Determining Final Hair Loss Pattern Based on Age? – Hair Loss Information – Balding Blog

Hello Doctors,

Most hair loss experienced by men is due to genetics and therefore there is really nothing that may be done to change one’s genetics. If a young man in his early twenties begins to lose hair with a Norwood 3 hair loss pattern does it mean the hair loss will be progressive and continuous (e.g., in early thirties be at NW4 and so forth)? I’m in my early twenties and heading to a NW3 hair loss pattern so in general does it mean my hair loss will get worse as I get older or will I keep that NW3 pattern up to my senior years? Also, is being at NW3 at early twenties a bad sign or greater probability that hair loss will get worse?

Thanks

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You can’t just use the age you start losing hair to find a clear view of your final hair loss pattern. You could start losing hair at 40 years old and stop at a Norwood 4. You could start losing hair at 20 years old and proceed to a Norwood 6. Your hair loss might stop at a Norwood 3.

Mapping the scalp for miniaturization will help you see the progression over time so we can estimate the pattern you’ll get to. At this point, there’s no way to say whether your loss will get worse.

My Twin Has Thick Hair, But I’m Starting to See Thinning! – Balding Blog

I’m a 51 year old male…. There is no baldness running in my family. My twin brother has a full thick head of hair. About 5 years ago I noticed my hair thinning a bit around my hairline above my forehead. Didn’t really give it much thought. But over the past couple of years I’ve noticed an overall increase thinning of my hair especially around the crown and the hairline. I don’t have any bald spots. Just thinning to where my scalp is more visible now.

I was in a very stressful job when I began noticing my hair loss. Not sure if that had something to do with it. I do use hair products in my hair to keep it looking nice and shiny. Is there a way to tell if it’s just a temporary condition and that my hair will re-grow or something more permanent? Not sure if I should see a dermatologist or a general doctor. Any suggestions?

If you have an identical twin he will also lose hair like you, but if your twin is fraternal then your genetic make up is not the same. Thus, your fraternal twin may not lose hair like you. The great majority of the time men see hair loss is due to genetics, and this is called androgenic alopecia (AA) otherwise known as male pattern baldness (MPB). So while most hair loss for men is genetic, it can skip generations making it impossible to simply look at your father, brother, uncles, grandfather, etc to know if you will be bald.

Hair loss from stress is different than genetic balding and it does not occur in a “pattern”, thus the term male “pattern” balding. I’d suggest your next step is seeing a physician. Either your dermatologist or general physician should be fine.




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Only 50% of Men Lose Hair? Looks Like More! – Hair Loss Information – Balding Blog

Dr. Rassman,

In prior posts here, you have stated that 50% of men experience some degree of balding in their lifetime. Yet, when looking around at older men, that number seems much higher than that! Men like Ronald Reagan stand out precisely because so few men still have ALL their hair in old age. Reagan’s hair would not be so striking if he was just part of the 50% who never lose hair. I am just wondering what that 50% stat is based on.

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I believe that 50% is loosely based on observations by doctors and is quoted widely (even by me). I am not aware of any specific studies that looked at men in a certain age group and categorized them on a hair loss scale. So I guess the percentage could be 42%, 51%, 69%, 71%, etc….

On a final note we generally consider 50% of men go through some degree of genetic, patterned balding. This does not account for age related general hair loss, where there is no pattern.

Airline Lost My Luggage with Propecia in It! – Hair Loss Information by Dr. William Rassman

My baggage was lost on a recent trip and I was without my Propecia for 8 days. Would this relatively short period of time without the mediction cause any problems or loss of hair that wouldn’t have occurred otherwise. Thank you. I appreciate your time and dedication.

There is some tissue fixation that lasts about 1 week so I would think that you would be alright. If we were your doctors, we could send you some temporarily or call into a pharmacy near where you are for a temporary supply. Check with your doctor in the future if it happens again.

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Propecia is Causing All of My Hair to Fall Out! – Balding Blog

7 months and 6 days and im seriously thinking of giving up on propecia. I am quite vein and when I seen my hairline had receded a tiny bit I decided to go onto propecia, I really wish I hadn’t, every day since month 3, my hair falls out, loads in the shower, loads on my pillow case and loads as I pull on my hair very slightly, propecia has without a doubt made it worse, I have just decided to take 0.5 instead of the 1mg i was taking to see what happens, if I continue shedding then Im getting off. I am 100$ convinced this made me worse, I have read its impossible and ive even been told by my doctor it doesn’t make it worse, but it has. I am jeopardising any chance I could have of a hair transplant, because the hairs that are falling out are all over, back and sides as well as the top, and for a transplant they take hair from the back and sides which are falling out rapidly. Why is this happening and what should I do? It’s so frustrating

There is no way for me to understand what is happening to you without an examination. What you are describing makes no sense unless your Propecia is counterfeit (a not uncommon problem). Sure, sometimes the medication might not show much benefits, but to make the hair fall out all over, including the donor area… that particularly makes no sense.

Basically, you need a good doctor to tell you what is happening and this can not occur over the internet.




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Hair Loss InformationDoes Stress Aggravate Hair Loss by Elevating DHT? – Hair Loss Information – Balding Blog

Doctor,
I am turning 23 years old in May. I have noticed that I have been thinning on the back of my head around the vertex. The thinning seemed to have started this summer. After slightly noticing it, I asked my barber if he had noticed anything. He said that it has been relatively the same for the past 5 years that he has been cutting my hair. I have been monitoring the situation and noticed that it has thinned out a little bit more. Today when I got my hair cut, my barber said it seems to be thinning now. It is visible to me that I am most definitely thinning at the vertex especially after cutting it a bit shorter around that area. I have just entered pharmacy school and I am afraid that with stress elevated levels of DHT can affect my hair.

My question to you is, first, does stress aggravate hair loss by elevating DHT? Second, I would like to take Finisteride 5mg and cut it up into 4 pieces. That extra bit of Finisteride, is that ok? Lastly, should I use Minoxidil? My beef with that medication is that it is a vasodilator and I am afraid that I would have to use it forever, I would rather take Finisteride forever (or until I decide I just do not care). My hair loss is not noticeable; it looks like it is simply the separation of my hair. However, I know my own hair density. I believe Finisteride should be enough to at best stop any further thinning. Also, I can provide you with pictures if that would help. Thank you for your time and have a wonderful weekend.

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I would doubt that stress is elevating DHT levels. Men with hair loss and thinning at the top/crown are mostly likely to have genetic male pattern baldness. Yes, DHT is one of the factors, but your genes are ultimately to blame. Chances are, the loss you’re seeing is coincidental to your entering pharmacy school.

If you cut a 5mg finasteride tablet into 4 pieces, that’s 1.25mg per day (if you get the pill cut perfectly)… and that’s ok. Ideally, cutting the 5mg pill into 5 pieces would be best, but getting 5 equal pieces would be extremely difficult. Using minoxidil with the finasteride is up to you. Some patients like both medications, but it could feel like a daily chore that you need to keep up with.

Finite Number of Hair Cycles? – Hair Loss Information – Balding Blog

Dr. Rassman,
Thanks for an amazing blog. I check it daily for updates. I wish I could fly to the US for a consultation one day, but it’s far away from Australia.

I have seen in a number of blog entries that you refer to hair going through a finite set of cycles (one cycle being Anagen, Catagen, Telogen). Is this based on research and/or from experience? Does all hair have a limit or does it not apply to the donor area?

Kind regards

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The anagen, catagen, and telogen phases are the well known life cycle of any hair. I think it is even taught in high school biology. For human scalp hair, the anagen (growth) cycle can last several years. This is followed by the resting phase (catagen/telogen), lasting several weeks to months. The length of time of the anagen cycle widely varies in people, but it is estimated to be anywhere from 2 to 8 years. If you take 3 years to be an “arbitrary” average, you can calculate your lifetime of cycles. If you have genetic balding or other hair loss conditions, the cycle of hair is obviously shortened (see apoptosis). The hair cycles apply to all hairs, but the pre-programmed genetic life of certain hair is variable. You really do not need research to see this… just look at all the bald men out there!

Norwood 7Now, I am not sure if I have completely answered your question, as I believe there may be some misunderstanding. For men most of the hair on the back of the scalp is considered “permanent” hair which will cycle and live on (see the Norwood 7 diagram at right). The hair you see in that diagram is considered the donor hair and this is a basis of hair transplant surgery for men. The research and experience you are asking about is evident on thousands of men who have had hair transplant surgeries. For example, see the hundreds of examples posted on our site showing patients we have performed surgery on over the last 18 years — the transplanted hair is still growing and cycling. Now the aesthetics and the natural appearance is what is highly variable, depending on who performed the surgery.

I Pull Out My Hair and My Doctor Recommended Propecia – Hair Loss Information by Dr. William Rassman

hello doctor,
my hair is thin and i dont know if all the hair that falls out is because of the telogen stage. my family has no balding but my hair getting thinner and always falling out. i keep on pulling it out all the time and i am always stressed about it so i am all day pulling and freaking out. i went to a doc but she recommend me propecia right away. i dont know if i wanna be on a medication. what should i do? thanks!

Did you tell your doctor about your hair pulling before the Propecia was recommended? Propecia might help if you are a man with genetic hair loss, but it won’t stop you from pulling the hair out.

It sounds like what you’ve got is an obsessive compulsive disorder called trichotillomania. I’m not an expert on OCD, but a good place to learn more and seek treatment help is at the Trichotillomania Learning Center.

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My Young Children Aren’t Growing Hair! – Balding Blog

Yes i have two daughters ages 2, and 3. when they were born they had hair. as my oldest got a few months old all her hair was gone. both of my daughters have very light almost white peach fuzz as i call it. it isnt even half an inch long. i have consulted thier doctors and they have never seen it. i dont know what to do. i just found out im pregnant again and i would like to find out what condition my daughters have so i can correct it. At least know what is causing it so i can become more educated in the matter. My oldest realizes there is something different about her and even asks mommy why dont i have hair like you, as a mother this is breaking my heart. Please help!

This sounds like a genetic disorder. I would want to know about your family and the father’s family history. Has this type of lack of hair been seen before in either side of the family? I really can’t help you much more through the internet without taking a careful history where, I suspect, you will find what is wrong.

A pediatric dermatologist would be the best place to visit first. There’s a group that focuses on pediatric dermatology, and they have a physician locator that might help point you in the right direction.




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Am I Losing My Transplants After a Shower? – Balding Blog

Hi Dr Rassman,

I had two transplant done. One in aug2008 and another one in January 2010. Total about 5000 grafts altogether. Sometimes after showering I see 2 to 3 hairs in the towel with a bulb. the hair that falls out is also thick. Do you think I am loosing a root? or its normal hair cycle. Please advice. I am not sure if the hair that is lost will grow back .

thanks

Everyone goes through normal hair cycling, meaning every hair will fall out and then after a few months in the telogen phase, it will regrow. I can not comment on any particular hair loss that you are reporting, because I don’t know exactly what you’re seeing. Both transplants would’ve taken hold by now, so those 2-3 hairs on the towel are likely nothing to worry about. You should go back to your surgeon for his/her confirmation of that. Hopefully, the transplanted area will hold its overall fullness and that will be the best indicator of the permanent nature of those hairs.




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