Author: Dr. William Rassman

Hi Dr. Rassman and Dr. Pak,

I am 29 years old male, taking Propecia for about 4 months now, and have 10% miniaturization, hair loss is not really noticeable. Also I am using a shampoo called Nioxin. But I see that a lot of hairs fall out when I am taking showers, combing my hair and just generally during the day. The hairs that fall out are healthy, thick hairs, but there are a lot of them, 200, maybe more! My questions are:

1. Why is this happening? And is there any way to stop shredding so much hair?
2. Another question I have is that, in recent years, my hair density seems to be thinner at the top of my head compared to the sides and back, even though the hair strands themselves are of same thickness. Is there a method to increase the density besides just taking Propecia?

Thanks very much!

You need to see your hair stylist for compounds that thicken the hair. Many of these compounds add water to thicken the hair as it is hydrophilic (water loving) and substances that cling to the hair follicle will increase the value of what you have. Usually, miniaturization of less than 10% is not really the classic miniaturization that we see in balding conditions. These miniaturized hairs may actually be the normal vellus hairs that are part of the follicular units in everyone. You should not be losing 200 hairs per day. If that keeps up you need to be evaluated by a hair expert as there may be a reason for that degree of hair loss. You say that the hairs that you are losing are healthy, thick hairs — well, healthy, thick hairs that fall out will not fall out in that quantity. There is a hair pull test which can be performed by an expert that will define if you are really losing hair at the rate you think.

This treatment is being promoted in Germany and in Europe called AC-Therapy. It is supposed to decrease the muscle tension of the scalp which in turn decreases circulation to the scalp. Supposedly, with less circulation there is less oxygen and nutrition and this is therefore claimed as the cause for patterned hair loss in men.

We do know that the blood flow to the scalp is decreased with patterned balding, but this is because as the hair is lost or miniaturized, it needs less blood and therefore the body reduces the circulation in response to having less hair. We also know that when a person gets a hair transplant, the blood flow increases as the demand for blood and oxygen increases to supply these new hairs with that it needs. There is no evidence that Botox will do anything other than paralyze the scalp and forehead muscles.

According to the article in Circulation, March 18 “Most US children start life with optimal cardiovascular health (CVH), but it declines substantially over time.

“Our findings indicate that, in general, children start with pretty good blood pressure. But if they have a horrible diet, it will drive a worsening body mass index (BMI) and cholesterol levels,” senior author Donald M. Lloyd-Jones, MD, said in a news release. Dr Lloyd-Jones is professor of preventive medicine at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. “The better we can equip our children to make healthy choices, the more cardiovascular health will be preserved into adulthood. And those who preserve their heart health into middle age live much longer and are much healthier while they live,” he added.

I remember a study where autopsies were done on Korean war dead. The finding, to the best of my memory, was that there was advanced cardiac atherosclerosis in most of them (most under the age of 21). When correlated with more modern times, a new study “shows that the rate of American service members with signs of coronary artery disease has declined sharply in the last half century, falling to roughly 1 in 10 military personnel today from about 8 in 10 during the Korean War. The findings came as a surprise to some researchers, who expected that the nationwide rise in obesity and Type 2 diabetes, including among young people, might have led to a similar trend in heart disease in the military. But instead it appears that national reductions in other risk factors for heart disease, like hypertension, smoking and high cholesterol, have had a greater effect on cardiovascular health.”

What is the lesson here. Start your children with a conscious focus on a proper, healthy diets. It may not be reversible if they eat poorly for years, so the best gift you can give your children is the gift of a good diet and hopefully a long life.

Any reason why I get bad heart palpitations from 2% min foam? Rogaine brand if that matters

Heart palpitations are a side effect of minoxidil. You are absorbing it systemically despite the fact that you are putting it on your scalp. I would speak with your doctor about this. You probably should stop using minoxidil.

I kinda have a weird sensation after applying minox. My heartbeat is normal but I get this weird feeling when I breath in and out, my heart gets cold and feels like a needle sticking.

Minoxidil causes reduced blood pressure and could cause cardiac symptoms. You should see your family doctor as this could be a sign of other heart problems.

Minoxidil is a hypotensive agent, so maybe your blood pressure came down a notch. Check your blood pressure and drink more fluids to see if it solves your problem.

Heart rate issues with Minoxidil after only 9 days – need some advice from tressless

Hello Im balding as a 16 yo guy. My temples are already norwood 2 (but it doesnt matter as my hair covers it) BUT now recently I started shedding in the crown. When I brush my crown I find 5-7 hairs everytime. It didnt used to be so much a few months ago. And This is scary as fuck. But I dont know what to do. Should I start minoxidil? Please note that my crown balding isnt really visible yet and seems more like a cowlick, but this is terribly scary.

Im also concerned that minoxidil wont stop the shedding, will destroy my collagen and make me look older. Of course finasteride and other DHT related meds are out of the question here because of my age. What should I do?? Im really lost here, nobody believes me from my dermatologist to my family, they are all in denial.

Start off by getting a HAIRCHECK test ( https://baldingblog.com/haircheck-test-how-it-is-done-and-what-its-value/ ) to find out if you are really balding and then with a metric, you can follow the process over the years with yearly tests. As you treat the hair loss, you will know what is happening with the impact of the treatment.