Author: Dr. William Rassman

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Thinning on Top, Sides, and Back of Head – Hair Loss Information – Balding Blog

Hi

I am a 23 year old male. Over the last 6 months my hair density has decreased to about 40% on top of my head (mpb zone), but also the sides and back (to maybe 70%). I went to a doctor 2 months ago who diagnosed me with mpb because of observed lower density in mpb zone, she did however not look for miniaturization (I asked her later about this). I have been on propecia since then, and may have noticed an increase of shedding, but this could of course also be due to accelerated loss.

I didnt realize the sides and back were thinning until recently. Another observation: The hairline in back of my head has always contained a lot of short 3 cm hairs. These hairs have started to fall out extremely fast, it comes out 6-9 by just pulling them slightly.

My questions:

1) Does this sound like DPA, DUPA or something else?
2) Can propecia cause shedding in sides and back?
3) Will a DUPA patient have any benefit of hair cloning (whenever is comes out)?

Thank you

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It might be DUPA, and mapping out your head for miniaturization will show miniaturized hairs in the sides and back reflecting over 20% of the hair population if it is DUPA (Diffuse Unpatterned Alopecia). Propecia should have no impact on the permanent hair in the sides and back of your head, so even if Propecia caused temporary shedding and hair cycling, there will be no impact on the permanent rim of donor hair. Hair cloning is still a pipe dream at this point, but if it were here today, one would clone the non-DUPA hair so it would be a reasonable alternative to becoming bald.

Be sure that what you have is actually DUPA before you get depressed. It may simply be other causes of hair loss, so be sure that you also get a medical workup for other causes of hair loss (e.g. thyroid disease).

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Reader Comment – Beware of Laser Treatments! – Hair Loss Information – Balding Blog

I have a comment on laser treatments. I went to a supposed hair restoration clinic in Minnesota and they used the low level light. They had a saleswoman who was very persuasive and guaranteed results in three months. I did this cause I was scared of propecia and wanted something more permanent. Well after six months my hair continued to fall out. I told them I would like to stop and be refunded and they refused. So beware of this supposed technology

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Comments like this emphasize the old adage, ‘Let the Buyer Beware’.

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Hair Transplant Growing Slow After Taking Avodart – Hair Loss Information – Balding Blog

I had a hair transplant 8 months ago and the doctor told me that my growth is slower than normal as my hairs are shorter than he would have expected. I am taking Avodart. Could this medication have an effect at slowing my hair growth?

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We really do not know a great deal about Avodart and what it might do to a new hair transplant. In theory, transplanted hair from the back and the sides of the head should not be impacted by Propecia (finasteride) or Avodart (dutasteride), but one might make an argument that Avodart is very strong and could be prolonging the telogen cycle for hair growth. In theory, it might also prolong the growth cycle when it start growing. Frankly, this is all speculative, but an interesting theory for an interesting question.

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What Do You Recommend for the Frontal Hairline? – Hair Loss Information – Balding Blog

What do you recomend for the front Line. I am on Propecia and Roggain right now. Will those medications help me?

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If you are genetically balding, then Propecia (finasteride 1mg) should work to slow down or stop the hair loss, even in the frontal hairline. It depends upon where you are with your balding pattern. You should get your hair mapped out for miniaturization, which will show where you hair loss may be going. Once you know where your hair loss is going, then you can make decisions about Rogaine or Propecia (or both). They both have value, but a doctor needs to tell you the value and what to expect.

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Selectively Transplanting Certain Hairs to Avoid Moving the White Ones – Hair Loss Information – Balding Blog

I have whote hair in front and dark hair in the back of my head. IF I transplant the hair from the back, will it be white or dark? Can you be selective which hairs are transplanted?

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The hair will be the same color as the place it was taken from. In your case, it would be largely dark. But, if there is enough white hair in the donor area, then the FUE procedure can take out the hairs, one follicular unit at a time, with a predominance of the hair color you want. Usually, white hairs are mixed with some dark ones.

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Does Sunburn Cause Hair Loss? – Hair Loss Information – Balding Blog

Dear Sir,I was out playing football the other day and my dome received a sunburn in return.My scalp was red but it wasn’t a bad sunburn but it was noticable.It doesn’t hurt.Will this cause hair loss ?I read that first degree burns can cause hair damage.
Thanks Sir

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First degree burns will not produce hair loss. I suspect from what you said, the burn was even less significant. If you constantly get sunburns or prolonged sun exposure, the UV light from the sun will damage the infrastructure of the skin and that is what causes skin cancers (amongst other skin problems).

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Hairs Falling Out in the Shower, and How It Relates to Growth Cycles | WRassman,M.D. BaldingBlog

Hairs Falling Out in the Shower, and How It Relates to Growth Cycles

/by William Rassman, M.D./0 /

how do the hairs that come out in the shower relate to hair growth cycles?

As stated here before, it is normal to lose about 100 hairs a day. To clarify that more, as hair falls out there are hairs that are also starting to grow. Hair grows in cycles and you may notice more hair falling out some days. Hair follicle cells have three phases of growth:

  1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
  2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
  3. Resting phase (Telogen phase) which lasts about 1- 6 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

If you think about it, the average person has 100,000 hairs on their head, with 100 hairs falling out each day. So in three years, the total hair population will have been replaced (you can do the math for yourself).


2007-02-22 13:39:32Hairs Falling Out in the Shower, and How It Relates to Growth Cycles

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Losing Hair After Having a Baby 15 Months Ago – Hair Loss Information – Balding Blog

I had a baby 15 months ago and had TE. Hair loss has been fluctuating for the last 15 months and my hair did grow back after TE, but now lose probably 120 a day (dermatologist told me to take a count)I still feel like my hair is thinning. Two dermatologists told me I did not have AGA but I feel like something is going on. Would I be losing more hair if I had AGA? Where do I go for answers?

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If you are seeing a good dermatologist, that is the place to be. They understand hair loss from a disease point of view and know how to go about diagnosing it well. Hair loss in women can sometimes be caused by underlying medical conditions, so it is important for you to be evaluated by your own physician before we proceed. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone. The following laboratory tests are often useful if underlying problems are suspected: Estradiol, FSH, LH, SHBG, Prolactin, T4, TSH, ANA, Iron, TIBC, Ferritin, Free and Total Testosterone. If your doctor has any questions, please encourage him/her to call me. We would appreciate a note from your physician that you are medically cleared for surgery.

Post partum hair loss sometimes may take up to two years to reverse, providing that there is not other defined cause.

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Almost Completely Bald from a Perm – Hair Loss Information – Balding Blog

Hi doctors,
Can a perm cause hair loss? My mother had her hair styled professionally a month ago and it now looks like she’s losing her hair. I don’t know if the style just made existing thin patches more visible or if the perm could actually cause the hair loss.

Thank you

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SalonI saw a lady just the other day who was wearing a ‘full helmet’ wig. When she took it off, she had almost no hair anywhere on her head. She looked like she had just had extensive chemotherapy, but in reality she had a perm some 5 years ago. The perm brought on an immediate reaction with about 95% of her hair gone within a month. The hair never returned. Unfortunately, there was nothing I could offer her to help her. What impressed me was the totality of her hairlessness from something simple as a day visit to her hair dresser. She was so concerned about exposing her hairless scalp to me, that I did not ask her to allow the use of her photographs, even from behind.

As for your mother’s hair loss, I wouldn’t be able to know what the cause is just based on the email you sent. It is possible that she had existing hair loss, or the styling could’ve caused it. There are a number of factors that could be the reason for her thinning hair.

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My Erect, White Nipple – Is it From Propecia? – Hair Loss Information – Balding Blog

I started taking 1mg of propecia, 2 months ago. I noticed less shedding. I also noticed that my right nipple is almost always erect. The tip is also white. I brought it to the attention of my physician. He says its nothing and likely not the result of the propecia. I’m a little concerned that it may be a side effect. Any thoughts on what I’ve just described?

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Breast enlargement may be behind the erect nipple. You could try stopping the Propecia to see if the problem goes away in a couple of weeks to even a few months. Have a doctor examine your chest for signs of breast tissue enlargement. There is not much I could recommend trying without examining you in person. For more, please see: