Category: Age

Dear Dr. Rassman,
Im 17 an i have been noticing when i shampoo im losing quite a bit of strands, i know its common to loss up to 100 strands but i ask my friends if they lose any strands of hair in the shower an they all say no. Also none of my family members have ever gone bald, so does this mean that i can or cant go bald?

You are correct in that 100 (and even as many as 200) hairs a day and is normal to lose. Hair grows in cycles, so sometimes you may notice more hair loss. If your hair loss is within that range, I wouldn’t be worried. Your hair may be in a cycle where it is in its shedding phase, but when we go into a hair loss cycle associated with genetic hair loss, the loss in the shower may be higher. The best way to judge is to:

1. compare what you are seeing to what you had been seeing in the past
2. see a good doctor who will map our your scalp for miniaturization looking for the findings that are always present in genetic hair loss

Hair loss in your genetics can skip generations, so even if you do not see it in your immediate family, it does not necessarily mean that nobody in your family has experienced balding to some degree. And chances are that your friends do lose hair in the shower and it goes down the drain. I couldn’t tell you for sure though — I do not shower with your friends.

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My little girl is three and her hair is falling out. When it does it looks and feels like a fur ball from a cat. When she was one she had milk indused anemia. She has been on iron drops since. Her iron levels are now normal, but she is still taking iron drops. Can this have any bearing with the hair loss? Could it be too much iron in her body? She was tested for thyroid, diabetes, and other tests that could cause hair loss – all normal. The way the hair started to fall out was on one side only and now has started to fall from the top of her head. One day at her day care, another girl pulled her hair and a clump of it was sent home to me in an envelope. She is very petite for her age. She is a very nervous little girl. I am a single mother, although she sees her father several times a week and he spends time with her on the weekends. Help me with some answers. Hair loss is not an issue in the family. My hair is red and very thick. With this info please help me?

You need to see a pediatric dermatologist, a specialty in itself. I wouldn’t know how to treat hair loss conditions in a 3 year old over the internet. Sorry.

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Dr. Rassman,

1. 18 Year old male
2. Hair loss started around the age of 13
3. This was when i first started geling my hair
4. This occured with dandruff
5. After a while this stopped, although hair remained very thin and became see through when wet
6. About 1 month ago, started to loose about 20 to 30 hairs every time i shampooed or brushed my hair (no dandruff)
7. Individual hairs can be pulled out fairly easily
8. Started using a new hair gel a few weeks before the problem started
9. During the period between my previous hair loss and now, i used gel in small amounts but these did not have any effect
10. My hair gets very oily and weak when my nails grow for more than a week without trimming
11. I had a blood test done and this only showed a very mild iron deficiency which the doctor said was not enough to make the hair fall out
12. I had a very high fever about 4 months ago (New Year’s Eve)
13. No history of hair loss in the family

Can you think of any reason why this is occuring and if so, is it treatable?

1. At 18 years old you may have the beginning of male pattern hair loss
2. At 13 years old, as your puperty hit, you may have had some juvenile hair loss or a change in your hair character which is normal (not male pattern hair loss)
3. Using a hair product, such as gel, does not cause or accelerate hair loss
4. Dandruff is not associated with male pattern hair loss
5. 20 to 30 hair loss during a shower is normal (we lose about 100 hair a day)
6. Stop pulling at your hair, it will cause permanent hair loss
7. Again, using hair styling products does not cause hair loss
8. Oily hair is not related to hair loss (you can try using shampoo for oily hair)
9. Your doctor was right — mild iron deficiency does not generally cause hair loss and it is easy to correct
10. High fever on New Year’s Eve won’t generally cause hair loss. Any one day is no worse than any other day
11. No, family history does not necessarily mean you will not have male pattern hair loss (there is no absolute rule)

If you had a complete medical workup and you are still concerned about hair loss, you should make an appointment with a hair doctor (a good dermatologist) to map your scalp hair with a densitometer to look for miniaturization and pattern of hair loss.

Is it true that by the age of around 33, if no genetic balding pattern has shown much of a sign of appearing it is unlikely that it will appear in a way that will result in major hairloss?

Although this is largely true, it is not a hard fast rule 100% of the time. Sean Connery had a perfect hairline (see update below) in the first of the James Bond movies (when he was in his early 30’s), yet today, his hair loss is quite advanced. His genes kicked in late enough for him to have developed that frame to his face which women find sexy. All of the James Bonds have that perfect, youthful hairline that set many standards for the sexy male image in Hollywood for years.

You need to find out what you have in terms of miniaturization. It would be unlikely that you would bald significantly if: (1) there was no miniaturization of the hair in the front, top or crown at 33, and (2) no one in your family started to bald later than 33. You can check your scalp for miniaturization by mapping it out. If none exists, the probability is that you may never bald, but nothing is ever certain, even for James Bond.

Update: A reader pointed out something I was oblivious to. Sean Connery was bald in his 20s.
From NNDB: “With an especially bad case of male pattern baldness, Connery began losing his hair at the age of 21. Without his toupee, he has been thoroughly bald for decades, except for a small ring of now-gray and thin hair above his ears”

Oops.