Author: Dr. William Rassman

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Hairlines and Race – Balding Blog

I was curious why less minorities lose their teenage hairline then white caucasion males? They eat similiar diets, why could this be?

There are clear genetic differences that must be responsible for the different shapes of the hairlines when comparing one race over another. African and Asian (all of Asia) have flatter hairlines (more convex shape) and may retain more of their frontal hairlines than Caucasians (where 95% of males lose their childhood hairlines and recede upward, particularly in the corners taking on a concave shape). It’s in the genes.




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Balding Forum - Hair Loss Discussion

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I Take Prescription Drugs — Are Any Causing My Hair Loss? – Hair Loss Information by Dr. William Rassman

I am a 29 year old male ive been on propecia since my was 20 my hair desity and hair line stayed the same until recently. moved to another state and started on a taking xanex for anxiety and stress i started noticing a great deal of diffuse hairloss all over the top of my head i stopped the xanex and got on dut,minox,spiro,tricomin and thought that if the hairloss was due to the drugs it would grow back to the way it was previously but it did not seem to change i am now on klonopin and think i am noticing more loss are benzoziapines known for hairloss and if so would stopping them revert my hair to its old appearance?

Xanax is not yet blamed for hair loss, but stress is. Some of the other medications you are taking could cause hair loss. Stress may have been accelerating the act of your balding genes. Although hair loss is reported with use of some prescribed medication, it is not easy to hold them solely responsible for hair loss and a combination of factors are involved. Hair loss is stated as a rare complication of Klonopin, but could it be the cause of your hair loss? Hard to tell!

Get your hair mapped out for miniaturization and make a distinction between genetic hair loss and drug induced hair loss. If there is a genetic pattern, the miniaturization study will show that clearly.

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I Want To Harvest Facial Hair for Transplanting Into My Scalp – Hair Loss Information by Dr. William Rassman

i am a 25 year old male with some male pattern baldness. I still have quite a bit of hair, but just want to have a full head of hair. I am interested in harvesting from the donor area near the back and sices of my head, but also was interested in hair from my beard (my chin). do facial hair transplants have just as low hair regrowth as body hair. also how many hairs can be transplanted from your chin with just one prcedure.

It would be malpractice for a surgeon to do beard to scalp hair transplants in a 25 year old. If you are committed, please do the standard thing and do not invent your own surgery. The price you will pay will have nothing to do with money.

Balding Forum - Hair Loss Discussion

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I Want to Take More Finasteride Each Day – Hair Loss Information by Dr. William Rassman

I’ve been on Propecia for 9 months with little sign of improvement and i’ve been seriously considering Dusteride or increasing my dose to 2mg instead of 1. What are your thoughts on this?

I am not your doctor, but going to 2mgs of finasteride should not be a problem. Discuss this with your doctor, though. The ideal dose of 1mg finasteride is an average for average people with average hair loss. I can not imagine that twice the dose should be a problem provided that there are no side effects noted. There are some doctors who actually suggest 2mgs, but there is no evidence that I know of which shows that 2mgs is more effective than the 1mg dose. The statistics on effectiveness were based upon general populations and large numbers, and clearly this would have some bell curve variation, so it would not be unreasonable to assume that some people will be more or less sensitive to the benefit. If you take 2mgs, take one mg twice a day (12 hours apart morning and evening).


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Losing Hair on Back of Head – Hair Loss Information by Dr. William Rassman

Doc, I’ve recently taken notice that along with my frontal hair loss, I’ve been losing way more hair from the back side of my head. Since that is the permanent zone, could this have an effect on any future hair transplants? I’ve been on Proscar cut into quarters taken daily since January. And can hair length increase or influenece hairloss (as mine is just about shoulder length)? Thanks

I must sound like a broken record. To make a diagnosis, you need to have your hair mapped out for miniaturization to determine what is actually happening. If you are losing hair from the ‘permanent’ zone and you are a male, then you may have Diffuse Unpatterned Alopecia (DUPA) (see Follicular Transplantation: Patient Evaluation and Surgical Planning?). If you are a female, then this is not unusual, especially if you have genetic female hair loss. Get to a good doctor and find out what it is and then what to do about it.

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Texture Change Over 5 Years — Is This a Hair Loss Indicator? – Hair Loss Information by Dr. William Rassman

As of now I don’t have any apparent signs of male pattern hair loss. However I am 25 now and my hair is definitely not as dense as it was 5 years ago. There is also a texture change from 5 years ago as well. The texture of my hair back then was thicker and harder and now it’s a lot softer. Is this an indication that my hair loss is occurring at a very slow rate? Also why am I able to pull out more hair from the crown vertex area of my scalp when tugging lightly as opposed to the front of my scalp? In the frontal area I can never see as much when lightly tugged on. Is this a sign that I may go bald in this area of the scalp? You’re answers are greatly appreciated. Thank you Doctor.

If there is a ‘texture’ change when you compare the back to the top or crown areas, you may be experiencing early hair loss. The best way to tell is to have your scalp mapped out for miniaturization and then the diagnosis will be evident, one way or the other. The loss of crown hair from pulling or brushing may also be a sign of early hair loss. The drugs like Propecia (finasteride 1mg) for those early in the process in your age group can be miraculous and you should see a change in the amount of daily hair loss within a few months of starting a drug like Propecia, assuming the diagnosis is confirmed.

Balding Forum - Hair Loss Discussion

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I’m Using Olive Oil in My Hair – Hair Loss Information by Dr. William Rassman

My hair is still thick, but it’s slightly receding on the left side, and a little from the front. I’ve using olive oil once a week, it seems like it’s ok, do u think I should keep doing that???

Do you use extra virgin?

I would add a bit of balsamic with a pinch of onion powder to make a great vinaigrette. All jokes aside, olive oil has been used as a wetting agent for the scalp. It has no value for hair loss, but if you like it, you can continue to use is relatively safely.

Balding Forum - Hair Loss Discussion

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My Daughter Had Lice and Is Now Losing Hair Where the Infestation Was the Worst – Hair Loss Information by Dr. William Rassman

My 10 year old daughter had head lice at the beginning of the school year-shortly after, like 1 week, I noticed that she was very rapidly losing her hair..It appears to be concentrated around her ears and back of head, where the lice were the worst, and she scratched the most!! I took her to a ped dermatogist..she diagnosed her with alopecia areata..All the lab work was done, and it was negative.. I am not convinced that she has alopecia, I feel it is related to the lice!! Either an infection, or reaction from the Nix!?? Would love your opinion, please!! Thank you

Infestation with lice can cause itching due to an allergic reaction and inflammation to the bites. This is a known cause of hair loss. Any irritation of the skin in patients who are prone to alopecia areata, can aggravate its occurrence. Clearly the differential diagnosis is alopecia areata in conjunction with lice or lice by itself. If you cure the lice (easy to treat) and the hair comes back, then the diagnosis will be evident. Hopefully, if she has been harshly scratching the scalp, that could have caused the hair loss.

Balding Forum - Hair Loss Discussion

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My Teenage Son Has Alopecia and Wants Laser Hair Removal – Hair Loss Information by Dr. William Rassman

My son, has had alopecia since age 13, when he turned 19 this year he started having laser treatments on his scalp to permantly remove the rest of his hair in order to look more uniformed and without patchiness. After 6 treatments already, the patchiness still exist, but permant damage was done in some areas. Is he now scarred for life @ age 20. Please help!!! He would like all of his hair removed nice and smooth skin, I wish he never would have had laser to begin with and had hoped for hair to regrow. Is regrowth ever possible now?

Regrowth of hair in the presence of active alopecia areata is likely not possible. I would need to evaluate him to understand the complex process and findings you are telling us about. Am I correct to assume that the lasers produced skin damage? Was it skin discoloration or is it real scarring? Is your son also balding from genetic causes? What was the last time he had a diagnosis for determing if the alopecia areata is active now? There are a number of doctors who specialize in the treatment of alopecia areata — has he seen any? It seems your son wants to be bald. There is nothing wrong with being bald (or shaving the head), but being scarred is a problem. Please send me photographs and if they are good quality, I can review the problem with you.

As an aside, bald has been coming into style in recent years and has been more accepted by the “hip” young men of today. It should be clear to most people that the option to shave the head may be lost if you have a hair transplant procedure performed. Anyone with a good hair transplant that uses strip harvesting would have a noticable scar if the head was shaved, even if the scar was only 1mm width in size. This is also true even with the minimally invasive follicular unit extraction (FUE) technique where punctate scars (1mm in size) may be present. The presence of a Master Plan is critical in whatever you do.