Author: Dr. William Rassman

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How and where should I seek professional advice for my hairline recession?

I’ve been slowly thinning and receded hairline since my early twenties. I’m now 37 and probably about a NW 2.5. I think it’s time to seek professional advice. Firstly, to officially diagnose what type of hairloss I have, to tell me how bad it will get and what my options are.

My question is, what is the best way to seek this type of help. Should I go to a GP and ask for a referral? Should I pay to see someone private? I’m thinking it’s not a good idea to go to a hair clinic, because they might try and sell me something against my best interests

You should find an expert in the field of hair loss. It might be a hair transplant surgeon like me, or a local dermatologist who has an interest in the hair field (many don’t). A proper diagnosis include video microscopy, HAIRCHECK instrument checks when appropriate, a good hair and scalp examination and a doctor willing to spend time with you to answer your questions.


2019-04-08 10:33:45How and where should I seek professional advice for my hairline recession?

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How Bad Would a Thin Strip Scar Really Look If I Shaved My Head?

Hello, thank you Dr. Rassman and Dr. Pak, for maintaining this fantastic site.

You’ve explained that once transplant surgery has been performed, a patient cannot shave his head without scarring (either a FUT line or FUE dots) being visible.

My question is: If someone had a thin scar from FUT, would it really look so terrible if they shaved their head in the future (if Finasteride’s effectiveness waned and hair cloning treatments fail to emerge, and they become an advanced Norwood 6/7)?

Obviously, there are pictures of strip scars online, but it’s difficult to imagine what they would look like on a shaved head. Do you know of any patients who have done this?

You can look at how bad strip scars may look on our scalpmicropigmentation.com website (see some of the before photos of scalp scars). Unless you shave your head, even the wider scar is not visible with long hair. My scar, after three strip surgeries, can barely be seen; however, if I decided to shave my head, everyone would see the 1-2mm scar I have. Now unless you are wanting to completely shave your head, you should not have to worry about the strip scar.

In general, you can keep your hair cut as short with a number 2 to 3 guard on hair clippers without the scar being noticeable in most cases.


2012-08-26 13:08:10How Bad Would a Thin Strip Scar Really Look If I Shaved My Head?

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How Bad Is It If I Forget to Take My Propecia One Day Every Once in a While?

In the grand scheme of things, what is the effect of NOT taking Propecia one day every few months? I have been on the medication for a year now, and it seems like once a month or so (for some reason or another) I miss taking the pill. How serious is this?

If a diabetic skipped insulin every other day, he/she may end up very sick. Skipping Propecia is not the recommended routine, but it is not life or death. If you forget to take the pill once in a while, you won’t lose all of your hair or benefits of Propecia. I wouldn’t recommend skipping it, but if it you happen to forget one day, you won’t run a huge risk in losing medication effectiveness.


2007-03-08 11:34:35How Bad Is It If I Forget to Take My Propecia One Day Every Once in a While?

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How Can I Determine If I Have DUPA or DPA?

Hi

I recently did research and wanted to know how i can go about finding out whether I am suffering from DPA or DUPA? I am devastated at prospect of potentially not being suitable for a HT due to potentially suffering from DUPA and wanted to know how i can go about finding more out, having density measured and who would be suitable person to see for consultation.

Generally a physician specializing in hair transplant surgery or a dermatologist can diagnose these things. DPA is diffuse patterned alopecia. DUPA is diffuse unpatterned alopecia. One has a pattern and other does not. Under clinical microscopy of the fringe area around the sides and back of your head, the DUPA patient will have significant miniaturization present, while the DPA patient will have a healthy donor area. I do not mean to make light of it, but a good physician should be able to diagnose these things.

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How Bald Should Someone Be Before Stopping Toppik?

Hi Doc,

Just wanted to know at what norwood class one should stop using a product like Toppik. I am a class 6 and have noticed that I need to put quite a lot of toppik on my head and it really just looks like a coating of coal dust! Does my hair have to be longer for it to look better? Or do you think I’m putting on too much!

I don’t know if you’re using too much or too little Toppik. I think the answer is really simple — just look at yourself in the mirror or ask someone if it looks too fake or if it looks normal. I really don’t know what to tell you beyond that, as there’s no way for me to tell based on an email if it looks like a “coating of coal dust” or if it blends well enough to be an effective camouflaging product.

Many early Norwood class 6 and 7 use Toppik with great results. The length of hair and hair loss matters, but it is on case by case basis.

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How Can David Beckham’s Hair Look So Great Now?

I was wondering whether it is possible to go from miniaturization such as these pictures of david beckham (click both links): Beckham 1, Beckham 2

To a head of hair such as what he has now in 2010 which is in the link below (click link): Beckham 2010

My question is, beckham actually cant take finasteride as sports wont allow him to take the medication. How is it possible to go from quite severe miniaturization to a good head of hair. Also is not a wig or hair piece as he shaved his head off infront of a live audience. Is it possible to get the results that Beckham has some how and with what.

Thanks

I’ve written about David Beckham before, and I agree that his hair does look great now. A see-through look can have multiple causes:

  1. character — fine hair
  2. length — short hair
  3. presence of miniaturization if the thin look is mostly on the front and top

And if there is actual hair loss, it could’ve been from stress in his life or some other medical issue causing some early acceleration of genetic balding… or this whole thing could’ve been as simple as poor/unflattering lighting. It’s tough to tell how real his loss is based on photos from differing angles and light sources.

Can medication be completely ruled out? Finasteride was at one time banned in most professional sports, but the World Anti-Doping Agency has removed it from their prohibited drug list. I don’t know if that applies to the various soccer/football leagues.


2010-01-12 09:21:13How Can David Beckham’s Hair Look So Great Now?

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How Can I Convince My Boyfriend To Treat His Thinning Hair?

Hi Dr. Rassman,

My question is simple, yet I need to have some advices on how to handle it. I am worried for my man. He’s turning 24 in a month and is having some, let’s say, noticeable hair loss on the side of his head. I’ve always thought it was just the way his hair was but his hairdresser told him lately that she felt his hair was not as thick as it was before and that he might be losing it. The problem with that is, even though he recognizes having a problem, I don’t feel like he’s ready to do anything about it. I’ve told him to talk to his doctor, but he haven’t done it yet and doesn’t seem to be willing to.

I know there’s not much I can do if he’s not willing to help himself but, what can I possibly say, on a medical side, to convince him to at least see a doctor? I know the younger you are, the better are the chances to have great results. In the end, all I want him to understand is that i love him and I don’t want him to suffer in the long run, like when he’ll be 30 and bald. What are the facts about losing hair at a young age that you could tell me, so that if he decided not to do anything about it, he at least knows where it would lead?

Thank you for your support.

Honestly, it is up to him to decide if he wants to treat his hair loss. If you can’t accept his thinning hair, I think the problem may be yours. Treating hair loss with medication when it is early will provide the most optimal results, but it isn’t your place or mine to convince someone to seek out treatment that they don’t want or aren’t ready for.

If your boyfriend wants to do something about it, he will. This is a cosmetic issue, not a medical issue.

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How Can I Be Assured That Treatment Will Work For Me?

I am 23 years of age and have a bald area in the front portion of my head. Many doctors who i have consulted told me that i have class 4 hair loss and can’t be treated by drugs. This may be true somehow because my hair started falling out from the age of 17 and i didn’t take a treatment then. Can you assure me that if i get treatment now, my problem will get resolved?

“In this world nothing can be said to be certain, except death and taxes.” – Benjamin Franklin

I can stop here with the answer, but if you’re not satisfied please read on:

I can not assure you that a medication will work for your hair loss. In fact, no one can assure you that any drug treatment will work. You stated that you were seen by “many doctors”, which I assume included an examination, and were still told that your hair loss couldn’t be treated with medication, yet you wrote to ask for my opinion. I suspect what the doctors were saying in ‘doctor speak’ is that Propecia usually does not regrow frontal hair so a Class 4A balding pattern (where all of the hair in the front is gone), I suspect the hair will not regrow. In a 23 year old (without seeing pictures of your balding) I would assume that there is still some hair in the frontal distribution and that what hair is there is miniaturized. Miniaturized hair will often respond to Propecia to some degree in a young man, even if it is in the frontal area. Unless you try, you will not know.

I suppose I should be flattered to be thought of as a hair loss authority to give you assurance on a medication. If your scalp has been examined for miniaturization and you have a diagnosis of Male Pattern Baldness (MPB), medication such as finasteride (Propecia) may work, but there are no guarantees.

If you need another medical opinion, feel free to make an appointment with me.


2006-03-28 09:05:38How Can I Be Assured That Treatment Will Work For Me?

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How can HAIRCHECK tell the difference between aging hair and balding?

How would a haircheck distinguish between balding, and simply aging. Won’t the hair check just confirm that there is a loss of hair or density either way?

If all of the hairs on the head are thinning as a result of aging, the HAIRCHECK test will show no differences between one area of the scalp and another. In a balding person, there will be distinct differences in the various parts of the scalp that show reduced hair bulk. See here: https://baldingblog.com/haircheck-test-how-it-is-done-video/


2020-12-28 07:51:53How can HAIRCHECK tell the difference between aging hair and balding?

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How Bad Might My Hair Loss Get If I’m Almost 30 and Am Norwood 2?

I am 29 years old and I have been slowly receding at the hairline since my early twenties. Although I am still at the “Pattern II” category, I am extremely paranoid and would love to know statistically what usually lays ahead for someone in my boat. I appreciate the help.

There is no certainty, but I might guess that you will not bald. If you have no miniaturization anywhere on your scalp, then the certainty of my prediction goes up. It’s really all guessing until you have an examination. There’s only so much info I can provide online without seeing you.


2006-12-08 10:26:06How Bad Might My Hair Loss Get If I’m Almost 30 and Am Norwood 2?