Author: Dr. William Rassman

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Hair Loss InformationIs Norwood Class 1 a Mature Hairline? – Hair Loss Information – Balding Blog

Hello, Dr. Rassman, I have a couple questions for you about hairlines. You see, I’m a little confused…

I am a 24-year-old Caucasian male with no outward signs of pattern baldness, even though it does run on both sides of my family. I was looking at pictures of myself the other day from when I was about 12, and noticed in one picture of me with a crew cut, that I at one time had a very rounded hairline, like that of a female. This got me thinking (and a little worried), since my hairline today looks like that of the guy in the first picture on the Norwood scale. It’s not the hairline I had when I was 12, but it’s not a “mature hairline” either. I did the brow measurements and my hairline is still very much in the juvenile position, albeit more square in shape and rising slightly at the corners, just like the guy in the picture.

So I’m curious, is it possible for the first Norwood illustration to be the mature hairline in some cases? My hairline has been like this since I was about 18 or 19-years-old and hasn’t moved an inch since then.

Thank you for your help on the matter.

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Norwood 1I’d say that yes, a Norwood Class 1 (see art at right) and a mature hairline are basically the same. The hairline you saw at 12 years old is your childhood hairline and it is completely normal for your hairline to mature to some degree a dozen years later. You can not tell at your age for sure, but with a good mapping of your scalp and measurements looking for miniaturization in the corners, you might just see where your hair loss is going, if anywhere.

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Hair Loss InformationMy Toddler Daughter Has Had a Large Bald Spot Since Birth – Hair Loss Information – Balding Blog

My 16 month old daughter has had a rather large bald spot since birth. It is about half of the back of her head. If you were to draw a line from the left ear to the right ear, the entire area below it only seems to grow very short, fine hair. Also, there are numerous tiny red spider veins in this area. I have no idea what this could be. Her hair is growing on the top and the sides of her head, although the hair on top is really short. I’ve had lots of people ask if they are bangs that I have cut. She prefers to sleep on her belly and I very rarely see her sleeping on her back. She is otherwise a very healthy vivacious little girl. She has another well visit in 2 months where I will address it with the pediatrician. She never mentioned any concern before, but it’s starting to worry me. Any help would be appreciated. Thanks.

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Although you have an appointment with her pediatrician in a couple months, I would suggest that you bring her to a dermatologist with an interest in children’s hair loss. There is no urgency here, so take your time and find the best doctor. The American Academy of Dermatology site has a dermatologist search, and I’d start with those physicians that list “pediatric dermatology” as a specialty.

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Hair Loss InformationDr. Rassman, What Do You Need to Finally Accept PRP? – Hair Loss Information – Balding Blog

Dr. Rassman,

I understand your skepticism and reluctance to accept or recommend PRP on the scalp. I was wondering though, what would it take to establish a definitive verdict in regard to effectiveness (or lack thereof) of PRP? There have been some very promising sounding testimonials and pictures that some doctors have produced. But nothing that I guess would qualify as a comprehensive medical study.

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I would need a well-controlled scientific study and if it proved to have value, I would likely become a convert. I generally keep an open mind about new techniques and love to see things progress as long as they’re safe and effective. The last thing I want to do is give false hope and waste anyone’s time or money.

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Hair Loss InformationWhy Is Surgery So Expensive? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I really like this blog, and all the help you’ve given us, but I have a question (not a good one for you, I suppose). Why there are such exorbitant prices for hair transplants, making them available only for those rich guys?! Another question, which probably will make you think before answering the first: Do you think those diagnosted with leukemia, who need a marrow transplant, don’t have the right to live on because they don’t have 150.000 $ for the surgery?! Medicine shall not be business, but as we all see it is. Anyway, thank you for your time and I really hope in the future medicine will be as it should be, available for everyone! (just a teenager view)

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Hair transplants are not just available to “rich guys”, but as you are a teenager with an interesting view on things, perhaps you consider anyone with a better-than-minimum wage job to be “rich”. Remember that hair transplantation is a completely elective procedure and not for everyone. If you buy a hair system and do the ordinary wig replacements and wig repairs, the cost will average $15,000/5 year time frame. Every 5 years the cycle continues. If you have a hair transplant, most people can get it for between $5,000 and $10,000. For me to do a hair transplant, I use a certified facility that is accredited (a process that is very expensive, but guarantees quality processes and sterility), I have a team of people working almost all day with the patient having the hair transplant, and I pay support staff, buy surgical supplies, and have rent, which is expensive. All of my staff are paid a decent living wage so that I can retain the best staff and they get medical coverage included in their employment. My overall costs are a fraction of what you would pay to have a surgical procedure performed on an outpatient basis in any hospital in the US (normally between $1000-2500 per hour) and our typical surgery runs 5-7 hours in length. And you’re always open to save a buck by using doctors who do not have my experience, many of them producing inferior results (or even worse).

By comparison, if you bring your dog into the veterinarian, the office visit often runs about $80, and blood work and any X-rays could run $1,000 or more. Your dog may not be cured in one visit, so repeat visits and repeat tests will drive up the costs further. He/she will probably get sick again another time. Another example: my son just had his timing belt replaced along with miscellaneous other things on his 11 year old Toyota car and it cost him around $2,500. I doubt it took a team of people 7 hours to do it. A good hair transplant, compared to a wig or a vet visit, is most often a one time cost that will probably not be repeated (if you take finasteride) in the lifetime of many people. Compare the value: a wig at $15,000 over 5 years or a hair transplant that will last your lifetime and will be less than the cost of a wig for 5 years. I think that comparing a bone marrow transplant is not appropriate here and your question about that is pretty ridiculous.

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Hair Loss InformationAre More Young People Losing Hair Now Compared to In Past Years? – Hair Loss Information – Balding Blog

In your experience, in the past few years have you noticed a higher percentage of young people (15-20 years old) losing their hair compared to years past?

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Shaved headThere’s a couple ways to look at this —

  1. The shaved head look is quite common, possibly more so than in the past, so it’s difficult to tell who is doing it because they’re balding or who is doing it for style.
  2. The internet has changed the lives of many people, especially with regard to education. Balding impacts many millions of young men and women, and they can get educated and become more proactive because of what they learn about hair loss and treatment options. So if anything, I’d expect less young people would be losing hair compared to years past.

However, the answer to your question is that there is no more balding today than in the past.

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Hair Loss InformationDr. Farjo’s Minoxidil Research – Hair Loss Information – Balding Blog

Dr farjo
i am aware that you have been doing research with Bradford university into the workings of minoxidil. i just want to ask if this research has shined any light on any potential improvements on minoxidil or even a better drug?

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The following response is by UK-based physician Dr. Bessam Farjo:


Response by:
Dr Bessam Farjo, United Kingdom
Dr Bessam Farjo
United Kingdom

Our research has made a big breakthrough in discovering the precise mechanism of action of minoxidil, as far as its action on hair loss is concerned. We have shown that this is done via the potassium channels in the tissue, which are sort of like on/off switches that help govern various transmission of signals and chemicals. This was previously unknown. The significance of this possibly lies in higher efficiency of minoxidil action, but more likely will result in discovering new drugs that act through these channels that may show better benefits to hair than minoxidil.

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Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

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Hair Loss InformationCloning Eyebrows? – Hair Loss Information – Balding Blog

Is hair cloning only limited to the top of the head or are they also working on cloning eyebrows? Hence they grow at the same length and density or are they soley working on head hair because it is of more concern to the majority of people?

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When hair cloning is available, it will have a genetic clock that should dictate the hair cycle for each particular hair, hence its length. But saying much about something that is not here now and possibly won’t be available for 10+ years, would be foolish for me at this time. It would be like having a long discussion about flying cars and the speeds at which they travel.

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Hair Loss InformationWoman Developing Itchy Pimples on Scalp – Hair Loss Information – Balding Blog

I’m a african american female 27yrs old that is having terrible time with my hair & scalp for about the past 2yrs i have been developing bumps on my scalp mostly in the back the bumps come & get extremely sore &can be popped & filled with puss & then it get very itchy & pain alot.Have you heard of these symptoms before cuz am dying need.thanks in advance.

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You need to see a good dermatologist. You may have a variety of conditions that are dangerous and will cause you to eventually lose hair. The internet is not a place to gamble the future of your hair and your health.

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Hair Loss InformationWhen Will I See Propecia Benefits… and Does Showering Cause Hair Loss? – Hair Loss Information – Balding Blog

hi dr Rassman,

i have a few questions i havent seen an answer to on here,

  1. how long does it take to see results from propecia? is 6 months the normal time it takes or can it take longer?
  2. when do u think cloning will be made available to the public? ( i know there is no way to tell)
  3. i used to spray rogain 5% on my hairline, however around 2 weeks back i switched and started using a dropper which probably meant im putting on my minoxidil than when i was using a
    sprayer, the areas i have been applying it to have thinned out, could this be because im using more minox now with the dropper?
  4. Does showering everyday cause or worsen hairloss? what temperature is best?

thanks

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Shower knob

  1. For Propecia results, I’d say 6-12 months. Benefits could be just halting the hair loss, not necessarily regrowth… so keep that in mind when you’re looking at results.
  2. Getting hair cloning to be effective and reliable is the first step. Making it available to the public is quite another. Maybe it’ll be ready in another decade or so, but nobody knows. I’m not sure how you haven’t seen me answer a question about hair cloning before. I’ve probably written the same thing over a dozen times already.
  3. Why did you switch from the Rogaine sprayer to the dropper? It could be that you’re not covering the same area. Using more minoxidil in the area shouldn’t cause hair loss, but using less might.
  4. Showering daily won’t cause hair loss, though if you’ve already got weak hair on its way out, be gentle to your hair when shampooing. Actually, you should be gentle regardless. Use whatever temperature is comfortable.

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I’m 18 Years Old and Can’t Cope with My Hair Loss – Hair Loss Information – Balding Blog

I went to the dermatologist this week to confirm that I had male pattern baldness, which he did confirm. I am only 18 years old, and since I am so young, I am not dealing with this very well. I cannot find much information on people close to my age balding, so I assume it is relatively rare. I am currently on 1mg of propecia a day and will start rogaine shortly. I just do not know how I am going to cope with this. I am so young, and it feels like balding will hinder my social life. I haven’t hung out with friends since I realized I was going bald. I don’t know how they will react of if they will treat me differently. I don’t know how I am ever going to get a girlfriend now. Do you have any advice on how someone as young as me can cope with the feeling that my life has been devastated?

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Most of the young men I treat, like yourself, get great response from Propecia (finasteride) and do not show any balding when picked up early. I have even seen men of your age reverse the balding process. Make sure that what you are seeing is not the maturing hairline, because the drug will not reverse this. Speak with your parents and the doctor who prescribed Propecia. This isn’t a death sentence and you do have options. You should be commended for the courage to start the correct treatment early and I’m hoping you will be spared the balding problem for years.