Author: Dr. William Rassman

Hi Doctor Rassman, first let me start off by thanking you for running the balding blog the way you do. Its the only real source for hair loss questions/answers that I trust in terms of reliability and i would be lost without it.

I am a 23 year old male who noticed a bit of a “wider part” and “larger cowlick” around 2 years ago. I’d wager I’ve thinned a bit since then, but i still have full coverage with no pure bald spots, thinning primarily noticable in the crown region. I took propecia for 8 months and then, like an idiot quit the medication out of fear it was doing nothing and i was throwing money away. approx. 4 months later I realized the thinning sped up so now I am taking the medicine again. I don’t really trust my prescribing doctor’s knowledge…he recommended using the laser comb and rogaine before I attempted propecia but I was persistent.

my questions:
1. Who can map my hair for miniaturization in my surrounding area?
2. assuming I will end up a norwood 6(like my father)what type of coverage could a transplant offer me if we assumed I had average scalp laxticity and average hair density?
3. Do you believe there will be breakthroughs in the next decade that will prevent most of my generation from being forced to live their lives as bald men?

Thanks again for this site

We have written in the past about the LaserComb — basically, we don’t feel it works for treating hair loss. Rogaine, however, is an option if you are persistent enough to apply it twice a day, everyday. In my opinion, most men are horrible at keeping to a regimen and it is a factor you must consider when starting any daily routine like this.

Thank you for sharing your experience on Propecia. It seems that you experienced “catch up” hair loss after stopping the medication. While you will not gain what you lost, restarting the medication was probably a good idea.

Now to answer your questions —

1. On the east coast, I would trust Dr. Bernstein in New York. He was with New Hair Institute until he branched off to start his own clinic and he’ll be able to map your scalp for miniaturization.
2. Coverage really depends on your hair character + hair/skin color contrast. If you’ve got black hair, white skin, and a very fine hair character… you won’t have good coverage. If you’ve got thick blonde wavy hair, you’ll have better luck.
3. Certainly there is work being done and there is a huge market for it, but what you’re asking about is essentially a cure for hair loss. While I do hope something happens within the next decade, I really have no way of knowing if the current work being done is the answer we’re all looking for. Keep your fingers crossed, but your expectations realistic.

i am a 24 yr old sikh male living in the uk. up until the age of 18 i had long uncut hair but then in 2003 i cut my hair. my hair has always been thin in texture from a young age. at first when i cut my hair it seemed to be quite thick on top and didnt seem to concern me too much. however after a few months of getting it cut i began to realise that a lot more of my scalp was visible, particularly in well lit areas.

so in following summer of 2004 i shaved my hair off completely in hope that it would grow back thicker which was really a waste of time. by summer 2005 i had realised that my scalp was a bit more visible than before so then i made the decision to start using rogaine. this seemed to work at good effect and by jan 2006 i had grown my hair a bit longer and had a new style cut. my hair appeared to be a lot better than before and a lot of people did notice. this however may have been due to the new style as well. but by summer 2007 i began to realise that my hair was appearing to be thinner again and i also noticed that at my crown the balding area had increased. the fact i have got a double crown does not help appearance either. so in late december 2007 i decided to switch rogaine for a private minoxidil 5% containing MPG. this too at first appeared to have made a slight improvement, and is a lot easier to apply than the rogaine. however by now in may 2008, i am still not to happy with the density of my hair. i went to a trichologist late last year, he advised me that i should not consider a hair transplant until i am least 25 and that i still have a bit too much hair for a HT. he advised me to take propecia, however i am scared of using the drug due to all the reported side effects. i would be willing to use the propecia, preferbly in a few years and after marriage! both my mother and fathers family have cases of hair loss, my father is bald apart from the hair on his back and sides. both my sisters have fine hair aswel, but they have a full head of hair.

i have seen pictures of hair transplants on patients who have diffused thinning and this would be my preferred method of sorting my hair out, however i am aware that i need to consider the long term instead of the short term. can you please give me some advice on what to do? thanks.

I don’t know what I can say that hasn’t already been said on this site —

I’m not sure I quite follow the logic about waiting until after marriage to start Propecia (finasteride 1mg). The side effects from Propecia occur in less than 2% of men and most claims you read about on the Internet are unsubstantiated. Without seeing your hair, I couldn’t tell you if you’re a transplant candidate, but if you’ve already seen a doctor and were told that surgery was not recommended, I’d listen to him. You could’ve very easily gone to someone that would’ve taken your money and performed a surgery on you just to appease you. I don’t know which doctor you went to, but by not doing surgery on you, he likely did you a favor. You are, of course, entitled to go to another doctor and I’m sure eventually you will find a surgeon that is more than willing to take your money.

See the following for more:

• Dr Rassman, Why Do You Insist on Young Men Taking Pills Rather Than Just Get a Hair Transplant?
• The Truth About Cheap Hair Transplants