Author: Dr. William Rassman

Posted on

Hair Loss Information18 Year Old with Hair Loss or Mature Hairline? (with Photos) – Hair Loss Information – Balding Blog

Dear Doc,

I’m an 18 year old male and worried that my hairline’s begun to recede. I don’t have any particular family history of balding, both my grandfathers had most of their hair and so does my mother’s brother. Its only my father who is balding (he is 50 and has lost lots of his hair on the top of his head).

I’ve noticed that when I run my hands through my hair I occasionally lose one or two. Also when the hair is wet i tend to lose a few if I run my hand through my hair. I don’t see more than two or three on my pillow when I wake up.

I’ve always had a high hairline with temples higher than the rest of my hairline, but I think its starting to move back slowly.

I also have little red spots near the receding areas of my hairline, almost like acne (I have very little acne on the rest of my face). Looking at my pictures, would you say this is just a mature hairline or the start of the balding process. Also sorry for the long e-mail, but I’ve tried to list everything I can. I’d appreciate some advice on what I can do, as my hair is still very much part of my identity, and I don’t want to spend the next couple of years worrying and counting hairs.

Many thanks

Block Quote

While I thank you for permission to post these, usually I require a frontal view with the eyebrows lifted high so that the creases on the forehead show. You supplied two side views with the eyebrows lifted and a poor quality photo that requires me to guess. I’ll take a stab at it anyway. Click the photos to enlarge.

 

It does look like you are developing a mature hairline, but there is also a sign of some thinning that goes further back than just the leading edge, suggestive of miniaturization behind a maturing hairline.

You need to get your scalp mapped out for miniaturization and see if there is thinning behind the leading edge and how far back it goes. This is suggestive of early male pattern balding at a level where a drug like Propecia (finasteride) can stop it. See a doctor who cares about you and what may be early balding.

Posted on

Hair Loss InformationFinasteride Interactions? – Hair Loss Information – Balding Blog

Hi Dr.,

I am a big fan of your site. I get to read your new posts everyday by subscribing to your RSS feeds. My question is, given that I take 1 tablet of 1mg Propecia everyday, will it interact with other supplements or even certain food?

For example, here’s a list of supplements that I take daily (i take throughout the day, separate times):
1. vitamin b complex and biotin
2. vitamin c
3. vitamin e
4. multi vitamin
5. omega complex
6. co-q10
7. methatione (gluthatione)

Or how about foods:
1. coffee
2. green tea w/ honey
3. soy milk
4. fiber (like wheat bread, fruits)

Just wondering if trying to be health by consuming these will counteract w/ Propecia or vice-versa? Hope this is a valid inquiry.

Block Quote

I have been getting these sorts of questions quite frequently lately. The supplements and foods you’re consuming shouldn’t have any negative interaction with Propecia. The only interaction I can think of with food is with grapefruit, which causes problems for a variety of medications.

The following 16 drugs are listed as having a moderate interaction with finasteride (Propecia): bosentan, diltiazem, diltiazem/enalapril, efavirenz, efavirenz/emtricitabine/tenofovir, fluconazole, fluvoxamine, itraconazole, nefazodone, nelfinavir, posaconazole, rifapentine, saquinavir, sirolimus, tacrolimus, and voriconazole. And there’s 1 drug that has a mild interaction: terazosin. These are the generic names, and for a more complete list (including brand names) see Drugs.com.

Posted on

Hair Loss InformationCyproterone Acetate and DHT – Hair Loss Information – Balding Blog

Dr. Rassman,

I know this may sound like an odd question, but, would an antiandrogen such as Cyproterone Acetate reduce the levels of DHT in the male body? Would it preserve hair in a person with very little balding. I realize there are major side effects with this drug, but am still curious.

Thanks, and keep up the wonderful work, your blog is quite informative!

Block Quote

Anti-androgens in men can cause a chemical castration, so yes, I would say that the side effects are major. A castrated male has no sex drive and may lose facial and body hair. Cyproterone is not something I’d suggest fooling around with.

The direct answer to your question comes from Wikipedia: “Some in vitro studies have suggested that cyproterone or cyproterone acetate may have a slight inhibitory effect on 5-alpha-reductase, however no significant reduction in DHT production has been observed in vivo.”

Posted on

Hair Loss InformationCould Getting a Perm Trigger Genetic Hair Loss? – Hair Loss Information – Balding Blog

Big permI’m a 19 year old guy who has had a moderately high hairline and slight recession at the temples since the age of 15. It seems to progress VERY gradually and I have no hair loss anywhere else. I always dye, style, tease, crimp and straighten my hair and it doesn’t seem to effect it, but I’m after a bigger style and am considering a perm. My hair is fine, but not extremely so.

Is it safe to get a fairly loose perm done at a good salon? Will it speed up my hair loss?

Block Quote

If you’ve got the genetics to lose hair, any number of things (including chemical damage) could trigger an earlier onset of the genetic process. You’ll have to decide if it’s worth the risk. I doubt you’ve got much risk based on what you described, but if you do decide to have the perm done you should try to minimize the risk by having it done by someone professionally trained.

Posted on

Hair Loss InformationCan a Straightening Iron Permanently Damage Hair? – Hair Loss Information – Balding Blog

Hi, would just like to say firstly that I have found your site really helpful and informative, thanks! I’m an 18 year old female, currently straighten my fringe every day and I’m really concerned that this will cause permanent damage. I know that straightening can make hair brittle, causing it to fall out until a new one grows, but I read somewhere that heat from straightening irons can travel up the hair shaft and burn the follicle, meaning the hair will never grow back. Is it possible to damage the follicles like this? I have had a look through the site but can’t find a definite answer. Thanks.

Block Quote

Straightening your hair everyday will make the hair brittle, as you already know. However, it will not kill your hair follicles, which are below the skin and not impacted by hot irons and the like. On the other hand, chemical straighteners could kill the hair roots if used improperly.

Posted on

Hair Loss InformationI Feel Propecia Has Dramatically Increased My Hair Loss – Hair Loss Information – Balding Blog

I feel that propecia has caused my hairloss to increase dramatically, I have been shedding rapidly for 3-4 months now and it is not slowing. My hair has become much thinner and is shedding in areas in which no hair loss was noticed before treatment. I am in the early stages of hair loss, with no completely bald areas. Is it possible that an increased period and volume of shedding is due to my high density?

I am becoming disenthused with the drug and am considering stopping it. In the 2nd month I missed 5 days of the drug and missed 3 days in the 5th month. Although a definite answer may not be possible, do you think I should stick with the drug as I may have begun treatment again after each period of missing the drug. If you think this is a possibility, it would help motivate me to continue, but please be honest.

Thanks

Block Quote

PropeciaDrugs like Propecia are supposed to halt the progression of the hair loss, but they’re not a cure and won’t stop your genetics from eventually taking course (just how long is anyone’s guess). In your case though, you’ve been seeing shedding since about the time you started taking the pill. I’ve received emails from men inquiring about an initial shedding phase after starting Propecia, and perhaps this is what you’re seeing. I’ve previously written about this phenomenon, but I don’t have any percentage of men that see shedding upon starting Propecia, nor do I know why it may occur in some men.

I’m always honest in my replies, but I can’t tell you to continue taking the medication as I didn’t prescribe it to you and don’t know your history. If your doctor prescribed Propecia to you, I’m hoping he/she took a miniaturization mapping of your scalp so that you can go back to see the changes, and together you can decide whether to stick with it or not.

Posted on

Hair Loss InformationEstimating Graft Count for 2 Inches of Hair – Hair Loss Information – Balding Blog

Dear Dr. Rassman. I was wondering roughly how many grafts, single to double hairs, would be required to fill an area of 2 inches? I have straight medium weight, dirty blond hair.

Block Quote

The average hair density is 1250 hairs per square inch (or 600 follicular units). So a 2 square inch area would contain about 2400 follicular units.

For the appearance of fullness, medium weight hair is certainly better than fine hair, and dirty blond hair with a white skin is better than black hair on white skin (less contrast is better). Take a look at the NHI Patient Photo Galleries, where there are well over 300 patients showcased with before and after photographs, and the number of grafts they received to obtain those results. Also, take a look at LA Sportscaster Steve Hartman‘s photos and see if the area you have roughly parallels his. His hair was medium weight, though he has black hair and white skin.

Posted on

Hair Loss InformationHair Loss After a Crash Diet 18 Months Ago – Hair Loss Information – Balding Blog

A little under 2 years ago I went through a rough patch in my life and decided one of the ways to get back on track was through proper diet and exercise. I decided to become a vegetarian and began running twice a day. Over the course of 4-6 months what had originally begun as an attempt to get my mind off of my other troubles became and obsession in its own right and I essentially went on a crash diet which lasted 3-4 months. I was not particularly large to begin with but suddenly had lost 40 pounds.

A few months later I noticed the hair at the front of my head seemed to be thinning. The thinning continued to progress in a diffuse manner with no discernible pattern. My hair has been thinning for the past year and a half and, although I still have a relatively intact hairline, there doesn’t seem to be any regrowth. This has all been made worst by the fact that I recently became relatively successful in a career that puts me in the public eye.

I have done a good deal of research online and it seems that I would fit in the time-frame for telogen effluvium. Is it possible that a bout of telogen kicked off by a crash diet could last a year and a half or should I just accept that I have some sort of permanent diffuse hair loss?

Block Quote

I’m sure you realize this, but a crash diet is not a good idea for so many reasons. Malnutrition can impact your hair and cause thinning and hair loss. Generally, it takes about a year before you start to see some form of recovery, but in my experience most men generally do not regain everything they lost from the malnutrition and stress on the body. It’s even possible that your crash diet triggered the genetic hair loss that otherwise would’ve appeared later, but I’m just making guesses at this point.

Posted on

Hair Loss InformationMy Hair Loss Stops and Regrows Whenever I’m Pregnant – Hair Loss Information – Balding Blog

I am a 48 year-old mother of four who has all-over gradual hair thinning that began when I began menstruating at 12. I recently went through menopause, and although I have not experienced any chance in thinning since then, I do remember that when I was pregnant, I did not have hair loss, and my hair grew in again to a normal thickness. Each time, over the course of the pregnancy, the hair would grow thicker, until about three months after the baby was born, at which time it would fall out rapidly (over a few weeks). Is it possible that that regrowth during pregnancy indicates that I have some underlying hormonal issue?

I do not have hursitism, and twice in my life I have been checked for low iron and for thyroid problems, neither of which showed any problem. My periods were severe early in life but became easier over time and were roughly regular. The hairs that do grow are very soft and somewhat easily damaged but not severely.

I would be interested to know if you think some underlying hormonal problem could be the cause, given the regrowth during pregnancy.

Thank you.

Block Quote

Many women lose hair with child birth/pregnancy, menopause, etc. It is well described and known and you are not alone! But the hair growth during pregnancy, isn’t something I’m familiar with. I can only assume along with you that it is hormonally related, as there are a number of hormone increases during pregnancy.

Here are a couple of links I found via Google that might explain more — Pregnancy-Info.net and PregnancyEtc.com.

Posted on

Hair Loss InformationTaking Half a Propecia Every 12 Hours? – Hair Loss Information – Balding Blog

Considering 0.5mgs of finasteride gives 80% of the effect of 1mg and the halflife is relatively short, wouldn’t better results be achieved from taking 0.5mgs once every twelve hours?

Block Quote

I doubt that 0.5mg taken twice a day would be much different than a once a day 1mg dose. I suppose it could be tried, but wouldn’t having to stick to taking half a pill every 12 hours be a little annoying?