Category: Hair Loss Causes

I had cancer a couple years ago and it has left my hair much thinner then it used to be. where its has got thin the most is on the top of my head. the top of my head used to be the thickest part. Ive heard that going through chemo causes scarring. Is there anything out there i can take or apply to help with the scarring and/or maybe get my hair back to the way it used to be? or should i just do some minoxidil and hope for the best?

Chemotherapy does not cause scarring. What happens when the hair falls out secondary to the chemotherapy, is that as the hair population decreases, so does the blood supply. When we transplant those people who are balding, the blood supply is often lower than on those people who have a thick head of hair, but with transplants, for example, the blood supply comes back as the hair grows. I would have to examine you if you wanted an opinion on the status of your scalp and hair.

i have scalp acne or pimples its scattered all over specially the back of the head…im losing hair and im really depressed…i really don’t know what should i do ? and is there a chance that i could have my hair back ?? thanks

You need a doctor to make a diagnosis and then treat your problem. Hair loss associated with infections of the scalp is not uncommon, but this is when you need a good dermatologist to take charge of the problem. I don’t know enough about your case to provide any real comfort here. Sorry.

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Thank you again for maintaining this blog. It’s very informative. I have two questions:

1. What does it generally mean when a man loses hair at the vertex first? I understand that every one is different, but do people who lose hair in the vertex and have little to no hair loss at the hair line tend to maintain their hair line? The Norwood scale suggests that hair loss usually begins with a receding hairline, with hair loss in the crown coming later. Also, I have noticed that men with receding hair lines generally state that they started to lose hair (in the front) in their early 20’s. Do men that make it to their late 20s with little to no recession tend to maintain strong hair lines, or have less recession?
2. I use minoxodil. However, I still have quite a bit of hair and don’t think it absorbs into my scalp very well. Even after 4 hours or so I can touch my head and my hands will be wet from the liquid sitting on my scalp. Should I use a scalp roller? I have read before that it may increase absorption. It seems relatively easy to use and inexpensive. So long as it does not cause any harm (or further hair loss) I would give it a shot. Thoughts?

Thanks again

1. Depending upon your genes, the balding may or may not start with thinning in the crown. If you keep your hairline into your 30s or so, you have a better chance that you will keep it — but some men do lose their hair later in life. I really can’t give you odds, as each case is unique. From your question, I am guessing that you’re losing hair in the crown and are worried about the hairline going, but I can’t provide you any clear comfort.
2. If you do not believe that regular minoxidil works well for you, try Rogaine Foam, which is reportedly easier to use and better on the absorption. I wouldn’t bother with the scalp roller until there have been some established trials that show it is worth using. Contributing author Dr. Bessam Farjo wrote about that recently.

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Is it possible to lose hair in the crown even with a juvenile hairline or am I most likely seeing a cowlick or nothing at all?

I, Dr. Rassman, am an example of a person who has no hair loss in front, but had established a mature hairline before I lost crown hair with a wide 4 inch circle of hair loss. My transplants were only done in the crown (1600 grafts). I am a happy camper.

The frontal area and the crown area have independent tracks on the hair loss timeline. Each hair follicle is genetically coded for the number of cycles in its lifetime and usually the frontal area gets impacted faster and possibly earlier than the crown in some men. I am afraid that there are no general rules for your hair follicles to follow. So to answer your question, yes, it is possible to lose the crown while retaining a juvenile hairline.

Hi Dr. Rassman:

A number of years ago, I had some hairloss related to having my hair tied back too tight. At first I thought I was losing my hair, by over the years it’s become increasingly apparent that I’m suffering from damage from traction alopecia. The hair is back, but grows only an inch or two.

Is there anything short of a transplant I can do to treat it?

With traction alopecia in some cases there are elements of damage that still leave hair there, but the hair is not healthy anymore. Yes, hair transplants can increase the density there and the hair transplants will grow to full length. There’s really nothing else you can do to treat it, unfortunately.

hi, i want to ask, hypothetically could a NW7 get an FUE but instead of getting a natural hairline get his grafts redistributed to a Mohawk so he would have no hair growing out of the sides but instead have all his hair concentrated to a 1 inch thick line going from the front to back and if that could be done, how many grafts would that be?

I’ve never had that request before, but yes, it is distinctly possible. What I tell all my patients is that the good and bad news about hair transplants is that they are absolutely permanent. As a young man, a mohawk may be a great idea for your particular look, but at 60 years old, will it still be great? Depending upon how thick you want it, it might take between 2500-6000 grafts.

Note: The image to the right is of the iconic Mr. T — and as far as I know, he didn’t transplant the mohawk to his scalp. I’m just using the photo as an example of the hair style.

Dr. Rassman,

I was given a single dose of oral testosterone by my endocrinologist and I had not taken my daily Propecia. I’m afraid that the DHT surge did some damage by “tagging” follicles. Is there truth to the DHT “tagging” myth? In otherwords: does DHT “tag” hair follicles and activate within them some sequence of irreversible self-destruction? Or, does fresh DHT need to continually bind to receptors on a follicle to cause it to lose function? Or, is the DHT binding cumulative? Does a hair follice only begin to lose function once a certain number of DHT receptors have been bound with DHT?

Castration is rumored to halt balding. Therefore, wouldn’t this indicate that the effect of DHT stops once the DHT is gone? However, their hair does not regrow. So, is DHT “stuck” to the follicles, or are the follicles just not able to revive?

DHT does not stay in the hair follicle for a long time, as the body will metabolize it. If you were to stop taking your daily Propecia (finasteride 1mg) and took testosterone at about the same time, I expect that more hair loss will occur. Each genetically impacted hair follicle has a number of hair cycles which is usually less than genetically non-impacted hair follicles. That is why we lose hair in different parts of the scalp and different points in our lives. The DHT will not stick to the hair follicle beyond a week or two, so those hair follicles that are not due to undergo apoptosis (cell death) will most likely live until their time to die comes.

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