Category: Hair Loss Causes

I recently read about a man who had been having issues with side effects from propecia only after many years of use (pain ‘down below’). He went to see a urologist who says that it is not unusual to see scar tissue in the penile tissue of long term finasteride users. Seeing as I have been considering taking propecia as a long term commitment this has me very concerned.

Can you reassure me on this at all? I’ve read that DHT is important for maintaining healthy tissue (binding to androgen receptors?) in all tissue apart from the muscles in the body.

I do not know how finasteride could give you penile scar tissue. This is news to me. Perhaps a urologist is a better person to pose this question. The only reassurance I can give is that I’ve never heard of a case of scar tissue forming because of Propecia, and can’t find any studies to suggest that this is a known phenomenon.

You must be careful with all the wealth of information available on the Internet, and understand that not everything you read is true. It’s very easy for things to be taken out of context or misinterpreted, which is why I always stress that you speak with a doctor face to face. Reading what someone on a forum wrote about what a doctor supposedly told him isn’t something I’d get unnerved about.

what happens if i keep telling my son to stop pulling his hair and remind him all the time. will he stop??

This is an obsessive compulsive disorder called trichotillomania. He should see a professional about this. Constant reminders might not be the solution, but feel free to try.

Can melatonin, a hormone, accelerate hair loss. Does it increase testosterone or lower it?

Thanks drs

Where are you reading these things? Melatonin does not cause hair loss or have anything to do with testosterone other than both being hormones.

Some people have tried using topical melatonin to treat hair loss (likely based on this pilot study that came out in 2004), but that’s not a proven treatment and likely not going to give the results one is looking for.

This isn’t another “does mastrubation cause baldness?” question but it is related. Many people seem to think that mastrubation increases testosterone which increases dht levels but does simple sexual arousion cause a rise in testosterone levels too? If I am sexually aroused, and find myself with an erection, is that enough to influence dht levels or is it ejaculation of semen that is the prime testosterone booster?

I guess this is another way to answer the same issue. Masturbation, erections, sexual arousal, ejaculation, etc do not cause hair loss. Your genetics are the cause of male pattern balding.

I’m not trying to be rude here, but I get this question many times a week and have answered it dozens of times already. And every time I write about it, I get emails from guys that disagree and tell me tales of going celibate with all of their hair regrowing on their previously balding scalp. I don’t buy it. If that was the cure to balding, I think the world would look very different.

If you believe masturbating or sexual arousal can lead to hair loss, then feel free to leave your genitals alone and stay away from anything or anyone that might sexually excite you. If you see your balding continue, you could probably find something else to blame it on.

I know you’ve discussed miniaturization mapping as the best way to predict someone’s future balding pattern. If someone shows mild miniaturization, does this guarantee the area will eventually be bald, or is it possible the person may never completely lose their hair in a miniaturized region?

Thanks!

Hair loss can not be predicted with 100% accuracy. We use miniaturization mapping as one tool to monitor the progression of hair loss, which allows us to give an educated understanding and prognosis for our patients.

Miniaturization does not guarantee balding.

As a 21 year old, I’ve noticed my hair getting thinner and dryer, it’s just not the same thick and healthy hair I’ve had all my life. It sheds like crazy, there’s hair all over my desk and often clothes. The only weird part is that, the hair shedding is occurring pretty evenly all over my head, everyone tells me my hairline and crown are absolutely normal, not juvenile “normal” but not “balding,” and that I’m crazy.

I know only a doctor’s visit in person can make a diagnosis, but could you at least help me out by telling me whether or not this sort of hair behavior is normal or possible for MPB? I thought MPB was unique in that loss occurred in a pattern, but there’s not really any pattern whatsoever. Does telogen effluvium also effect hair density, because I’ve crash dieted numerous times about 7-9 months ago, while also enduring insanely gripping stress.

Would it be wise to start minoxidil, because I don’t even know where i’d apply it if it’s occurring all over.

also, If health insurance is an issue, what type of doctor would you advise I see if I’m paying out of pocket?

I wouldn’t advise you to start a drug treatment program without knowing what you have to begin with. You know that you need to see a doctor for a diagnosis, so that should be the place you start. A hair transplant doctor should be able to determine what’s what. Some clinics offer free consultations, but you can check for a doctor in your area by using the physician search at ISHRS.org. If you want to run it through insurance, you can try a dermatologist.

Male patterned baldness (MPB) is hair loss in a pattern that affects about 50% of the male population to some degree. Generalized balding and diffuse balding is different and there may be other medical issues that are causing the loss you’re seeing. The stress and crash dieting can’t be helping.

I have been asked over and over again if I can you predict a balding future for the young man with a family history of balding. I have also been asked to explain how I would go about such a prediction. I have two tools: miniaturization analysis and bulk measurements. Below, I’ll discuss the difference between the miniaturization studies we have been preaching about in the past and the bulk measurements we are now also doing in our patient assessments.

Miniaturization mapping:
I use miniaturization measurements to get a general idea if there is genetic balding present. It can not give us (without special software) a metric on what is going on. From a practical point of view, checking for miniaturization over the course of months could never truly be in the exact same areas unless we place a tiny dot tattoo as a reference point. Then months after the first exam, we could examine the exact area again by finding the tattoo and measuring the degree of miniaturization at a point anterior, posterior, or lateral to the dot. In those people with a measurement of miniaturization, it varies from place to place even within a defined area (without a tattoo). The area observed is often just over a square mm. In other words, it’s using educated guesses.

Hair bulk analysis:
On the other hand, bulk measurement using a tool like HairCheck can cover a relatively large area (square inch) and finding anything in that area as measured by distance from the nose is replicable. So from a value point of view, it can give the doctor an assessment of bulk comparison to a person’s normal hair bulk when compared with the donor area in the back of the scalp. If the measurement changes over time, it will allow the doctor to produce a metric (number) which reflects the status of our hair bulk. In everyone with genetic balding, some part of the scalp hair will lose bulk.

To identify areas that can not been seen grossly for bulk measurement, we can do a miniaturization analysis to identify the worst areas on the scalp and then do a bulk assessment in those areas. It can also distinguish the differences that we can not ascertain from the naked eye or a photograph. I have seen people who report balding, my eye says no, but the bulk measurement shows significant differences to the donor area, confirming the diagnosis of genetic balding. I am sure that over a year, these bulk measurements will be able to help us show change (positive or negative) with the treatments we are prescribing.

So… am I going to go bald?
I am asked over and over again by young men with a history of balding in the family, “Am I balding like my father?” There’s no way I could answer that over email, but with the ability to do miniaturization analysis and bulk analysis during examinations, we can now tell much more about the status of a balding young man and we may be able to refine a prediction as the young man matures. Diagnosis and measurement is the backbone of any Master Plan we come up with.

I had a hip procedure in Oct then Back surgery in Dec. Since then, my beautiful THICK LONG hair has gone.Also, my finger nails are really brittle. Nothing in my diet or my life has changed except that I am taking vicodin. My PCP and pT have told that vicodin is causing this. Is there anyway to fix this. I can’t come off the meds because the PT is terrible.

It is not unusual to develop hair loss after a traumatic event like what you went through. This is called telogen effluvium and it usually passes, unless you are male and have invoked the genetic balding process.

A telogen effluvium usually reverses in time, and a doctor can make this diagnosis with a simple pull test.

Thank you for baldingblog, a wonderful source of information on hair issues. My wife just started on chemotherapy for colon cancer with a drug known to cause hair loss. She wrote this to a friend about her chemotherapy and the Cold Cap experience and with her permission, allowed me to send it to you to post on your site.
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“The chemo was on Tuesday – and I slept through the entire event. I thought to call Dr. Rassman and thank him for the reference to this cold cap therapy. He is among the most caring people I know.

They loaded me up with lots of anti-nausea meds and some Benadryl which really made me sleepy. Now you might wonder how one can sleep with a turban at -24 degrees Fahrenheit on your head – well I did. In part to counteract the cold, you wrap yourself in an electric blanket set to sizzle – and that put me right to sleep. My husband had to wake me every 30 minutes or so to trade the cold cap for a newly chilled one. You keep up the cold caps till 4 hours after chemo is done so I didn’t really wake up till about 6:15 PM on Tuesday – that included the drive home. We were quite the spectacle at the clinic and had many doctors and nurses coming in and out to see the changing procedure. I actually think my husband was enjoying the attention. Almost everyone at the clinic knew about cold cap but none had direct experience with it and all were very interested to see if they work. Needless to say I am too.

I did hook up a small group of patients in a support group, a couple have used the cold caps successfully for their chemo. It is more involved than just the turbans – there is a lot of extra hair care but all say that it is worth it. So we are “all in”. We did look like we were moving in to clinic for a week wielding our two coolers on a rolling dolly, a rolling suitcase filled with the blankets and extra needed accoutrements (including welders gloves to handle the dry-ice), and an extra bag of layering clothing.

I am feeling ok – I wear out easily and then crash hard. I am still not sleeping well – what they have given me is helping a bit but I don’t get more than 5 hours of solid sleep and then doze as best I can. Today is the last day on the heavier anti-nausea meds and when the steroids will wear off – they say that tomorrow is the trail day.”

I try to get involved in the lives of my patients and have developed many close friends from this group of wonderful people. I’m glad I could offer some help to this patient and his wife, and I wanted to post this so people considering using Cold Cap Therapy during chemotherapy might know what to expect. There’s a good article about this treatment here.

This reminds me of another time that I wanted to share, when a hair transplant patient got a routine heart scan on my recommendation and found that he had an aortic aneurism. This is a time bomb that kills almost everyone when the aorta (the main blood vessel that exits the heart) leaks and bursts. I helped him find a great doctor who brought his body temperature very low at the time of surgery, stopped his heart, and replaced the blood vessel with a cloth one while everyone hoped that his brain would function after they restarted his heart. He lucked out and survived, brain fully intact.

Right place, right time.