but more of a rare side effect. If hair loss is caused by a medication, I do not think it would happen in the time frame of a few days, but more likely several weeks to months.

Finally keep in mind of the big picture, rather than focusing only on hair. You are taking a certain medication for a reason, such as the SSRI to treat depression. What you are experiencing with respect to hair loss may or may not be related, but the reason of WHY you are taking the SSRI or other medication is real and the pros and cons (risks/benefits) need to be discussed with your physician before taking any action.

Posted on

Hair Loss InformationNew Hair Loss Gene Finding, APCDD1 – Hair Loss Information – Balding Blog

I’ve received quite a few emails in the past day or so about the news of a hair loss gene finding that was announced. Thanks to all the readers that sent in links.

Here’s a snippet from one of the articles:

Researchers have found a gene mutation which leads to thinning hair and which can even start taking effect in childhood. The gene, APCDD1, causes hair follicles to shrink, leading to thinner hair. Now the team at Columbia university hope the findings could help discover new ways to treat the condition.

The condition leading to thinning hair is known as hereditary hypotrichosis simplex and the researchers believe they have pinpointed the gene behind it. However the scientists the cause of the more common male pattern baldness, which affects most men at some point in their lives, remains elusive.

Block Quote

DNARead the rest of this article at Telegraph UK. And here’s a couple other news links about this — CNN and WebMD.

I wasn’t involved in the research so there’s not much I can add beyond what these articles have already mentioned. It is an interesting finding and I am pleased that there is ongoing scientific research into the cause and the genes for hair loss. Unfortunately, as Dr Angela Christiano (lead author of the research) notes, “The gene we discovered for hereditary hypotrichosis does not explain the complex process of male pattern baldness.”

One thing I am particularly happy to read about is that they discuss the miniaturization of the hair follicle, which is a process that needs to be quantified as a miniaturization study when diagnosing balding patterns (as we have stressed here on this site for many years).

Posted on

Using Toppik to Cover a Transplant Scar? – Hair Loss Information – Balding Blog

Hey dr. How are you on this fine day ?

i was just wondering on your opinion on using toppik to camouflage a transplant scar so buzzing hair down to a number 1 would be an option with the addition of the use of a trichophytic closure. would this be a viable route for someone who appreciates short hair?

Block Quote

ToppikI am fine. Thank you for asking.

Some people use Toppik, DermMatch, black marker, or even permanent tattooing with reasonable results. I am not sure if you already have a linear scar or are thinking of having a hair transplant and worried about a scar, but really, successfully camouflaging a scar on the scalp all depends on the scar itself. If the scar is wide (despite a trichophytic closure) a number 1 clipper haircut may still show it somewhat.

Posted on

Dry Scalp Contributing to Hair Loss? – Hair Loss Information – Balding Blog

I notice my hair has been thinning quite quickly the past few months and my scalp has been awfully dry which I’m sure is a contributing factor. When my hair falls out I can usually see the “roots or follicles” at the end. I have taken notice of your responses regarding alcohol and hair loss. While I usually over indulge on the weekends, I wouldn’t call myself an alcoholic.

My main question is, I am taking Milk Thistle supplements to try and maintain healthy liver function, but if I were to start taking Zinc and Gingko Biloba supplements, do you have any knowledge of these helping? Thank you much!

Block Quote

If you have a zinc deficiency then taking zinc supplements might be helpful. Otherwise, zinc and ginkgo biloba are used in some hair products to promote healthier hair, but they won’t stop genetic hair loss if that is what you are experiencing. Also, a dry scalp will not likely accelerate your hair loss.