Category: Hair Loss Causes

Hello Dr.Rassman!
Thank you for the previous answers! I have another question:

If guy A starts losing his hair when he is 20 and guy B at 27, is it 100% sure that guy A will have less hair than guy B at his 40s? Once again thanks for your time!

If guy A starts out traveling at 55mph from Los Angeles on the 405 freeway going south at 4pm on a Memorial Day weekend in an SUV and guy B starts out traveling at 70mph on the 10 freeway east bound at 5pm on the Friday of Thanksgiving weekend in a Porsche, who will have traveled the farthest by 7pm?

If you can answer that question, then I will attempt to answer yours.

For those of you who can not calculate the math challenge (hey, I can’t either) — I would say that no two people lose hair at the same rate, so time varies with the patient.

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Hi

I’m 27 and first noticed that my hairline was receding at the temples when I was about 19. It has since been very gradually receding at the temples to the point where I’m now at a 2 on the Norwood Scale.

What you are telling me sounds like the normal transition from a juvenile hair line to a mature hair line. A Norwood Class 2 pattern is a normal mature male hairline and most men will see a rise in their hairlines and some corner recession between the ages of 19-29. Sounds like you are fitting that pattern of change, not worth obsessing over what may be just a normal maturing process.

A couple of months ago, I began to notice the top of my scalp more prominently after getting out of the shower. Not balding per se, but certainly thinning. I finally went to see a PCP (who took a thorough history and performed the hair pull test) and he felt it was Telogen Effluvium and not MPB, but that we should give it six months and reevaluate then with a blood panel to determine DHT levels before prescribing Proscar.

I’m conflicted about this diagnosis. I did admit I had been feeling some anxiety lately, since my wife and I are expecting our first child in November, and that the stress may be triggering the TE. But on the other side of the debate, my father started experiencing his MPB around my age (my mother’s father left this earth at 90 with a full head of hair, however).

Is this a common approach for a PCP to take?Should I get a second opinion, possibly from a specialist, or should I attempt to be an adult and patiently wait the six months?

Thanks in advance for your time.

I would recommend that you get a second opinion about your hair loss and in that second opinion, I would get your scalp mapped out for miniaturization, which will show if it is genetic balding as seen in your family line. A hair specialist and dermatologist are in a better position to diagnose your hair loss than your primary care physician, because they see men with the balding process all of the time. Assuming that you do have genetic hair loss, the earlier you get on Propecia, the faster you can save your hair. Time is of the essence and the stress of fatherhood may be a precipitating factor.

Do I have Ringworm, that is scarry? Where are the worms? I looked very carefully for them and did not see them. Are they like earthworms? Here is a picture of what my doctor called Ringworms as the cause of my hair loss.

Ringworm is a terrible term and I apologize for the medical profession’s use of it. A better term is tinea capitis and it is not a worm at all, but rather it is a fungal infection of the skin. For more info on this, please read:

• BBC News – City ‘ringworm epidemic’ warning
• eMedicine.com – Tinea Capitis
• MedlinePlus – Tinea capitis

This is one cause of localized hair loss that is relatively easy to treat and diagnosis is easy in the hands of a good family practice doctor or dermatologist.

Here’s a photo of what tinea capitis (better known as ringworm) infection looks like on the scalp:

The relationship between iron levels in the blood and hair loss have been a known cause of hair loss in women for years, but there is a suggestion that low iron levels may play an important part in hair loss in men as well. Women lose blood every month (menstruation) and that blood loss depletes iron levels producing anemia, a direct result of depleted iron levels. It is not clear from the article (see below) how men get reduced levels of iron short of some bleeding disorder or some malnutrition. The article is worth reading, but be careful that you do not blindly take iron supplements to treat your hair loss, as overdoses of iron have dire consequences. Red meats are rich in iron and is the source for much of the iron your body needs, so if you are a meat eater, it would be doubtful that most men reading this would have an iron problem without some digestive abnormality present in their gut.

• FOXNews.com – Hair Loss May Be Caused By Iron Deficiency

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Hi Dr.Rassman,

I’ve heard that caffiene is bad for the hair and may cause hair loss. So does that mean that Green Tea is also bad since it contains caffiene?

Also, does propecia lose it’s affect after five years?

Caffeine does not cause hair loss. If it did, I would be bald by now because I drink 5 cups of coffee a day! I have also heard sex is bad for hair, but I wouldn’t give that up either. With regard to green tea, see past blog entries here.

Propecia does not lose its effects after five years.

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