Category: Hair Loss Causes

Dear Dr. Rassman,

first of all, what a fantastic blog! And what a distinguished hair transplant surgeon you are. Once I decide that I need a hair transplant, I will come to your office and would request you to personally do it.

In the meantime, I have one suggestion of something that I think is missing in the hair restoration / hair style business, and I just wanted to share this with you as an inspiration, maybe it is something you might want to try.

On the one hand, there are hair transplant surgeons like yourself, who can map out my scalp, do a master plan, do surgery. Then, there are hair stylists who can discuss with me hair styles etc. What I think is missing is marrying the two, in terms of a consultation. I would immediately pay $200 if I could come in and have a conversation with yourself or one of the other doctors in your office, and an expert hair stylist, discussing what kind of looks a combination of say hair transplant surgery, Toppik, and hair styling could do. I have never seen anyone approach this subject from this angle, and I am thinking esp in LA there might demand for such a wholistic approach in terms of consultation.

Thanks, and keep up the great work!

There are many clinics who have your sense of business idea. We as physicians do consult our patients regarding different types of hair styles and adjunct products, such as Toppik or DermMatch, to enhance the look of the hair transplants or hair style in general.

It would be great if we can partner with a celebrity hair stylist as well and the opportunity remains open. On occasion, we have patients come into the office with their stylists for advice, and there have been some particularly helpful discussions.

Hello doctor. I have a question concerning STDs (venerial disease) and hair loss. I hope this question does not sound absurd, but I am really unfamiliar with the connection between STDs and hair loss. Are there any STDs that can trigger or cause hair loss in a male?

Also, can herpes/crabs be passed onto the hair on your head? For example, if someone were to touch their vagina and then run her fingers through your hair, is it possible for someone to get an STD this way?

Again, I am sorry if this seems really absurd as I am not familiar with the possibilities of the transmission of STDs. Thank you very much.

Don’t they teach sexual education in high school? You will not get a sexually transmitted disease (STD) if you touch a vagina and then touch your head… perhaps unless you have a bleeding, open wound on your scalp. And even then it’s quite a stretch.

Syphilis can cause patchy hair loss in later stages, but by then you’re probably also going to experience several other warning signs. There’s no STD that causes male pattern baldness, though. Pubic lice (also known as crabs — see image at right) and herpes won’t cause hair loss.

If you think you might have an STD, I would think balding is the last thing you should worry about. Get yourself to a doctor!

Hi doctor,
I am a 19 year old male who had really long hair a year ago. I use to tie my hair in a bun with lots of rubber bands. The rubber bands were pushed really hard against my scalp and my scalped from a bruise/bump. The bruise was red, painful, itchy, and bumpy. I pushed down on the bump with my thumb to make it flat and applied Neosporin. The swelling went away but the hair loss remains till this day. My dermatologist recommended rogaine foam but i have seen little progress(5 months in.)My doctor does not recommend cortisone injections.

You were not doing yourself justice with making tight rubber bands pull on your scalp. This can cause traction alopecia. In your case though, I can’t tell you what is going on with your scalp without seeing you directly.

Are you balding all elsewhere or just one hairless spot? Are there local areas that are missing hair? I can keep asking questions, but without even a picture, I am helpless.

You may wish to see another dermatologist if you don’t feel you were given adequate time or treatment. Or go back and ask your dermatologist for a follow-up.

Dear Dr,

I was wondering what the percentages are for DPA vs regular progression of male patterned baldness? I am 30 years old and have a norwood 2 or 3 pattern but most of the men in my family are bald to a large degree. Only my father has a complete head of hair.

Regards

I don’t have statistics directly comparing diffuse patterned alopecia (DPA) to male pattern baldness (MPB). We don’t get asked all that much about DPA here, so check out this link for more info.

Essentially… if you are balding from genetic causes, the hair can fall out without thinning in a specific pattern (DPA) or it can thin according to a specific pattern (MPB). In either case, the final pattern will be determined by your genes.

There is also a condition defined by us in the medical literature called diffuse unpatterned alopecia (DUPA) which reflects that the hair all over the head shows miniaturization, including the sacred donor area that is usually genetically protected in men. Most genetic female hair loss appears similar to DUPA, in that it is diffuse and over the entirety of the scalp.

Hello Dr.

I was hoping you could answer a quick question for me about hair transplantation. If I were to get surgery to repair some of the loss I have in the temple region, but genetically I’m predisposed to lose more (and possibly at a rapid rate). How would that work? I would get some hair transplanted and then immediately the rest would be lost? Do you have to wait until you’ve lost everything before getting the surgery?

I really appreciate your website, I think you’ve really helped a lot of people.

Best

You ask a good question, and this is exactly why we advocate a good examination that includes a miniaturization study.

Depending on your age, your family history, miniaturization of hair, etc a good doctor should be able to assess the degree of hair loss an individual may have in the future. Doctors are not fortune tellers (or in this case misfortune), but if one is balding, it does not necessarily mean that they will go completely bald. Usually, a pattern emerges that you can see in the Norwood classification chart (see here). The Class 7 pattern patient is only present in 7% of the general population and most of these young men see that pattern emerging by the time they are 25 years old.

A good doctor would be able to advise you on how to go about the treatment process. If the doctor is concerned you may completely go bald, he may recommend a treatment plan differently.

hi. I would be most grateful if you could help me…My hair was pulled out 4 weeks ago. It hurt and bled a tiny bit. The bald area pretty much immediately grew (sparse) stubble, so I am assuming this will eventually regrow. However, the bald patch has increased in size (about half an inch forward and back), and the hair surrounding it still falls very easily.

Is it possible these hairs were disturbed in the follicle (a big handful of hair was pulled) or could there be an underlying problem? Or could this be a localised anagen effluvium (if this even exists). In the beginning the area and whole scalp ‘burned’ intermittently for about 3 wks although now just the ‘patch’ burns occasionally. I find if the surrounding area itches and I scratch thats normally when the hair comes out (1-8 hairs at a time). I have looked all over for an answer but I think this must be unusual which I find worrying.

Thank you for your time.

If you are really worried, I’d have a doctor examine your scalp. I would expect, however, that if you wait up to 8 months, the problem will take care of itself. Generally, a one time hair pull will not result in permanent loss.

Perhaps the surrounding hairs became weakened after the hair was yanked out and that’s why you see loss in that area. Without seeing what you’re talking about, I am having a hard time understanding what you are describing.

Hi Doc!

During my teenage years, I used to completely shave my head (0 mm) during the summers. I quickly changed my mind each time due to my flat head shape that bothered me.

At age 28, I’ve been experiencing a slow hair loss progression in a class 4A-pattern for some years, still fairly invisible to others I hope. This made me shave my head completely once again, revealing that the front of my head now didn’t look as flat as before. My hair loss almost exactly follows the frontal skull bone which clearly has turned into a more egg-like shape than before. The back of my head, where there is no apparent balding, remains the same however. The frontal bone seems “higher” than the back of my head and I can see and feel a distinct edge between front/back of my head.

Is it be normal for a head shape to change this obvious after 18-19 years of age and could it be the reason for my frontal balding? I would really like to here you opinion.

Also, have you seen shaved, non-balding people with an egg shaped head?

There is no connection between skull shape or changing skull shape, and hair loss. Hair loss is genetic and not influenced by the underlying bony skull. I’ve seen all kinds of head shapes over the years, but an obvious change in skull shape in the adult years is not something I’m familiar with.

Obvious changing of the skull shape usually occurs because of trauma or disease. There are diseases which can result in the skull expanding, though I’d expect you’d have vision issues or at least severe headaches. Or there’s this man that was left with a misshapen skull after a run-in with a stampeding bull. This isn’t my specialty, so I don’t mean to worry you… just speaking in complete generalities.

An electrologist removed a lot of my eyebrows without my permission, leaving me with an ugly, too thin shape. It’s been 9 months since then and not enough hairs have grown back to improve the shape. Since she only treated the hairs once, do you have any idea how many of the follicles could still be alive, even if they’re damaged? And do you have any advice about things I could do to repair damaged but not destroyed follicles so that they could regrow hair?

I am a woman in my late 20s. I had naturally very thick and strong brows that I never had to fill in with makeup and still have very thick and strong head hair. Thank you for your help.

If on target for the eyebrow hair you are treating, electrolysis can be effective in just one treatment. In other words, eyebrow hairs often do not regrow after having been killed off with electrolysis.

Eyebrow transplants using scalp hair work very well to solve your problem. As you indicated you’re in California, I have offices in Los Angeles and San Jose if you’d like a free consult with a physician to see what can be done about your eyebrows. If so, please call us at 800-NEW-HAIR to setup an appointment.