Category: Hair Loss Causes

Dr. Rassman,

First off, Thank you for the excellent information you provide here on Balding Blog. I have been following your site for years now during college in Ohio, and I must say it has been my primary source of information in my research regarding hair loss. Now that I have moved to Los Angeles after graduating school I’ve had the opportunity to meet you in person, which was exciting for me after following your blog all this time!

Anyways, I am currently wondering how much more regrowth with Finasteride I can hope to see. I have been on the drug since August of 2010 and continue taking it today without fail. My results have been fairly typical. In this time I have seen some minor thickening / reverse miniaturization of my frontal hairline and my crown which had minimal thinning has went completely back to normal. This was indicated by you during my bulk analysis and miniaturization mapping exams.

I would like to add that I had the HairDX Finasteride Response test done in Ohio before starting the drug and my CAG score of 23 indicates I should only have a slight response to the drug, but I did start taking it at age 26 when my hair was only in the early stages of thinning. I know everyone is different but typically/statistically do you see much more regrowth in patients like me after 18 months of Finasteride use?

Secondly, what are the chances I would suffer shock loss at age 28 and having been on the drug well over a year if I had a transplant done to restore my frontal area. (You said I was an early Norwood 3 pattern).

Thanks for everything

I believe that improvement while taking finasteride has been reported for as long as 24 months.

Shock loss is often protected by finasteride… so as long as you stay on the medication, having a hair transplant should not produce shock loss.

Hello dr.Rasmman your site is really informative.Thank you for all this information.I have a question to ask.Is sebum rich in dht and testosterone? I mean if you don’t wash your hair and have an oily scalp,can this accelerate male pattern baldness allot sooner than it would normally start?

I’ve written about this before. And as I said then, most of the claims of sebum containing high concentrations of DHT (thus leading to hair loss) seem to be coming from companies that sell shampoos. These claims are just not supported by today’s science.

Taking finasteride does seem to reduce the amount of sebum, but the connection between sebum and hair loss (because it contains DHT) has no basis.

I’m 18 days post op and i just got a hair cut today. I asked the lady cutting my hair to be gently when she combed my hair, but for some reason she didn’t pay much attention to my request. She rubbing up against my recipient site several times, i definitely felt some pain. While i know grafts are generally anchored after 9 days because of your joint study with Dr. Bernstein, but is it possible my grafts were damaged internally?

You may still have some tenderness, but I do not think you have anything to worry about that far out from your surgery. Shame on your stylist for not listening to you!

Hi. I wonder if diffuse thinning stops or if you’re losing it diffusely, are you’re sure to end up a NW 5/6? I mean some people’s hair loss stabilize at one certain point like NW3 (like my dad who’s been a NW3 for about 20 years). But if you’re a diffuser, does the same thing happen?

Thanks.

You need to be examined by someone with competence in genetic hair loss and who can predict the hair loss based upon miniaturization and bulk analysis. Without an examination, I couldn’t say one way or the other if your diffuse loss would cause you to finalize to a Norwood 5 or 6 pattern.

Hey I had a quick question,

I am sure this has been answered before but can you explain how someone with no history of balding on either sides of their family can go bald? And vice versa how someone whose entire family is bald can keep their hair their entire lives?

Thanks

Genetics should be studied back a few generations to outline the real incidence of balding in the family line. Balding can skip a generation or two. In some families, a child may be adopted and not be told, so the genetic line may not be pure. In any case, I hope you are not going to blame your grandparents for the balding you may be experiencing.

As for how someone can keep their hair with a great incidence of balding in their family — well, it’s just how their genetics played out.

This is the final part of our post on epigenetics. Part 1 of this series can be found here, and part 2 can be found here.

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I continue to hear from patients who say they look like their dad or their grandfather, but “he has more hair and lost hair much later in life” and this suggests environmental issues that are impacting and accelerating the epigenetic changes influencing the timing and degree of male generic hair loss. It will be helpful to our patients if we can learn more about them.

Stress is also an important factor in hair loss. I saw a 45 year old man go from almost full head of hair to a Norwood class 6 pattern balding in just half a year, as his 6 year old daughter died after a difficult bout of leukemia. The stress must have been enormous.

Dr. Richard Shiell wrote that smoking is an interesting factor and he tried to do some trials about 30 years ago. The strange thing is that his hair transplant patients were all such “health freaks” that after 6 months he had not gathered more than one or two smokers, so the trial was given up. I know many surgeons attribute poor-growth of transplants to post-operative smoking, but this was never able to be confirmed and occasional “poor” results may have been due to other factors.

The real issue is to see if there may be dietary manipulations that can benefit our patients. If we think there may be a way to do that, we should not leave it in the hands of someone who has questionable ethics, but we should not ignore any useful message we get from dietary supplements in the epigenetic story as it unfolds.

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This post was in part taken from an email sent by the brilliant Dr. Sharon Keene in Tucson, Arizona.

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Snippet from the article:

She describes motherhood as ‘amazing’, but Selma Blair has candidly revealed she is experiencing an unwanted side affect. The Cruel Intentions actress, 39, who gave birth to son Arthur Saint four months ago, has revealed she is suffering post-partum hair loss.

‘This is so not glamorous, but it’s true: I need to take longer showers so that I can collect the hair that falls out and throw it away so I don’t clog the drain,’ she tells People magazine.

‘Why do actresses never talk about that?’ She continued: ‘It just started falling out at the three-month mark. And I’m not a girl who likes extensions, so Selma’s going to be bald!’

Read the rest — Selma Blair reveals she’s suffering hair loss after birth of son

I’ve written about hair loss after pregnancy before, and it can be a normal occurrence caused by hormonal changes. Obviously, celebrities are not immune to this. There is little that can be done to prevent it, but more info can be found at the American Pregnancy Association.

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This is a lengthy post that will probably lead to more questions, but while most topics have been covered on this site over the years, one topic hasn’t had much attention until now.

There is a field called epigenetics that addresses those heritable factors, other than our DNA, that impact how we express our genes. We have long suspected that diet plays an important role, but the science that backs this up has been lacking. We know, for example, that there are some known dietary anti-androgens out there like turmeric (spice used in many Indian and Asian dishes), as well as the omega 3 fatty acids, which may be why a diet higher in fish/fish oil may impede hair loss and why the Westernization of diets in Asia may have accelerated it.

Dr Masumi Inaba of Japan wrote two books in the early 1990s (Androgenetic Alopecia and Human Body Odor), which were translated into English and published by Springer around 1996. He always claimed that there had been a significant increase in hair loss in Japan post-WWII and he attributed this to increased fat in the Japanese diet due to Western influences. This was back in the late 1980s. Again, the shadow of diet and hair loss is interwoven. As an aside, Inaba was also the first person to describe his FUE technique in detail.

At the last ISHRS meeting, a “power shake” that increased hair growth in those impacted with genetic hair loss was discussed. Dr. Jerry Shapiro presented his “power shake” at the meeting (PDF here), which is essentially a whey protein concentrate formulation loaded with a variety of elements that have been reported to help all people grow their hair faster after a hair transplant.

What about the individuals who are nutritionally deficient? Are we all nutritionally deficient in some way? The basic questions raised by many doctors is that those individuals who are known to have poor nutrition (e.g. alcoholics) have not shown to demonstrate significant hair loss apart from the general population. One might suggest that these particular individuals metabolize testosterone differently than non-nutritionally deprived people by producing estrogen instead of DHT, thereby protecting their hair from the ravages of genetic balding. There is intriguing data on cysteine/glutathione and hair, which would be boosted by the undenatured whey in his power shake. Kudzu root has known anti-inflammatory properties.

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Part 2 will be published tomorrow.

This post was in part taken from an email sent by the brilliant Dr. Sharon Keene in Tucson, Arizona.

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What are the symptoms of bacterial and fungus infections.Can they permanently destroy your hair and leave you with thinning hair?

Some symptoms of bacterial or fungal infection of your scalp may produce (but not all) some of the following symptoms: pain, irritation, itchiness, foul smell, discharge, fever, and hair loss. These are very general and vague symptoms and the main point you should take away is to see your primary care doctor if you are concerned about an infection!

The Internet is a horrible way to self diagnose or self treat medical issues (even hair loss). If you leave infections untreated, you can possibly lose your hair permanently.

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