Dr. William Rassman – Page 1442

July 8, 2008

Man with Female Pattern Hair Loss or DUPA? – Hair Loss Information – Balding Blog

Hi,

What could cause a male to have slightly thinner donor zone hair than on the top of his head. Most people can’t tell I have thinning hair, but the top is a little thicker than the sides. Even my barber has said so. The only strange thing is I have been buzzing my side and back to a number three every 2 weeks for 15 years.

Also, there was a post a few days ago about questioning if dupa was real. I’m confused: what exactly is the difference between a male with a female pattern and someone with dupa? I mean they are discribed exactly alike. Diffuse thinning throughout the whole scalp, but you said fpb is NOT dupa?

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If you have thicker hair on the top than on the sides and back, well, I would assume that you were born that way. We could record the differences in densities and confirm that observation if you like, but measurements are the key to the validity of that observation.

Diffuse unpatterned alopecia (DUPA) is generalized thinning of the entire scalp hair and presents that way in men. Women also may have diffuse unpatterned thinning as a presentation of their genetic balding and it may look similar to DUPA in men. Female pattern hair loss may not be uniformly diffuse, while DUPA is more uniformly diffuse (though still unpatterned). Both men with DUPA and women with classic diffuse genetic unpatterned hair loss may have similar mechanisms behind it, but the science is unclear to me as an expert. It is easy to get confused, and I’ve rewritten this response twice trying to make myself more clear. Medicine is a descriptive science and therein lies the problem.

July 8, 2008

I’m 21 Years Old and My Doctor Is Rushing Me Into Hair Transplants for a Mature Hairline – Hair Loss Information – Balding Blog

Dr. Rassman,

I had a question regarding traction alopecia. I’ve always had a widows peak/high forehead. For years I had really long hair. Yet, I never knew the affect of tightly tied back hair would result in hair loss. I recently worked a job for a year where I would tie it back quite tight. Everyday it seemed I was breaking hair and after a few months I started to notice my front corners looking thinner and broken. I saw a dermatologist a few months ago. He gave a quick glance and asked about my family history. I do infact have some family members who have baldness and others who don’t on both sides. I was instantly given the MPB diagnosis. I was prescribed to Propecia on the spot and basically told good luck and that I should look into hair transplants. As I’ve been reading more about shock loss in young men. And as I’m 21 years old. I’m curious to know if I should begin looking into it, or wait and hope the propecia can help what’s been thinned. I’ve read that you’ve seen some patients reverse frontal loss with propecia.

Is it likely to help a hairline that’s intact but thin?

Thanks for your time and most importantly for having this blog. It’s a place that gives many hope.

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Do not rush to transplant your frontal hairline. You can just say no!

Stop pulling on the hair and get a caring doctor who is not so much interested in your wallet and get one that is more in your welfare. Get a proper examination. If you are just having a loss of the mature hairline accelerated by the traction, then there is nothing to treat. If you do indeed have MPB, you should take Propecia for a year or so before you even consider a transplant. Then again, at 21 years old and with early hair loss, most respectable surgeons wouldn’t transplant you anyway (you may continue to bald and you don’t want to use up your valuable donor hair just yet).

July 8, 2008

Physicians Are Against Prescribing Propecia Unless You Have Later Stages of Hair Loss? – Hair Loss Information – Balding Blog

Hello,

Unless you are experiencing later stages of hair loss, it seems physicians in Canada are against prescribing Propecia. Can you please advise if you offer prescriptions for patients in Canada that are looking for use as a preventative measure?

Thank-you.

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I don’t think doctors are against prescribing the medication until you’re losing a major amount of hair, as the drug will do more good in the early stage, but in your particular case perhaps the doctor does not feel you have balding or even early signs of balding. You should not be taking Propecia (finasteride 1mg) for a preventative measure if you are not even balding. You may want to see a hair transplant doctor for a detailed examination of your hair.

July 8, 2008

Some Miniaturized Hairs Are Normal in the Hairline? – Hair Loss Information – Balding Blog

Hi,
i just have a question. I am almost 21, my hair looks good, but the thing that worries me is that I have a widows peak and in the widows peak I noticed that there are like some vellus hairs that are almost invisible between the terminal hairs. The rest of my hair is thick and healthy but the thing that worries me is that they can be miniaturized hairs. I also notices some very fine hairs that dont grow more than 0.5 cm in the very front of the hairline. Is this normal? You said that it is normal some miniaturization at the beginning of the hairline.

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Yes, there are vellus hairs in the frontal hairline and that is normal. This is not necessarily miniaturization or balding, but if the miniaturization continues well beyond the front hairline (say 1/2 to 2/3rds inch back) there is reason to take notice. Keep having your hair mapped out for miniaturization at least once a year to see if there is the beginnings of genetic hair loss.

July 8, 2008

23 Year Old Running Out of Donor Hair After 3 Hair Transplants! – Balding Blog

Hi i started balding when i was about 19 and now i am 23. I have had 3 transplants within that time period and have got some coverage on the front of my scalp, but it still is thin and it makes my forehead look big. My problem now is the crown is balding and i don’t think i am going to have enough donor hair for the crown. Is there something else i can do or what do you think my best option is because it still is thin in the front but is getting alot worse on the crown. Thank you

You may be in big trouble. I would want to know things like:

What was your Master Plan for hair loss?
Did your doctor tell you about the possibility of running out of your donor hair?
Were you led to believe that you could get all of your hair back with good coverage?

Regular readers of this site may notice that I’ve written time and time again about the problem with transplanting younger men with early hair loss — and it is for precisely this reason. I am concerned about a 23 year old (who is probably still balding) asking me a question like you did. If you ran out of donor hair (or are about to), then you need to sit down with a really good doctor (hopefully you have one) and get some basic answers to questions about your future. An in-person exam with an expert is key for you right now. You should be worried.

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July 8, 2008

Hair Loss Information » Can Daily Washing Damage Your Hair? – Balding Blog

Hello, Dr. Rassman

I have a question about washing your hair daily. For us minoxidil users it’s obviously recommended to use the products twice a day on a clean scalp. My question is: Does washing your hair twice a day damage your hair? Of course, the more you mess around with your scalp the more hairs will tend to fall. So, does the constant washing “damage” the follicles and weaken them?

Thank you for all the information in your site and all your help.

If you wash properly and do not rub your fingers vigorously into your scalp, twice a day hair washing will not cause a problem.

July 8, 2008

Propecia and Paxil – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,

Can Propecia be taken along with Paxil (Paroxetine)? Do you have any patients on the combination?

Background: I am a 22 year old male. I have had social anxiety disorder and was prescribed Paxil CR 25 mg. I had weaned myself off it 15 months ago. Now my hair has started thinning and I was prescribed Propecia. But within 2 weeks of use I have had intense anxiety.

Please help me with your suggestions. thank you.

As far as I am aware, you can take Paxil and Propecia, but you need to ask your prescribing doctor before starting or stopping any medication as he/she may have more insight into what is going on with your problems. I am not your doctor and my suggestion to you is to speak to your doctor and ask him/her these questions.

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July 7, 2008

Hair Loss InformationHair Transplant Doctor Credentials? – Hair Loss Information – Balding Blog

Good Morning Doctor,

My husband is consider hair restoration surgery. We are looking for a qualified surgeon. Are there training programs for hair restoration surgery I SHOULD be asking our doctor if he or she attended? It seems like a lot of dermatologists are doing this surgery, but I don’t see a training program or fellowship in hair restoration in their title or advertisements. Is this something the doctor learns on his/her own? What should I look for to be sure I’m getting a good doctor?

Thanks.

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I’ve written about this many times. The first link below is probably the most comprehensive of the articles I wrote on the subject, but the others should also prove helpful:

Many doctors do learn this on their own and some of those doctors learned it well, while others never learn it. I’ve discussed how to select a doctor and what to look out for in the following posts:

July 7, 2008

Maturing Hairline at 30 Years Old? – Hair Loss Information – Balding Blog

After reading some of the questions and answers on your board. I am hoping my hairline is just maturing, both my grandparents(both sides) have a full set of hair still. I deployed about a year ago and noticed my hair was receding on the hairline. I thought it was because I was smoking, gained 20 pounds before I deployed which raised my blood pressure and was taking in too much caffeine. Well I just quit smoking, stopped taking in as much caffeine and lost about 15 pounds. I am also using a shampoo called nioxin to help out. My hair however is continually receding on the hairline. I noticed you said it was natural to start in the late teens to early twenties but I am 30 years old. What should I do, wait or go see a doc when I get back? I can handle the insurgents but this hairline thing is driving me crazy!!!

Thanks

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A mature hairline can appear at 30 years old. If you are not balding behind the hairline, then wait it out until you can be examined. Gains and loss of weight, plus the stress you are under are not helping, but you did not need me to tell you that. As a former Vietnam vet, I understand what you may be going through. Certainly the stress alone could induce hair loss if you have the genetics. If, however, these factors do not induce hair loss (and you are just moving to a mature hairline), then i doubt that you will ever lose your hair.

July 7, 2008

Hair Loss InformationWould Dreadlocks Cause Hair Loss? – Hair Loss Information – Balding Blog

First of all, thank you very much for your work in putting this site together.

I have a question(s) regarding dreadlocks.

About two years ago my hair started thinning and so I began treatment with propecia and minoxidil. It seemed to work; there was new hair growth and my hair gradually became quite a bit thicker. In addition to this treatment I’m thinking about having transplant surgery eventually.

My question is, would it be possible/adviseable to grow dreads? I’m concerned about the dreads either making my hair look thinner and/or actually causing it to thin.

With the regimen I mentioned and a transplant (assuming the transplant is necessary) would it be possible to have dreads that don’t produce an appearance of thinning hair and also don’t actually cause the hair to thin.

Thank you so much for your time.

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Dreadlocks cause traction alopecia. The constant pull on the hair root will cause the loss of that hair in the long term.