Author: Dr. William Rassman

Dr. Rassman,

I am a nineteen year old middle-eastern male. Since about five years ago, I have noticed mild thinning on the front of my scalp (that is, top and sides). In direct light it is very evident that my hair is thinning.

I feel as though my hair is not “that bad” that I need to start a Propecia regimen or that I need to consider hair transplant. Since my hair doesn’t seem to be worsening (my hair is just as thin as it was over the past few years) I feel as though my thinning hair is a result of a hormone/testosterone surge during puberty. Now that I am on the tail end of puberty, my hair is not worsening but what was lost is still noticeable. An endocrinologist confirmed this for me.

Here’s my question: what would you say would be the best option for me? I am not bald/balding; I just need something of a “shove” to restore lost hair. I (and my endocrinologist) strongly feel that it is not continual hair loss and it was just due to testosterone imbalances several years ago. The options I’ve researched are as follows:

-Gaunitz HairGrowth Laser Therapy. A handheld laser that restores bloodflow to the scalp. Taken with supplements.
-Biotin suppplements. A friend reccomended these to me, but according to a post I found on your website, these will not do much?
-Minoxidil application
-Shampoos that lack sodium lauryl-sulfate

Which combination of these would you reccomend? Cost is not an issue. Thank you so much.

First, as a healthy 19 year old, I am surprised you have an endocrinologist.

Second, if you are of middle-eastern descent who typically have a very low frontal hair line, your frontal hair loss may be a part of juvenile hair loss which is not considered a male pattern hair loss. Perhaps this is why your endocrinologist has advised you that your hair loss may not progress much further (he/she just did not use term, “juvenile hair line”).

Third, you are still concerned about hair loss, see a hair transplant doctor so he can evaluate for miniaturization and patterns of hair loss. The products you have listed have very little (if any) medical benefit for hair growth. Even finasteride (Propecia) which has the highest medical success has minimal benefit or regrowth on the frontal hair line, but it may prevent further hair loss. If you have the diagnosis of genetic patterned hair loss established by mapping your scalp for miniaturization, then if you do not take Propecia (finasteride), the process will progress. The concept of a “shove” is not valid here because genetic hair loss is progressive.

Finally, if money is of no concern, I cannot stop you from trying your ideas. It may help, at least in making you feel that you are doing something but be prepared for it not working and if it does not work, then what will you do if you never follow through getting a proper diagnosis of your situation? Too many people who say that money is not a problem will become victims of those wanting to take your money, promise you lots of hair, and actions even include some doctors.