Homogeneous Genes and Hair Loss

Dr. Rassman,

I understand that hair loss is understood to be a dominant trait. I also understand that men can be homogeneous dominant or heterogeneous. Would it be fair to say that main with homogenous genes are the ones to lose their hair early? say in their 20s and 30s, while men who are only heterogeneous dominant lose their hair later in age? say their 40s and 50s, I was just curious because I figured that maybe men who have a double gene are the ones more likely to have severe hair loss. Or does it not matter either way?

Regards

Hair loss is not a dominant trait. If so, a bald man’s sons will all be bald — which is not the case. What you are describing is a classic Mendelian type of genetic inheritance. The expression of the genetic factors also often skip generations. The hair loss gene(s) is not so simple to categorize and no one really knows how many genes are involved with hair loss.

Homeopathic Hair Cures?

Any comments on Dr.Batra, he claims to have cured 70,000 hairloss patients. It supposedly worlds biggest homeopathic chain of clinics. Does homeopathy have any drugs that are proven?

I’m not familiar with Dr. Batra, but homeopathic treatments have been used for years and are claimed to be effective in a variety of ways. Unfortunately, most of these claims are not supported with scientific research and third party studies that do not have a financial interest in the success of the products, are rare. This clearly applies to claims of cures for the treatment of baldness. We can recommend a procedure or treatment only if it is proven to be safe and effective.


2007-05-11 11:38:38Homeopathic Hair Cures?

Hormones after 18 months on finasteride & dutasteride

Added dutasteride after 6 months on finasteride. It’s total 18 months now.

Bloodwork results :

Testosterone Total – 584 (249 – 836)

Testosterone Free – 19.2 (8.8 – 27)

Estradiol E2 – 13 (11.6 – 41.2)

DHT – 389.2 (250 – 990)

DHT is still in normal range. I thought combination of fin and dut would crush DHT to undetectable levels.

Hair is still the same(no regrowth though).

Why are my hormone levels all normal?

You are having a normal response. That is the reason I don’t get blood tests as it has nothing really to do with the impact of finasteride that you can expect to see.

Hot Weather = More Hair Growth?

Hi Dr. Rassman.

I was wondering if you knew why hair seems to grow longer/faster in the Summer time. I don’t know if this has ever been scientifically proven, but I have always noticed this with myself and my hair dresser says she notices it all the time with her clients. I assume it has something to do with the warm whether.

If this is true, do you think heat/body temperature would have any affect on the way finasteride behaves?

TemperatureHair growing faster/longer in the summer isn’t a proven fact, but if it is something you notice I can’t dispute it. I’ve read all kinds of theories about why hair might grow faster in the summer (if so, likely due to hormones), but some people believe that hair actually sheds at a higher rate in the summer compared to the winter. Unfortunately, there is no good science on this subject. Maybe it is from a subjective perspective.

There is also no correlation that I am aware of with respect to body heat and finasteride. For that matter, humans are warm blooded and our body heat stays right around 98.6 degrees Fahrenheit (37 degrees Celcius for those outside the US), perhaps fluctuating only around a degree F.

Horror Story with a… Happy Ending?

Here’s a story about a dermatologist who had a hair transplant when he was 25 years old, in 1975. Forgive the blurriness of the photo below.

What is particularly important about this first picture is the amount of hair that he actually had when the transplant process was started. He was clearly thinning his hair in the Norwood Class 6 balding pattern and if he were treated today, he would have been put on finasteride (Propecia) to halt the hair loss and hopefully lock in the Norwood Class 6 pattern. When he had the plugs put in, the hair was still there, although clearly heavily miniaturized. The photo above was taken in the first month after the surgery and the hideous looking islands reflected grafts that contained between 20-30 hairs and crusting after the surgery. The crusts which are shown here are only a few weeks old, but in those days, the patients were deformed for months after the surgery as the healing progressed very slowly. The only good news for this man was that many of the hairs failed to grow, reducing the pluggy appearance, simply because of the failure of hairs to grow. His first procedure put two lines of plugs in the frontal hairline, which were followed up with many more plugs at another surgical session.

Norwood Class 6He eventually lost all of his hair native in the Norwood Class 6 pattern. The grafts were taken out of his donor area with hollow drills measuring slightly under 1/4 inch which left him with white spots about 1/4 inch round that could easily be seen through the thinned out donor area. After he completed his surgery, he developed a comb-over to hide the plugs, but the hairline was still deforming and even with a comb-forward style, he could not hide the hideous grafts.

In 1988, he went to Denver and had a few hundred micrografts placed in front of the hairline by the inventor of the micrograft. The focus was to put camouflage in front of the plugs. This surgery did much to soften his look. Still, on meeting people in his dermatology practice, eyes focused on his hairline and the top of his head. That convinced him that he needed to find a better solution. Eventually, he had grafts removed, received dermabrasion to smooth out the bumps and cobblestoning, and had about 8 laser hair removal procedures to kill off the hair that he worked so hard to put there. To deal with the deformities created by the harvesting techniques, he had finely stippled tattoos created to look like hair and this hides most of the scars on the side and back of his head. His final look, one of a bald man, seems to work for him. His approach to his problem was creative and it showed me the value of the old saying: “Necessity is the mother of invention”. This doctor, armed with a unique set of skills (dermatologist) and facing his deformities every day in the mirror, applied his talents to solve his problem. He got there and now people who see him as a doctor, look straight into his eyes, not at his head. Congratulations!

Note: Most people see someone just like this man walking down the street, at a movie, in a restaurant, or at an airport. There is a perception that this pluggy look is the look of a hair transplant, but this type of procedure, if done today, would be clear malpractice and not acceptable in this litigious legal climate. Unfortunately, tens of thousands of men had this awful surgery done worldwide years ago. The victims were many — far too many. Personally, I can not imagine why a doctor would ever perform such a surgery. Fortunately, there are many ways to treat this problem and becoming bald is just one option (see Repair – Dean’s Story for an example of using hair transplantation to correct the old plugs).

For even more information on repair, please see:


2008-02-08 13:47:49Horror Story with a… Happy Ending?

Horrible side effects from finasteride

I was 2 months into fin and then got horrible ED and horrible horrible horrible brain fog. I was eating clean, working out, staying fit, and yet the brain fog was horrible. I quit the fin the past month and it finally has gotten a little bit better with a shit ton of adderall. I don’t want to loose my hair but also can’t be brain damaged like I felt when I was on fin. Anyone have any recommendations or other alternatives to fin? I’m 22 btw.

Men like you, at the first sign of problems with finasteride, should get off the drug. Of course, a conversation with your doctor is just as important.


2021-02-27 10:51:40Horrible side effects from finasteride

How about doing a small hair transplant? Is this reasonable?

I don’t need a hair transplant now but maybe in the future I will. If that happens, do I start off with a small hair transplant and then get more as the balding progresses? I’m curious if in the future I ever do need a small one. Whats the minimum amount of grafts you can have for a hair transplant or the minimum they would be willing to do (provided of course you only needed a very small amount obviously and had very minimal hair loss)

I always tell patients that a hair transplant should be part of a Master Plan for genetic balding that is a progressive state in all men. There is no such thing as being a ‘little bit pregnant’ so if you are going to do a hair transplant, plan it and take your time. A good decision today is a good decision tomorrow.


2019-05-19 10:23:30How about doing a small hair transplant? Is this reasonable?

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?

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?