Are scalp pimples an indication of hereditary hair loss?
Simply put — no. Scalp pimples may reflect small infections in single hair follicles. Most times they take care of themselves, but sometimes they swell, at which time you should soak them to help them drain.
Do any other androgens other than DHT contribute to MPB? And is there a difference between like injecting testosterone like steroids and rises in natural body testosterone from i.e. going to the gym, eating meat, etc.?
Androgens cause balding. For example, women who have polycystic ovary syndrome / PCOS (who produce androgens) get into the male balding process, plus the appearance of facial hair (though not as much as we men). I think that if you look at the biochemical metabolic pathways, you will see many similarities of testosterone and DHT to other androgens. I do not believe that working out or eating meat will cause you to raise you testosterone (long term) to a point that causes you to lose hair.
For a list of androgens see Wikipedia.
Attached is my photo. I have started losing my hair after an operation last year around Oct’07. Its June’08 now, I think I am at Norwood2-3. I am 21 years old. My brother is at norwood 4-5. I believe if I dont take any necessary action I will end up like him. I have been on Propecia since March’08 and it has been almost 3 months I am on it. DO you think propecia can help on stopping or reversing my current lost? I had high fever and was diagnosed with dengue fever( which afterwards found out wasnt), and I had surgery back in october. Is it normal for TE cases that hair lost happens on the temples?
Your have been very sick and have had a surgery — either of these can produce hair loss induced by this medical history. You doctor thinks that it is a telogen effluvium and if he is correct in that diagnosis, it will reverse in less than a year. But the hair loss from your photos (which I will not post) are that of early genetic hair loss which can be accelerated by illness or surgery. This may not return if it is genetic acceleration. The Propecia you are on is good, but you will not see its value for at least 8 months. Good luck.
I think you are making DUPA up to have people come to your office for a miniaturization study. Here’s way….
I have spent a lot of time looking into balding and watching balding people. Your last post said that you don’t think DUPA has anything to do with DHT. You also mentioned that FPB is not DUPA even though FPB most of the time has miniaturized hair in the donor area and entire scalp.
Also, if you look at probably 80% of all balding people I bet they would have SOME miniaturization in the donor area. I for one have thinner donor area then I did when I was 20,(I’m 42). You also mentioned that FPB & DUPA don’t respond to drugs when we know the cause of miniaturization is the effects of DHT. Science has proven this.
I think that a lot of men can have hair loss in both a MPB & FPB patterned combined. Thus resulting in a slightly thinner donor area. (less than 30% miniaturization throughout the whole head). Maybe some people just miniaturize throughout their whole heads and never progress from there.
I understand the importance about evaluation someone for miniaturization in donor area to avoid a disastrous transplant scar. I applaud you for it. My problem is the fear of god you have imposed on some people about this thing called DUPA and how nothing can diagnoses it accept a miniaturization study, which you and a few colleauges provide. I think it is just a male with a female diffused pattern. This in theory should response to DHT blockers. Unless you can think of another cause for miniaturized hair throughout the entire scalp other than MPB/FBP or as you call it DUPA.
I doubt you will post this but I felt it important to express my personal opinion.
I am posting this just to allow other opinions.
Less than 1% of the men I examine in my office have DUPA. There is always some appearance of miniaturized hair all over the head, but I believe that we are looking at are the vellus hairs in the follicular unit which may account to about 20% of the hair in the “permanent zone”. Medical science is a descriptive science and DUPA is a description of what we are seeing — diffuse unpatterned alopecia (alopecia without a pattern to it that is diffusely found all over the head).
I guess if you were a blind man, you would doubt the existence of something that is clearly visible to a sighted person.
My father and my brother both showed significant hair loss in the crown area by the time they were my age (25). I do not currently have any hair loss in the crown. I guess my question is how closely does one follow their relatives hair loss timeline? In other words, if I’m not showing the same hair loss results he had at my age is it safe to assume that I have another family members hair loss pattern?
If I were a gambling man, I might bet that you would not follow the family pattern, but if you let me map out your hair for miniaturization, I would consider that “stacking the deck” on my gamble. With no crown miniaturization today at 25 years old with that family history, I would think that there is a high probability that you will not follow the family pattern and the timeline.
I have a patch of hair missing on the back my head, size of a quarter. The spot is not shiny or totally missing hair, there is some hair growing but not alot. Is this still a sign of Alopecia Areata. OTC methods?
Thank you
This is often the way alopecia areata presents, but you could have other causes such a ringworm, as well. Get to see a dermatologist and have it evaluated. There are no over the counter medications to treat what you do not know you really have.
Hi Doc,
I’ve been working at the same office for 17 years. Many of the same guys I started with are still there. As I looked at pictures of the group over the years I noticed every guy has less hair. Not bald, but you can see a decreasing hairline or slight thinning in the crown over time. Do drugs such as Rogaine and propecia prevent or regrow age related thinning which appears to happen to most men over time?
About half of the male population will have genetic hair loss so what you may be observing is just that. Not everyone with genetic balding gets very bald.
I’m unclear about what you mean by “age related thinning”. If you’re talking about the natural maturing of the hairline or the thinning that occurs as men age, then no, it is not likely that medication will regrow this hair. If you happen to work at a place where the men all coincidentally have some degree of genetic male pattern hair loss, then yes, those medications will likely help in some degree.
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Hi Dr. I love this site, been reading like crazy. Thank-You. I first realized that I was developing some balding at the right front side area when I was 29. I didn’t pay much more attention until about 32/ 33 because my hair covered up okay and frankly I had never heard of propecia as an option. As I type this I’m now 34 and have been on propecia for just 10 weeks (no side effects) as my hairloss is more noticeable in the front. My hair is full in the sides / top and back with virtually no balding at the vertex but if you look at me from the front I have the shape of hairloss in and upside down U with the centre still intact at the original hairline . I’m taking the propecia as a defense measure against any further balding and because I NEED to keep this middle centre portion to have any chance of styling at all. My question is …. At nearly 35 is there a good chance I have stabilized ? I am committed to propecia for life because a pill a day is no big deal….is there a chance I could turn those “thinned” out hairs into better coverage hairs in the ” upside down u”. Thanks.
P.s the generosity of your time here is very appreciated.
Genetic hair loss is progressive, and although it does generally slow down, that may not apply to you. From your history, you did not really lose enough of your hair to notice it until you were in your early 30s. That means that you were a late starter and that your hair loss will be progressive later in life than the general rule in the majority of young men.
Get your hair mapped out for miniaturization ASAP so that you can compare the impact of finasteride 1 year after you started taking it. Between the two measurements and the degree of miniaturization that is there now, you and your doctor may be able to predict what will happen to you in the future.
dear doctor,
PLEASE HELP ME!
i am a 16 year old male teen. the hair on the top of my head has been thinning since age 9-10, and i fear that at the rate i will not have hair on the top of my head by this time next year. this has been 6 long years that have been devastating to my self-confidence and i dont know if i can deal with being bald at age 16.i did plenty of research on my dilemma, and i didnt find any record of a case that is similar to mine. i have been to a doctor, and have been tested for things such as thyroid, but it always come out negative. my doctors dont really seem to care much to help me. they tell me its just hereditary, but i dont understand how it could be. i started losing my hair before i hit puberty, and also my my whole family still has there hair. even my grandma and grandpa who are in his 70’s have nearly all there hair.
at age 12 i was told to start using rogaine, but stopped because i know that there is something else wrong that is not being found. every day i wake up and look in the mirror to see that i have lost more hair. it getting harder and harder to hide it from my friends. and everywhere i go im constantly reminded of it because my hair shows up everywhere like in my sink, or on my desk at school.
anyway, please please please answer me back. you’ll be the one person in the world that cares enough to truly help me find out the problem and hopefully the answer. thank you for listening.
I wish I could offer you some solid advice or anything of substance, but you really need to be examined, as your case is quite unusual. I couldn’t do you any justice by just guessing at your problem via the web. As you indicated in your email that you’re located in New Jersey, try to arrange a visit with Dr. Robert Bernstein (with offices in Fort Lee, NJ and Manhattan, NY). He can examine you and offer suggestions.
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I don’t understand the difference between Type I and Type II DHT. Why does finasteride only block Type II? DHT is DHT right? Also, if you’re going to lower DHT levels by blocking it from forming, why not just block all of it?
In the clinical trials for Propecia, I heard they tested finasteride at 20mg and its effects on hair loss were marginally better or more or less the same. And if Propecia is great but not perfect, there must be something else causing hair loss, perhaps another enzyme acing on type II or 5AR or another enzyme acting on Type I DHT.
Is it possible for Propecia to cease hair loss where it is forever?
Cheers for your time.
DHT is DHT. It works on different receptors in the body and these are discussed on RXList.com. Essentially, “The type 2 isoenzyme is primarily active in the reproductive tissues, while the type 1 isoenzyme is also responsible for testosterone conversion in the skin and liver.”
The last question in your message is not clear. If you are asking if taking Propecia forever will keep the DHT blocked at the same level forever, then the answer is no. There is no forever anti-DHT treatment. Your body will eventually start to produce more DHT than Propecia will be capable of combating, and you may begin to see hair loss again years and years down the line. Some doctors actually increase the dose of Propecia to combat at progressive ineffectiveness, but there is no proof that a higher dose works, but it may be a logical direction to go if the drug is less effective after years.
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