I’ve read many times that castration will stop male pattern baldness, in that case how are there forms of female hairloss?
Male pattern baldness occurs in MEN (as the term implies). Female hair loss has nothing to do with men or for that matter androgens (males type hormones made by women, including low doses of testosterone). It is considered genetic, but it is not cause by the male hormones women produce.
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I notice most females get transplanted hairs into diffusely thin areas and seem to get better results than men in those areas. In your experience, do men tend to get more shock loss than females? And if so why? Would a male who has female pattern balding (mostly diffuse thinning down the middle front area) have a higher chance for shock loss even if they are on Propecia versus a women with the same balding pattern?
Women are not always good hair transplant candidates because they usually have diffuse thinning, including in the “donor area” (rim of hair around the back and sides). Contrary to what you may have seen, women do not necessarily have better results than men. What you may be noticing is that women tend to keep their hair longer, curl their hair, layer their hair, or style their hair that is more conducive to disguising their hair loss.
There is no difference in shock loss for men (who are on Propecia) or women. Young men that are not on Propecia are the ones that get the worst shock loss, but both sexes can get it.
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Dr. Rassman,
I am grateful for the information on this blog but after going through the forum, there doesn’t seem to be a case that is similar to mine. I am a 23 year old Asian male located in the Los Angeles area and on the top of my head is a circular spot which is nearly bald. I am 99% certain this circular spot is a callous that was developed by the many headstands and spinning I used to practice when I was 18-22.
The rest of my head is fine, I notice losing the usual hair but my crown appears to be thinning because the hair from the crown area is combed up to disguise the circular spot. Is a hair transplant the only way to deal with this callous on the top of my head and where can I go to get consultation on that procedure?
Please help, Dr. Rassman.
It sounds like you developed traction alopecia in the area that is callused. Hair transplants should solve the problem, but you must make sure that you stop standing on your head and spinning. If you want to continue to stand on your head, use a circular collar to keep the pressure evenly spread.
As you indicated you are local, you should visit me and let’s look at your problem (I’m in Los Angeles).
Dear Doctor. Thank you for this blog. It has helped me so many times!
I was wondering…Im only 21 and I’m already beginning to loose my hair. Actually my hair loss already began in the age of 19. But I was looking at some old pictures of dad when he was about 33-35 years old, and his baldness first kicked in around the age of 36. I really dont understand why I’m already beginning to loose my hair? Is it just bad luck, because you can’t look at your dad and foreseen when your hair loss will start? I was just thinking that 15 years is a lot before my dad’s hair loss started! Can there be another reason to my hair loss besides genes? I’m in good shape and I’m eating healty. I can litterly “pull” oyt my hair when strokeing my fingers trough it. Or when I’m washing it my hands are full hair. Thank you for your time!
Best regards
The most common cause of hair loss in young men is genetic. There could be other causes, but it is much more likely that it is your genes. The fact that there is hair loss in the family tree helps, but you won’t necessarily follow the exact same timeline of loss as your father.
A direct examination of your scalp with mapping for miniaturization will tell you the diagnosis. Then if you are positive for genetic hair loss, Propecia is a great (prescription-only) drug taken daily to address the loss problem as it will slow down the loss, possibly stop it, and if you really lost hair it might even reverse it at your age. See a good doctor.
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i was diagnosed for MPB, BUT i naturally have thin hair according to my mom. I have thinning hair at the crown and the vertex…and back of my head, left side… but i dont know whether it is MPB or diffused hair loss. Do you have any suggestions of how to find out which one without going to the doctor as there are no good ones in my city?
If you have loss at the back and sides of your head, that is not typical male patterned baldness. It could be something like DUPA, but first, to be sure you’re actually losing hair on the back and sides, I’d take a look at this page to show you how you can perform miniaturization mapping on yourself, since you say there is no local doctors you like.
I had a dermatologist that recommended although I don’t /appear/ to have MPB, he suggested that I use Rogaine once a day as a preventative measure, so if the thinning does start it would be severely curtailed. On one hand, this does not seem like conventional advice, and I would be paying money for drugs for nothing, but on the other hand, paying $80 a year (six months supply stretched to twelve months) for relative peace of mind regarding my hair seems like a decent investment.
What do you think? Is there any value to using medications as a preventative measure if you are not balding (yet), but MPB still runs in your family, or is it better to wait for miniaturization to start showing?
If you don’t have balding or any miniaturization, then I wouldn’t use anything. Personally, I don’t think it’ll help that much and your dermatologist’s theory makes no sense. I certainly wouldn’t recommend a medication to a patient that doesn’t need it.
If you don’t have MPB, but you are one of those people who feel compelled to try something, then you can consider Rogaine (minoxidil), as it has the least side effect potential and is available over the counter.
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I was wondering a couple of things about hair loss/thinning.
I am half Asian and half Caucasian. I have read that Asian people tend to have fewer hairs per square inch of scalp VS Caucasians. When I was younger, I had very thick hair typical of a small Asian child. As I’ve gotten older my hair seems to have gotten thinner. Does it make sense that this is a result of some sort of genetic maturation? As far as physical appearance, I also went from appearing like a purely Asian child to look so white that most people think I’m adopted upon meeting my mother.
Second, I was wondering how difficult it is to actually find a doctor to prescribe generic Proscar for hairloss treatment. Is this a common thing or will I be pretty much forced to get Propecia which is much higher in cost?
And finally, I was just wondering what is keeping Propecia(or just generic Finasteride) from being an over the counter medicine available the same as Rogaine. Is it really so dangerous, for lack of a better word, that the general public can’t handle responsibly acquiring and taking it?
Hair changes its character as we age. It is not unusual for an 8 year old boy to have a coarser hair than he has when he is 20. We see that even more often as a person gets older (greater than 50-60 years old). Your physical appearance has little to do with your hair character and hair thickness (coarse vs finer).
Propecia/Proscar (finasteride) is a prescription medication. Some doctors may have an issue prescribing Proscar, but you’ll just have to ask them and let them know you’re aware that the pill needs to be cut and you just want the generic (only available in 5mg) to save money. There are many doctors in the New York area that can see you for a consultation if you are losing hair, one of which is my colleague Dr. Robert Bernstein in NYC.
As for why finasteride isn’t available over-the-counter, sometimes it can be a danger issue, other times it can be political. The FDA must decide upon a drug’s safety, effectiveness, and whether it can be managed without a doctor’s supervision. There’s an article about the road from prescription to OTC, relating specifically about the emergency contraception medication known as Plan B, but a good overview all the same.
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(male) ok, i have dreads and when someone did my hair, dreads started to fall out so my mom said it was because of tightness. i heard that a shot will regrow it. what do u think i should do? i really dont want to cut em. i bonded with them actually and i like them
Your mom is correct. The tight pulling from the dreadlocks is called traction alopecia, and that will cause hair loss (tight constant pulling for any hairstyle will cause this). I don’t know what shot you might’ve heard about, but regrowing hair lost from traction alopecia isn’t as simple as getting a shot. What you have now might just be temporary, so all hope is not lost, but at this point I have no way of knowing if it will regrow on its own or not. The best way you can tell if it’ll come back is by removing the dreads, crossing your fingers, and patiently waiting. I’m kidding about the fingers, but you will have to wait a few months (possibly up to a year) to see if the hair comes back on its own.
I can appreciate that you are attached to a hairstyle, but if you want to stop the traction alopecia from continuing, the sooner you get rid of the dreadlocks, the better. Or you can continue with the dreads and save your money for a hair transplant. Bottom line though, always listen to your mother!
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i had an HT-surgery in the late 90ies with a 20 centimeter linear scar. a year ago i made a scar repair (FUE-technique) and i can cut my hair now from 1.8cm down to 0.9cm which is a great improvement.
now, i am considering to do a fraxel treatment on the scar and wanted to ask if the FUE-transplants (~250 follicles) would be damaged with the laser
For those that aren’t familiar with the Fraxel laser treatment, it is an outpatient procedure that renews the look of your skin. The depth of these lasers do go into the dermis and therefore create a partial 3rd degree burn, but apparently the damage is limited to a narrow column which is claimed to heal quickly. If the laser took the burn into the depth claimed, any hair could be killed… and in theory, there could be an infection risk, as 3rd degree burns open that possibility, even if it is an a narrow column.
Check with the doctor offering this treatment, as he/she has practical experience. You might also wish to research a little about safety issues on your own. For more info on how the Fraxel laser works, see here.
I had taken Propecia for about half a year. Recently, I was found that I had a hepatic adenoma. I had consulted to my doctors and they said it is unrelated to taking Propecia. I want to know whether it is caused by the Propecia effect. Is there such effect by Propecia for this?
A hepatic adenoma (benign tumor of the liver) can occur in people who’ve never taken or even heard of Propecia, and I’ve not heard of any cases where the medication was even suspected as a cause for something like that. I agree with your doctor.
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