Category: Hair Loss Causes

Hello Doctor,

I know there have been various posts on this topic and please feel free to ignore the question given that you have already provided comments. Also, I wanted to thank you for the blog as it has really allowed my to expand my knowledge of hair loss and related topics which is greatly appreciated.

I had what I though was a thick head of hair on the top of my head and historically my worries over thinning was limited to a receding hair line. Recently I got a short hair cut (borderline buzz-cut) and seemed to notice that in certain house lights I can see some of my scalp. That being said other lighting I cannot see through at all including when I am outdoors. I am not sure if this is a function of how my hair is parting, the use of hair products which I read can ‘clump’ hair together giving a thinner look or whether there are legitimate concerns to be had.

My question(s) relate to the miniaturization process and the speed to which it can occur. I recall from a previous blog that hair will grow at a rate of about ½ inch per month and would it be possible to have ‘normal’ hair on the top-half of a follicle and a miniaturized bottom? Is the process of miniaturization more gradual or can you go from thicker to thin in a matter of a few weeks?

I can sympathize that people are different and will go through the process at different paces but I am looking for some general comments based on your experience. For further information, my hair tends to be quite straight and sticks up when short and could this growth pattern contribute to a thinning look i.e. sits in such a position that gives a thin look? I should note that I am 33, currently taking Propecia but nothing else in the way of medication.

Regards

I am not sure how fast miniaturization occurs. I would think it happens over weeks to months (not days). It is a gradual process. I do not know of any documented studies on how fast miniaturization occurs. Usually we follow patients on a yearly basis (not monthly).

If you would like to conduct your own research, you can buy a handheld video microscope and take pictures of a specific area over a period of time and document the results. We wrote a 3-part tutorial on doing this a few years ago — Mapping Your Own Scalp for Miniaturization.

in reference to a quote at the end of this article:

Link: Baldness cure could be for sale in just two years

I am concerned that in the next two years they will come up with a drug that will retain hair, and I (25 yo male) will be the last generation of bald people. The rest of my life it won’t be normal to be bald…. urgh? do any of these ‘on the horizon’ cures actually regrow hair???

I wrote about the possibility of the baldness cure being just a couple years away here.

You’re assuming a lot to suggest that it won’t be normal to be bald for the rest of your life, and even then, there are options like Scalp MicroPigmentation (SMP), hair transplantation, and even medication, to make it so that you don’t appear bald. I expect that we’re more than just two years away from the cure being a reality, but research is ongoing. And even if balding is somehow completely eradicated for future generations, there will still be millions of men around the world that have hair loss, so I wouldn’t get too worked up about it being abnormal.

Hello how are you? I am patient under dialysis treatments because my kidneys do not work anymore, and I wonder if some of your doctors could prescribe me generic 5 mg. My doctor did not want to prescribe generic finasteride 5 mg, the doctor just prescribe me Propecia, but is very expensive. It cost more than 80 dollars for thirty pills, I can not afford to pay that, I’ll be waiting for your reply. thank you!!

You can make an appointment with any dermatologist or a hair transplant doctor if your doctor won’t prescribe the 5mg. Did he give you a specific reason for not prescribing it (even if you are instructed to cut the pill)?

You would first need to have a good medical diagnosis for androgenic alopecia before you receive a prescription for Propecia or its generic finasteride. In general, there is a consultation fee for patients, but most hair transplant doctors waive the first visit fee.

Dear doctor,

I am a 22 years old male with very little family history of male pattern baldness. Yet a few months ago (I think last may or april) I started to experience some drastic hair loss. I was literally shedding all over my clothes, the tub, the kitchen floor… As I grew really desperate I went to visit a dermatologist who told me I was going through telogen effluvium. I actually changed my diet at the beginning of the year by becoming a vegetarian, so I figured it made sense that my hair would undergo a moment of weakness. I took various vitamins for two months or so and things seemed to get better until october.

I have always been very sensitive to the changing of season, hair-wise, so it didn’t worry me at first, but now I find it weird that this is still going on to the present day. But what confuses me the most is the nature of my sheds. I had already noticed that I would lose hair that were a lot shorter than the others (my hair is mid-long), although they seemed to have the same thickness. This could all be a result of effluvium. However, I started to find these days hairs that were thinner than what they should be… Some of them have a normal length but are just pretty thin and fuzzy. Others are also really small… I have no visible recession of my hairline (yet ?). I can tell my hair still fall from all over my head, even in the areas never affected by AGA. But I am scared to death, are those tiny sheds a definite sign of MPB ?

I hope you will answer my message. Sorry if I made a few mistakes. Regards.

You should get baseline measurements on your hair bulk to determine the significance of the shedding, and quantify just how much hair you are losing over time.

As for a seasonal shedding, I’ve had a few reports emailed to me from readers over the years about this, but there is no medical explanation that I know of for it. Humans have asynchronous hair growth, which means that we do not shed in seasons, but do so relatively uniformly over the year.

Dear Dr Rassman

I am a 19 year old male with a Norwood 3 balding pattern. I was wondering whether it is possible for hair loss to stabilise before a NW4 or larger phase occurs?

Also how long does it take for someone who is destined for a NW5+ to become a NW5 from a NW3?

Thank you very much

The Norwood hair loss patterns are not meant to be seen as a progression of hair loss, but rather how you fit into a certain pattern trait. You can be a Norwood 3 your entire life once the pattern forms. Or you can be an early Norwood 5 in your 20s (now) and eventually lose all your hair in this pattern to a full, clearly defined Norwood 5 later on in life. So there’s no defined length of time for a pattern to fully emerge, as everyone is different.

In general, you can tell by looking at your pattern under a bright light when your hair is wet. In the office we also have the luxury of seeing if there is a pattern using miniaturization mapping and taking hair bulk measurements.

Hi, I’m a 22 years old male. I have a very strange situation. I didn’t have MPB before, at least it wasn’t noticeable. I was a vegetarian for some time, but then I started eating meat again, but not red meat. One day I decided to eat red meat again, then the next die I noticed some balding on my temples and increase in body hair.

Everytime I exercise or eat red meat, the next day I wake up with more hair lost and thicker body hair. It’s not a coincidence.

But why? I started taking Proscar, and I get the same effect as eating red meat the next morning: more hair loss and thicker body hair.

What can I do? Every solution for hair loss just comes back and bites me from where I least expect it. If it’s because of testosterone, does this mean that I had low and stable levels until I started eating meat again?

Hair loss or growth does not happen overnight. For that matter, the texture of your hair does not change overnight either. Your body just does not work that way. The biology of hair cycling is in the order of weeks to months.

If you decide to abstain from red meat that is your prerogative, but I do not believe there is an overnight correlation with eating meat and the changes in your hair.

Hello,

I got in a fight w. a girl and she pulled out a lot of hair from my roots. A few months after that incident, a group of girls tried to jump me and one of them pulled my hair out from the roots.

I have searched this site and I understand that “generally, hair that is pulled out once will return almost 100% of the time.” However, in my case, it was not a one-time thing. I would really like to know if my hair will grow back after 2 separate incidents or hair pulling?? Please help me, thank you.

I have similar incidents of violence reported by others (see here).

Generally, one or two pulling incidents should still see the hair return in 6-12 months. No guarantee, of course! All you can do at this point is wait it out.

Can frequent, obssesive pulling back of the hair cause traction alopecia at the hairline? I’m a 20 year old male who cannot go past a mirror without pulling my hair up to look at my hairline. If there is a comb available, I use that as well. I do this to the point where the left side of my hairline in particular feels sore. Would you have any pictures to illustrate this sort of traction alopecia?

If you have an obsessive compulsive disorder to constantly pull on your hair, that may cause permanent hair loss to the area (depending on the severity and length of the offending habit)… but just looking at yourself in the mirror and combing your hair back will likely not cause traction alopecia.

It may seem like a chicken/egg conundrum (which came first…), but most men who have frontal recession are likely experiencing male pattern baldness. Particularly men around your age, which is when it wouldn’t be uncommon for genetic hair loss to begin.

If you are indeed worried about your possible hair loss or an obsessive compulsive disorder, you would establish a diagnosis with your doctor.

Is Alopecia Universalis a dead end?? hair cloning and transplant isn’t beneficial at all in this stage ?

Thank you

There is no medical cure for alopecia universalis patients. Cloning isn’t available and transplantation isn’t an option, since alopecia universalis patients don’t have hair to harvest.

There is an alternative option — Scalp Micropigmentation (SMP). We have had one alopecia totalis patient treated with SMP. Look for Client 26 here (4th one down on the right).