Author: Dr. William Rassman

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What insight do you gain when you see a frontal pic with the eyebrows lifted high so that the creases show?

The frontalis muscle is responsible for the folds on your forehead and it gives me anatomic location for where the juvenile hairline belongs, as it usually hugs the highest crease and is concave. The mature hairline is one finger breadth above the highest crease in the midline and then establishes a gentle V- Shape so I can tell if the changes are maturing or recession and how much recession.


2021-01-10 07:31:29What insight do you gain when you see a frontal pic with the eyebrows lifted high so that the creases show?

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High Anxiety and Hair Loss

If I have been using Propecia religiously but also been experiencing anxiety to the point of palpitations and twitching, would Propecia blunt any possible stress-related hair loss? If stress is what has lately been causing thick hairs to fall out when I gently comb my hair with a wide-tooth comb, are those hairs gone forever?

anxiety

Propecia is only for the treatment of androgenic alopecia in almost exclusive men. It has no effect on other types of hair loss and no effect on most women. Hair loss from stress is not androgenic alopecia.

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High Forehead in Teenager

Hey,
I’m 15 years old and my forehead is huge, my hair is about 1-1.5 inchs further back then it should be. I have long hair to cover it,but I hate having it, I would prefer having short hair. Is there anything I can do? Is this permanent?

I’m not certain if you are male or female, so I am assuming your are male. If I am incorrect, please send me another email and reference this response.

There are a series of reasons that can produce a high hairline:

  1. if this is new for you and is an evolving process then it could be a maturing hairline
  2. you could have a genetic high hairline, something that is not uncommon
  3. you may be experiencing hair loss

Youthful or female hairlines: Wrinkle your brow while you look into the mirror. The highest wrinkle reflects the top of the frontalis muscle and both youthful and female hairlines start at this level in all children (male or female). If your hairline is touching this line, then you may have a genetically high hairline.

Mature male hairline: Repeat the above procedure, and if the center of your hairline is about 1/2 to 3/4 inch above that top wrinkle, then the hairline is a normal mature male hairline. For you, at 15, that would be unusual as this hairline usually starts to appear between the ages of 18-29 in most men.

Genetic hair loss: This would be higher than any of the two above hairlines, certainly higher than 3/4 inch above the highest wrinkle. One way to rule out hair loss is by mapping out your head using densitometer or a magnifying video-camera. A good doctor should be able to tell you this.


2006-03-06 10:12:12High Forehead in Teenager

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High Hairline in Women

Hi I am a 24 year old blonde female. I am not experiencing hair loss, but I was born with a weak/receded hairline. Is it possible to correct something like this? I have very fine hair in two spots on either side of my hairline but you can’t see the hair unless you look closely. Let me know if there is any hope. Thanks

High hairlines in women or thin hairlines are very common. Many women who have them would like to have them fixed, but not many come to people like us who have the expertise that might apply. Without discussing which one is better, they are:

  • Moving the entire hairline forward with a surgical procedure, similar to a brow lift but with a focus to bring the hairline down. This gives a very fast result and healing is fairly fast as well.
  • Transplanting the hairline. This has great value in many cases, particularly when the hairline is weak in an identified area as you seem to be describing. This may be one of the most popular hair restoration procedures we do in women.

Send pictures in digital format to me via email and I can give you an opinion.

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High-Fat Diet and Hair Loss?

Hello doc,

I found this text on a website recently “If you look at Japan, male pattern baldness was almost unheard of prior to World War II. The Japanese diet is now far more fatty and Westernized, and Japanese men are going bald everywhere. It’s clear that a high-fat, meat-based diet raises testosterone levels, and that may adversely affect hair follicles.”

– Do you have any information about this? Could this be true?

CheeseburgerWhile it is true to some degree that we are what we eat, hair loss comes about because of four components. Our food intake (if normal nutrients are ingested) is not one of those four. They are:

  1. Genetic elements for balding
  2. The male hormone in adequate quantities for healthy men
  3. The time the hormones and the genetic defect interact
  4. The amount of stress in the life of the person

I have a problem when someone is comparing early 20th century assessments of hair loss and modern 21st century assessments of hair loss. I also have a problem with the comment that ties healthy diets to hair loss in any way. The “authority” seems to originate from a talented man and nutritionist, Michael A. Klaper, M.D. He does not cite any evidence for his opinions and uses the term “may” when commenting on the connection between meat in the diet, testosterone, and hair loss. In my opinion, a statement like, “male pattern baldness was almost unheard of prior to World War II,” really can not be based upon any reasonable scientific observation and if I am wrong, I would want to see it. Who would be making such an assessment in a closed, almost feudal society like pre-war Japan? Balding is big business in modern Japan, which supports the largest hair wig manufacturer in the world. Many of the people of Japan still maintain the more traditional diets (they are not hamburger freaks) yet they lose hair. Studies have shown that there is little difference in balding statistics between races.

The website which originated these comments appears to be MotherNature.com and it does not show any convincing evidence to support the posted statement. Show me the science and I would be willing to change my mind.

However, it is documented that daily vigorous exercise (like endurance training) and lower fat/total calorie intake will decrease the free testosterone and DHT levels, and you can assume that this can decrease hair loss (see Relationship between stress hormones and testosterone with prolonged endurance exercise). Does a low fat diet alone decrease the levels of testosterone and DHT? That is not clear.

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High Hairline in 22 Year Old Man

Dear Doctor Rassman,
I am a healthy 22 year old man. I was born with a naturally receding hairline. It has been with me since I was a kid. I am experiencing no hair loss and I use Revivogen to shampoo. My receding hairline has always bothered me since I can remember and I wanted to know of some remedies to get rid of this hairline that is natural to me. I have been recommended a hair transplant and would like some recomendations from a professional such as yourself.

At only age 22, you can not be sure if the hair loss may come on in the future. By age 30, you can tell by mapping out the hair for miniaturization. For this reason, we generally do not treat high hairlines, but that is a generality and is something that should be worked out with your doctor. I have transplanted the frontal hairlines in actors and male models your age, and would only do so after I had made a diagnosis and developed a Master Plan with them for a worst case scenario. I would consider this non-therapeutic and might consider doing it.

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Does this Article Link Finasteride to Mental Side Effects?

Hi doctor, what do you think of this article? https://www.reuters.com/investigates/special-report/usa-courts-secrecy-propecia/

TLDR: The article indicates that Merck appears to have lied about side mental effects of this drug.

I have read the article previously. There is nothing to link finasteride to the change in behavior with absolute certainty. This type of change can happen in mental illness as well. This man should have stopped taking the drug with these side effects. His doctors should have been involved in his management. Many possible things could have happened that may have altered this person’s course.

UPDATE: There are two more studies that are concerning about post-finasteride syndrome and the mental side effects can be found here:

  • https://www.ncbi.nlm.nih.gov/pubmed/32033719: The article states: “Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies”
  • https://www.ncbi.nlm.nih.gov/pubmed/31935720: CONCLUSION: Men under the age of 40 who use finasteride for alopecia are at risk for suicide if they develop persistent sexual adverse effects and insomnia. Further research is needed to establish whether finasteride has a causal relationship to suicide.


2020-02-19 08:33:11Does this Article Link Finasteride to Mental Side Effects?