Category: Age

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Hair Loss InformationPropecia’s Major Side Effects – Hair Loss Information – Balding Blog

Hi Dr., I am a 20 year old male who is goin bald and is considering a hair transplant. I was wondering what you recommened to maintain hair after a transplant, other than propecia because i have heard of major side effects. What is your opinion on rogaine and other topical treatments ?

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I often receive questions on finasteride (Propecia) from patients like you quoting “adverse” or “major” side effects. All drugs have side effects (even Tylenol), but when used correctly under the supervision of a qualified medical doctor it serves its purpose. I often find people are misinformed from the mass amounts of uncorroborated information available on the internet or just word of mouth. It is the source of folk legends and superstition. It is one of the reasons why these medications can only be prescribed by a medical doctor.

Propecia has been well studied for male pattern hair loss in men. The following is taken directly from the Healthcare Professional Information Label for Propecia (finasteride 1mg).

Drug related adverse experience for healthy men taking Propecia during a 12 month period:

  945 men on
Propecia		 934 men on
placebo (sugar pill)
Decreased Libido 1.8 1.3
Erectile Dysfunction 1.3 0.7
Ejaculation Disorder 1.2 0.7

Rough translation: 1 in 100 (1%) patients had some form of sexual dysfunction. “Resolution occurred in men who discontinued therapy with Propecia due to these side effects and in most of those who continued therapy”.

There have been incidence of breast enlargement or tenderness (gynecomastia) reported. This occurred in 1 in 200 (0.5%) patients taking Proscar which contains 5mg finasteride (5 times the dose of Propecia) in a 12 month period. There is probably less than a 1 in 300 chance of gynecomastia from Propecia (which is 1mg rather than 5mg finasteride). This is also reversible.

Please note inb my practice experience there is a 1 in 10 chance of INCREASED libido (some may call this an “adverse” or “major” side effect for married men). I experienced this when I started taking it myself.

I believe the take home message for anyone who is serously concerned about their hair loss is to be make an appointment with a medical doctor (primary care doctor, dermatologist, or a hair transplant doctor) to discuss possible medical causes and its treatment options.

With regard to your second question, some doctors recommend the use of Rogaine (minoxidil) with a hair transplant on the belief that it accelerates the hair growth. I have used it on patients (half of the head with minoxidil and have without anything) and there was no difference with the use of minoxidil. The beauty of the hair transplant process, with the robust donor hair from the back and sides, is that no matter what you do or do not do with additional medications, the transplanted hair grows.

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Propecia in 20 Year Old Male – Hair Loss Information by Dr. William Rassman

I am a 20 yr old male who noticed a large amount of hair coming out while in the shower and during the day; I have also noticed visible miniaturization in the strands that fall out. I am about NW2 now, and I notice slightly less density on the very front of my hair line. At my age, are there side effects to taking Propecia? Are there any other courses of action?

Also, I am in Europe; do you know of my options here? (Is Propecia available/branded under a different name/does it require a proscription?)
Thanks!

The drug Propecia can be taken at any age. There are possible side effects, but they are rare and vary per person. Please review the many, many posts on this blog that discuss Propecia and side effects.

Some countries have not yet allowed the drug in, while others allow it to be sold under a doctor’s guidance and control. I am sure that if you ask your doctor for finasteride, you will find it in the 5mg dose and then would have to cut it into 1/4 dosages to treat hair loss.

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Dandruff and Hair Loss in 16 Year Old – Hair Loss Information – Balding Blog

My son is 16yrs old. I noticed when cutting his hair he had a thick piece of what seemed like caked dandruff it was there for the longest time. Then one day when cutting his hair the thick piece of dandruff was gone and ther was a bald spot. As I looked at his head I noticed there was a thin straight line of baldness then off to the right was another little spot. I took him to the dr. who did a blood test for his throid and that came back good. His spot is getting bigger and it doesn’t look like any hair is growing back from where I orig. saw the spot. There is not balding in either of the families. I checked his head tonight it looks like there is flakey dandruff all over his scalp and even some broken skin like he had been scratching. I have made an appointment with a dermotoligst but what should I expect. Do you have any idea what this is?

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What you are describing may be a localized area of psoriasis or seborrheic dermatitis which crusted and then with the crust ‘ripped’ off, the hair came out with it. The loss of local hair from an acute traction episode, could be responsible for what you are observing, and if this is the case, the hair will return if your son leaves it alone. What appears like dandruff may turn out to be seborrheic dermatitis, eczema, psoriasis, alopecia areata, or some other dermatological inflammatory disease of the skin. Your planned visit to a dermatologist for further evaluation is a good next step.

On a separate, interesting note, doctors have recently pinpointed the Psoriasis gene: Forbes.com

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Who Do I Take After in My Family? – Hair Loss Information – Balding Blog

Hello,
I guess like most other guys, I’m a bit paranoid about hair loss. I (age 25) got a haircut recently and my dresser said it was ‘thin’ in the front and that thickening shampoo will make it look better. After CAREFUL examination, I’m quite sure it’s NOT thin, it just looks that way because it’s right where I part the hair and after spiking it with gel, the distribution of hair is completely even. Not that I should even put stock in a hairdresser.

Anyway, I have a question about the ‘genetics’ of hair loss. I realize that it’s not a cut’n’dry thing where you get it from your grandfather. However, in your judgment, whom am I taking after – I have my dad’s color (light brown dirty blonde although he was balding by 20) but my maternal granddad’s hairline and texture (his was black but wispy/baby fine) and he kept it until he died at 84. PS: My mom was graying at 21 and and that is exactly when my graying started. Although my dad’s hair has thinned out majorly he has no gray. So I THINK I’m fairly safe.

Also, this isn’t a question but more of an observation – many people think that treating hair loss is failure to accept the aging process, just like skin creams and facelifts for wrinkles. HOWEVER, I’m pretty sure that anyone with baldness would take a few wrinkles and a full head of white/gray hair ANY DAY!!! So in essence it seems more like not a fear of getting older but the lack of power over an incessant degradation process. Thanks for your input. :)

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It is normal to be worried about hair loss. We live in a ‘hair society’ and the history of every civilization has focused upon linking hair and health and virility. We are a product of those prejudices and each culture has its own twist on the balding process. Male pattern baldness (MPB) has a major genetic component, but it does not follow one to one from generation to generation. It can skip generations and what is inherited may not ‘express’ itself the same way as it moves down to the next generation. That is what makes the process so confusing to those that try to sort out some clear, predictive model like the Mendelian genetic predictable pattern.

If you are concerned about hair loss and want a scientific or medical approach, you need to map your scalp for miniaturization to see if the hair loss follows a pattern for MPB. You can setup a free consultation in my Los Angeles office by calling 800-NEW-HAIR or visiting the Request Additional Info page. Your options do not necessarily include a hair transplant. It may be just that you are noticing a mature hair line.

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2 Year Old Daughter Has Bald Spot on Crown – Hair Loss Information by Dr. William Rassman

My 2 year old daughter started with a bald spot on the crown of her head and now it is really thin on top. She pulls out her hair when she gets mad but not often enough to cause this. She wont eat well and vitamins dont seem to healp the situation. Can you please tell me what is wrong?

First of all, your pediatrician should be central to your daughter’s management of her ‘hair loss’. Young children go through varying quality of hairs at different ages. Have you noticed that many children are almost bald under the age of 1? This is not really balding, but rather a migration from a baby’s fine hair to a child’s thicker hair that occurs in the first few years of life. Could you daughter be in such a transitional phase, assuming that the bald spot is not really a spot but rather an area that appears bald? Although there are many causes of hair loss in children (infections, genetic and autoimmune diseases, etc.) you have to be sure not to overreact. See your pediatrician.

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Hair Loss After Using a Hair Relaxer – Hair Loss Information by Dr. William Rassman

Hi. I have read a lot of your articles but still confused. I am asian american female age 18, and about 2 years ago I used a relaxer kit I bought from Walgreens for my hair becuase I had thick Frizzy hair. I asked the lady at the store to see if I can use it beucase I thought it was only for African Americans. She said yes so I bought it. After I used it my hair, it has been falling out really bad after showers especially. I let it fall all it wants knowing that I had thick hair for about a year and a half. About 4 months ago I noticed that my hair are growing thin. I have hair that is at least 16 inches long but my hairs that are newly grown comes out very easily. And the my short hairs come out very easily. When i get out of the shower, about 1/4 of hair that falls out are thin and decreased in size. And they look very thin and you can barely see them. the diameter of my hair has decreased to half the size it used to be but I don’t have any bald spots. Some of my friends I talked to say that it cant be the relaxers becuase chemicals can’t have an effect that last 2 years. And 2 years ago was the first and last time i have ever done that to my hair. I havent dyed my hair since… and my hair should be fairly healthy beucase there arent any chemicals i have put in these for 2 years.. All the relaxed hair has been cut off already… but the hair is growing thin. they said it could have been becuase i switched off and on Birth control. But i dont believe that is the problem. I have gone on and off birth controls before and never encountered this problem. And i only realized it right after that relaxer i used. My father is going bald at the crown but none of my aunts or uncles or grandmothers or father has this issue… even if I am a girl, could I have inherited it from my father… and if so why would it hit me so young. But I did notice that after I used the relaxer, i started getting dandruff and i have never had dandruff in my life before that.. Not the dandruff is still around… But it seems to run in the family from my mother. But the thing I dont understand is that why would i start getting dandruff right after I used that too.. Ugh it is ruining my life and I feel like I have nothing to live for..

Your problem does seem a bit serious and if the hair that is falling out is really much thinner that the hair that remains, this complaint is very characteristic of a genetic female hair loss problem. This is best determined by visiting a good hair doctor and having your scalp mapped out for miniaturization. If what you are experiencing is female genetic balding, it will show up in the mapping.

Since it has been over two years since you used the hair relaxer, it is very unlikely that it may have an affect on your hair now. Birth control pills can affect hair loss and hair composition, however, this is generally on an individual basis, so it is not absolutely clear whether it is the birth control that is affecting your hair. The dandruff problem you mentioned does not affect hair loss unless you are scratching your scalp vigorously, but you might want to check into some products such as Selsun Blue or Head and Shoulders. Dandruff seems more detrimental to your self esteem moreso than thinning hair. Getting back to the thinning hair and hair loss, it is normal to lose about 100 hairs a day, but these hairs should not be much thinner than those that remain.

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I’m Taking Proscar On My Own At Age 18 – Hair Loss Information by Dr. William Rassman

Hi, I started taking proscar on my own, I have noticed significant thinning in my temples, and I decided I had to take it, it was obvious that my hair was receding. I’ve only been on it for about 3 weeks now. I am only 18, and my beard is far from being grown in, and I have little body hair. Will being on proscar stop my body and facial hair??

I know you probably suggest not to be on proscar/internals when at my age, but I’m willing to risk some side affects if I can help my chances of not being bald at 20. I’ve heard all about its in effectiveness on the temples as well, but I figure since i’m so young it might help. I just really want to know about what will happen to my body/facial hair, as well as perhaps stunted growth if I am still growing/broadening (which is possible)

Thanks a lot.

You seem to think that you know the answer, but you should not be taking Proscar without the supervision of a doctor. Proscar is 5 times the dose needed to address hair loss. In addition, especially without a diagnosis of male pattern baldness or a map of the hair on your scalp for miniaturization, you will have no clue what you are treating, where you are going, or if there is anything really wrong. I often discuss the benefits of finasteride (Propecia), but taking medications without a doctor’s supervision is wrong, risky, and may be unnecessary.

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Dandruff and Hair Loss – Hair Loss Information by Dr. William Rassman

I grew my hair for a good 10 months before cutting it much shorter because it was too messy, it has been 3 months since. I have noticed my hair is much thinner at the front of my head, i’m 18 years old and this is quite distressing…How do i know if this is baldness or just because i grew my hair for so long? I also get a lot of dandruff, could this be the cause?

Neither dandruff or leaving your hair long will cause hair loss. Otherwise, most of the rock stars with long hair will be bald by now. You need your hair mapped out for miniaturization to determine if you really have early male patterned balding. Visit a dermatologist or a hair doc to get this evaluation.

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My Son Became Vegan And Started Losing His Hair – Hair Loss Information by Dr. William Rassman

My 17 year old son became a vegan (6 months ago) and now his hair is falling out in an alarming manner. He eats fruit,nuts,beans and soy products. He has lost 15 lbs and was only 120 to begin with. Tired all the time and now depressed. I took him to a dermatologist and he said nothing was wrong. Can you help us?

From your description of your son’s condition (weight loss, lack of energy, depression, hair loss), there may be an underlying health issue. He should be seen by his primary care doctor who can evaluate his health (not just his hair loss). Of note, a vegetarian diet lacks certain vitamins such as vitamin B12. Anyone starting a new diet should be evaluated by a medical doctor and receive proper nutritional eduacation. Mal-nutrition is a known cause of hair loss.