Category: Hair Loss Causes

Hello Dr.

Question: When hair loss is hereditary, is it always the same type of hair loss pattern? I believe my father suffered a Type V hair loss, and my hair loss has been at a Type 3A for about 4 years now. Will my loss eventually become a Type V over time?

-Thanks!

I do not know your age, I have not examined you for miniaturization or bulk analysis, and I essentially know nothing about you other than a connection to hair loss by one side of your family (father). As you know, there is a 50/50% chance of getting his pattern if we blindly guess using available statistics.

Dr. Rassman:

I am 39-years-old, and while there’s no advanced balding in my family tree, the Norwood 3v pattern is very common, slightly more so on my mother’s side. As a result, I’ve been very vigilant through the years for even the slightest signs of hair loss.

Even still, I recently visited a hair loss specialist who told me that I am still a Norwood 1. She took pictures of my scalp and analyzed the hair follicles, and informed me that the hairs seem uniformly thick and there’s no significant miniaturization.

What are the chances that I could still develop a Norwood 3v pattern showing at this point?

It would be highly unlikely that you inherited any balding if it has not shown at your present age, your hair is thick without miniaturization, and there is no frontal recession.

Thank you for running a great site. I’ve found it immensely helpful in learning about this condition.

My question is – earlier last summer, you mentioned that Prince William would likely be a good candidate for a hair restoration procedure. I am curious though why that is the case. I had always been under the assumption that a young man with an aggressive pattern like the Prince would not be a candidate. Am I mistaken? If so, what particularly sets someone like Prince William apart? Is it the fact that he is a diffuse thinner rather than a receder?

In general if a person has male pattern baldness (like Prince William) and has good donor hair and scalp laxity, they WANT and DESIRE a change, and they have REALISTIC expectations of what is possible, they can be a candidate for a hair transplant surgery.

I have never met Prince William and my answers were just based on the reader’s hypothetical questions. Perhaps Prince William does not want a hair transplant surgery and is fine with his hair and the possibilities of eventually going completely bald in the Norwood class 6 pattern. I do not know if he has (a) fine, medium, or coarse hair, or (b) what his donor supply looks like or how it would measures out if I checked his hair density in the donor area.

From his overall pattern, I would suspect that he might benefit from Propecia (finasteride) based upon his age and overall pattern. Many class 6 patterned individuals who are young and go on this drug, may notice increased coverage, reflecting the thickening of the existing hair shafts or even new hair growth.

Finally based on pictures alone, I do not think he has a disease like DUPA, as it appears that he has good hair on the sides and back of his head.

Drs. Rassman and Pak,

I’m a 23 year old man with fairly extensive loss. I was on 1mg Finasteride for over two years with no success (I know, of course, it’s impossible to tell how quickly my loss may have progressed had I not been on the drug, but the rate of loss while on the drug was certainly no slower than it had been prior to beginning the medication.) Finally giving up, I relucantly sought, and obtained, a Dutasteride prescription, and have been on 0.5mg for some considerable time now, again with little to no discernible success. Not least thanks to warnings issued on this blog, I’ve finally woken up to the fact that my health is more important than my hair, and that, especially given its apparent ineffectiveness in my case, Dutasteride is not worth the risks. I’m about to stop the drug and let nature take its course.

As someone who has had little to no benefit from two treatments widely known to be effective in most patients, my question is this: do you or any of your colleagues in the field have any thoughts on why the two major oral DHT blockers aren’t effective in some men? Is it simply that in some men they somehow fail to block the DHT, or is it rather that some men have so much DHT that the drugs, though they may reduce it by a massive amount, still leave sufficient DHT to impact upon the hair. (I wonder if this scenario might be true of young men with aggressive balding patterns, like myself?) Or, alternately, is the fact that DHT inhibitors aren’t always effective in treating androgenic alopecia evidence to suggest that there are factors other than DHT at play in the hair loss game?

Just a theoretical brainteaser really, but I’d be interested to hear your thoughts. Lastly, you have my thanks: whilst it’s unfortunate that, at my age, my ‘baldness journey’ ends with sanguine acceptance that for me there is no realistic ‘fix’ for my hair, and that therefore I’m to be a bald man pretty soon, the calm, well-informed and often witty advice you continue to offer here has over the years helped me greatly in coming to terms with my situation.

Read through the HairDX Test for Finasteride Response site and you will see some reflections on why some men do not respond to finasteride. Minoxidil is still another story.

You need to establish a good doctor-patient relationship and get the opinions of a good doctor who might help you. Sometimes, it just is what it is. I know it sounds cliche, but I don’t have all the answers and drugs do not solve all problems. Life isn’t that simple.

Dad and his family have been diffuse balding since his early 30s. He has super fine, thin hair. I have the same super fine, thin hair, though luckily no signs of balding yet. A cousin on my dad’s side has pretty severe diffuse balding, the other also has diffuse balding but not as severe.

All of the males in my mother’s family have very thick hair, and none of them are balding even though they’re well into their 60s.

Since I have my dad’s fine hair, does it mean that I’m more likely to have his balding gene? Or is the gene completely separate from the hairs’ characteristics?

Hair characteristics are unrelated to the genetic hair loss process. So just because you have fine hair from your father, doesn’t mean you’re guaranteed to have his hairline.

Came across this article about hair loss in the the daily mail. What are your views doctor rassman?

How a £30,000 hair transplant can still leave you going bald

That’s a nice looking transplant result in the first photo set in the article. The article goes over the various treatments that are available, and warns about scarring and shock hair loss following transplant surgery. Nothing new here that we haven’t written about dozens of times before on this site, unless I’m missing something. It appears to just be a general hair loss treatments article for the UK audience with a punchy headline to grab readers.

Hi Doctor,

When shampooing my hair, I notice that I lose the most hair from the sore parts of my scalp. What do you think could be causing this? I alternate between Head and Shoulders and Nizoral.

Thank you.

There’s no way for me to answer this question or even take a stab at an explanation without knowing your hair loss history. If you seriously want answers, you need to have your scalp examined by a physician.

Sore spots on your scalp could be a variety of things, from dermatitits to psoriasis to acne. The vast majority of hair loss in men is caused by genetic androgenic alopecia, but if you’re concerned you should see a dermatologist about your tender scalp.

[tags]tender scalp, hairloss, hair loss, shampoo[/tags[

Is there facial and body hair loss DUPA? And if not what type of hair loss could cause diffuse hair loss all over?

By definition, diffuse unpatterned alopecia (DUPA) can be over the face and body, but we generally only use the term to describe hair loss on the scalp. There are other conditions that cause hair loss on the face and body, such as alopecia areata or alopecia totalis.