Would an untreated ailment such as an exposed pilonidal cyst cause chronic telogen effluvium?
Anything is possible, but likely improbable. Sometimes people try to link one ailment with another. This may be valid in some cases, but often difficult to prove or correlate.
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Hello Doctor,
My hair loss pattern is probably a NW3 and I have little to no miniaturization. I am in my early twenties. I went for a consultation about 7 weeks ago and was told to hold on to take Propecia. My hair loss keeps getting worse. I keep losing hairs and are not growing back. Also, on the sides there does not seem to have the same fullness as years before. I would like to know if I should start taking Propecia even though I do not have miniaturization?
Thanks
I’m not sure how I can help you. A doctor who examined you did not recommend taking Propecia. If you want a second opinion, you need to see another doctor. I am sure if you look hard enough you will find a doctor who will prescribe you Propecia, but I don’t think that is the issue here.
You point out you have “little to no miniaturization“, but consider yourself a Norwood class 3. Some men will recede without noticeable miniaturization, so Propecia could bring value to you. I would disagree with your doctor if you, in fact, have recession beyond just a mature hairline. Without an exam though, I’d have no real way to know that.
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Dear Dr. Rassman,
My question is regarding the non-approved use of minoxidil for frontal balding. In your response here your thoughts were that it might work to some degree. My question is whether there is a physiological difference between balding at the hairline and on the crown? If not, is there some other reason why minoxidil might be less effective at the hairline, or is it simply the case that Pfizer didn’t test it there, and if not, why not as it would surely increase sales.
The drug PI in fact specifically says not to use it for receding hairline, do you believe that it’s possible that it may have negative effects? Further, is there a likelihood that minoxidil use by a man who in fact wasn’t balding but only having a maturing hairline would have negative effects (other that normal drug side effects)?
Many thanks
You raise an interesting question, but no one really knows why minoxidil or finasteride work better on the crown area. There may be a physiologic difference of hair follicles in the frontal area versus the hair follicles in the crown area, or it could be that hair loss in the frontal area is more rapid and medication works better when the hair loss is earlier with more miniaturized hairs. I do not think there is a danger or negative consequence of using the medication for the frontal area, though. In fact, many of my patients do use these drugs for the frontal area with some success.
I really do not know why the drug companies did not study the effect of the medication on the frontal area of the scalp. My cynicism would tell me that their initial results were very weak and they’d rather not publish poor results, but I actually believe that it was too complex for a good science study to show the type of results seen in the crown.
Here is a quote I just found on a health & fitness website:
“Over-masturbation or over-ejaculation converts too much testosterone into dihydrotestosterone(DHT). High levels of DHT overload the body causing baldness and possible prostate enlargement. Reducing the frequency of masturbation or ejaculation will help maintain low levels of DHT and avoid hair loss.”
So should I really believe this stuff and, well, ‘keep it in my pants’? I’ve never heard of ejaculation elevating DHT before, so any comment would be appreciated.
Older studies show masturbation cuts prostate problem risks, but a more recent study shows that it could possibly increase prostate troubles for younger men. Yet the study suggests that older men should have frequent sex or masturbate more frequently. Some male health experts believe that men should either have sex once a day or masturbate once a day, but the evidence is really not scientific.
Every man has DHT, yet not every man loses hair. For those that are susceptible, DHT is a cause of hair loss. But even if ejaculating caused a DHT increase, you’d have to be genetically inclined to lose hair for it to actually cause hair loss. Why does this not make sense to people? Masturbating doesn’t cause hair loss. Genetics does. If you never masturbated or had sex in your entire life, you could still lose hair.
Hi Doc
I am a 22 male with fine blond hair, and ever since I can remember I have always had fine hair (used to be able to pull out chunks of my hair) however since the age of 16 I have become obsessed with my receding hairline. Don’t get me wrong, I accept the fact I’m going bald and just waiting for the day to come where it becomes TOO noticeable so I can get the clippers on them. What I don’t understand is …. why now? I cant even grow a beard.
Surely it cant be normal for my hair to be falling out and I cant even grow a proper beard? I got stumble on the chin and upper lip but nothing else….. I am starting to think maybe I have a underlying illness that I don’t know about. Could it be because I am a smoker and that why my hair is falling out? Is it normal for someone to be going bald that hasn’t properly finished puberty yet? or maybe I am just being paranoid? I don’t know.
Any advice would be greatly appreciated
Kind Regards
Sorry to hear of your hair loss. It seems you have accepted that inevitable. Unfortunately, if you are destined to go completely bald (Norwood 6 or 7) it usually starts very early, possibly as you described.
Growing a beard has nothing to do with scalp hair loss. It is in itself a genetic trait (like balding). Some men just never grow a beard. Also, smoking is bad for you (hey, I’m a doctor — what did you expect me to say?).
Hey Doc,
This is such a great site and I learn so much from here. I had some questions for you. I see you mention that certain events can cause an onset of MPB. Can you elaborate on this, as far as how certain events can cause an early start of MPB. Also, is it possible that a person may never have developed MPB even if he has to genes for it, if that person would have never engaged in an activity that that you say can cause an onset of MPB.
Last question, I asked you once about perscription meds causing hair loss. You indicated that a women should regain her hair back with in a year if the hair loss was caused by the meds. How long would it take for a male to regrow hair that was lost due to perscription drugs?
Thanks!
No one really knows exactly how it happens, but stressful events (such as a major illness) can start a process of genetic hair loss. It can also be such that the genetic hair loss was in progress all along and that the stressful event just made the hair loss more evident (with rapid hair loss during the stressful times), but I doubt that it’s possible to avoid MPB by avoiding these stressful events.
Prescription medications may cause hair loss, but that may be the last item on the list of possible reasons for your thinning hair. For both men and women, one year is a good, safe rule of thumb to wait for regrowth of hair that was caused by medications. But in the real world things are not so simple and there may also be other factors involved for the hair loss.
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Greetings Dr.Rassman,
I am an everyday reader of your site. Here’s a question I didn’t find an answer to.
- All hair loss websites say that a man should reduce his fat and sugar intake, because sugar increase DHT. Is this true?
- is there a connection between sugar & hair loss?
- What can I use to sweeten my un-avoidable green tea cups, since i know too that artificial sweeteners like aspartame cause hair loss
- is Stevia good choice?
Ever smash your finger what happens is pain followed by swelling and more pain. Smash your finger and put it in ice the pain lasts a very short time and the swelling in reduced dramatically. So I wondered if hair transplantation has the same effect on in essence relating to the act of the surgery and implantation. If so would a post op cooling of the implantation area for say 30 min or so reduce the inflammation and shock of the surgery thereby improve the results, recovery time and reduce the shock hairloss.
No I don’t claim to know anything but I was curious.
I believe some doctors do use ice on the forehead to reduce the swelling, but in general there is no significant inflammation on the forehead where most doctors put ice. I do not know if the ice really helps, but I am confident that it does not impact the degree of shock loss that occurs in some men. Icing the recipient area (the grafts) could do more harm than good if the grafts are disturbed while the ice packs are put on and taken off.
Hi Doc!
I was wondering if male pattern baldness can also strike at one side of the scalp?. I’m looking at my hairline almost everyday, it appears to be the same as when i was 15, i’m 19 now, but i’m worried it might be receding really slowly on the left side as it doesn’t seem as strong as the right side of my head. the right side as far as i can tell shows absolutely no signs of receding or miniaturization, it’s really strong!
Kind regards
Unfortunately, you’re not going to be excited by my response. Be patient. The other side will catch up eventually.
I am a 35 year aged female who has been wearing weaves for 2 1/2 years. I decided to grow out my perm so I can eventually have only chemical free hair. I have taken out my weave recently and have flat-ironed it to see how long it was and to get an idea on the health of my hair. My hair was not only brittle but very thin.
Is this a result of the sew in weaves? If so, is there anything I can do and/or products I can use to bring the health back to my hear and to a normal thickness? Please advise.
Sew-in weaves can cause traction hair loss. Constant traction on your hair can cause thinning as it is being progressively damaged. This does not happen 100% of the time, but it is a common problem for women who wear their weaves tight or have a tightly braided hairstyle. If you lose the hair, it may never grow back.
Flat ironing your hair can also cause damage, particularly if it is already weakened from the weave. I would give your hair a full year to see if it recovers. At this point, patience is really the only thing I can recommend.
