Category: Hair Loss Causes

Hi doc, Im 23 I have always had a naturally high forehead with thin blond hair but over the last year or so Ive noticed that my windows peak is more prominent than usual and the sides of it are ‘coming in’ a bit so I have a small strip at the front of my head and very high temples. I have been paranoid about my hairline since about 16 and recently it just seems it that its actually beggining to recede. Baldness does not run in my family btw! Im not sure if its my imagination but the hair on top my head does no longer feel as thick as the sides. My question is:

Are there any renowned H/T doctors in the UK i could look into? And also is the hair transplanted permanent or will that eventually fall out? Ive read somewhere that excersizing the muscles in your forehead and scalp can help reverse balding (something to do with circulation – ie: why do bald men have hair at the side and back – is it because eating everyday works these muscles?) Proffessionaly speaking – is there any evidence in that?

This is another great rumor about hair loss, ranking right up there with hats and naughty thoughts causing hair loss. Hair loss is caused by a combination of hormones (DHT mostly) and genetics (in combination with hormones even if it does not run in your family). Transplanted hair is permanent because it comes from an area of the scalp that is genetically pre-programmed to be resistant to the main hormone that causes hair loss, namely, DHT (DiHydroTestosterone). Therefore, with the possible exception of some rare disorders, it will not fall out.

Incidentally, there are muscles at the back of your neck and on the sides, but none to speak of on the actual scalp. Exercising the muscles in your forehead will give you wrinkles and a really strong eyebrow raise when you want it, but unfortunately will do nothing for your hair. There are surgical procedures that can lower the hairline. For doctors in this field all over the world, go to ISHRS.org, but keep in mind that each and every doctor needs to be evaluated by you very carefully. It is very important to do your own research.

I have had recurring alopecia since 2003. Gradually it worsened and in February of 2005 my dermatologist gave me a heavy dose of corticosteroids. Within three to six months virutally all of my hair fell out! In addition, I was suffering from lethargy, anxiety, depression and weight gain and decided to not continue the steriod injections.

My hair seems to be growing back, but very slowly. It also grows in white and frail. Is this a sign that I have skin atrophy and is this condition permanant? Also, is it possible that the drugs were conducive to my hair loss? When injected into your scalp, how long does it take before the cortisone is out of your system? Does it change your cells radically for several months to years? Is this a reversible process?

Thank you for your contributions.

From a brief history it is not clear if corticosteroids were the cause of your hair loss, as it seems you have other medical problems (“lethargy, anxiety, depression, weight gain”). Please note that most hair loss from drugs are reversible if you are not genetically programmed for hair loss. Injections of corticosteroid into the scalp are not an uncommon treatment by dermatologists, but I have remained skeptical of this approach unless there is an active inflammatory process going on, such as Alopecia Areata. It seems you are under the care of a dermatologist who should be able to answer these questions in greater detail since he/she knows your medical history.

The right side of my head started to recede around age 17 and by age 21 it started to recede slighty on the left side but not as high as the right side. I went to see a doctor to be evaluated and he said that I had nothing to worry about. There is no balding on either side of my family. I went for a second opinion to another doctor and she said that I was losing my hair and prescribed propecia. I haven’t started taking it yet. I am trying to figure out the cause of my receding hairline. Please let me know.

One doctor told you there is nothing to worry about. Another doctor prescribed Propecia. It seems the second doctor thinks you have male pattern baldness, which may respond with Propecia. Men between the ages of 17-29 will develop a maturing hairline, which means that the hairline will rise about 2/3rds inch in the middle, and slightly over an inch on the sides. The frontal edge of the juvenile hairline disappears in 96% of Caucasian men and it is not genetic balding. The exception to the rule are those 4% of men who maintain their juvenile hairline (e.g. Bill Clinton). You need to have this evaluated by someone who understands. If this is just a maturing process, then Propecia is not needed at all. Send photos with your eyebrows lifted high and I will be able to tell you if you are just losing your juvenile hairline.

Paid advertisements (not an endorsement):

I came across this site (http://www.hairgrowthcenters.com) and it looked promising. If you could just browse it and read some things. I just wanted to know what your opinion is on it. There is 100% satisfaction or your money back, and there are magazine articles and news reports about it. I know judging from your character that you will truthfully tell me your thoughts on it.

Also, on a side note, if hair is lost from shock loss during a hair transplant and doenst grow back, is the hair follicle still there and healthy and just not producing hair? If so, could the laser potentially stimulate those follicles back to making its hair again? Thanks so much and best of wishes to you.

There are some promising studies out there about low laser light therapy treatments for hair loss. There is still, however, a need for better and more appropriate science to back up claims that this therapy can actually grow hair. I’ve written about lasers many times before on this blog, such as here, here, and here.

Shock loss from surgery occurs very rarely, especially when the patient is taking Propecia. The hair that falls out from shock loss will regrow if the hair is not genetically impacted (miniaturized) in which case it may not return. This is why I like to use Propecia in my young patients as it seems to protect the patient against post-hair transplant shock loss. Again with regard to your last question, in shock loss, the role of the laser has not been defined.

I’ve read some articles that said smoking can cause vanes to constrict and possibly cause hair loss. I was wondering if there is any truth to that or not? Also do product like skoal and copenhagen also have this same constricting effect?

It is well known that smoking and tobacco products have adverse health effects. Nicotine in tobacco products are known to constrict blood vessels. This could lead to poor circulation and possible hair loss. To see this effect (of poor circulation) squeeze your nail bed until it turns white and see how quickly it returns to its natural pink color (it should be under 2 seconds). Compare the time difference after smoking a cigarette. You will see that the blushing time changes. Some hair transplants surgeons feel strongly that the effect of nicotine on scalp circulation is reduced more significantly when a hair transplant is done, leading to poorer growth of the grafts and less than idealized results.

It is remarkable to see how some people continue to smoke even with the Surgeon General’s Warning Label. I wonder what may happen if there is a Dr. Rassman Warning Label — “Warning: Dr. Rassman Has Determined That Smoking May Cause Baldness“

Paid advertisements (not an endorsement):

Dear Doctor,
I am losing my eyebrows hair (23-male).

1. Can dandruff be a reason for it?
2. Do you always recommend scalp hair for translpanting to eyebrows? Can chest hair be used? Or armpit hair?
3. I have always heard about scarring at donor site. Are there scars or marks at recipient site ever?

Thank You very much indeed.

There are many reasons for eyebrow hair loss, including hypothyroidism, plucking, trichotillomania, psoriasis with scratching, dermatitis, infection, any inflammation process, and a series of autoimmune problems including alopecia areata/totalis. Using hair at the occipital area to transplant by single strands to the eyebrow areas is the best way to do it.

1. Dandruff is not the cause for it.
2. Experience with other body hair (armpit, chest hair, leg hair) is not well documented and must be looked at as experimental at this stage.
3. I have never seen scars in the recipient area.

I often have little balls of sebum that form on my scalp and it seems like no matter what I do they’re always there. I’ve been using Head and Shoulders, which seems to have reduced the numbers and size, but I still have somewhat of a problem. Also, my hair falls out pretty quickly and I was wondering if there might be a connection. What can I do for this?

Sebum is the oil from your sebaceous (oil) glands around your hair follicle. You may have oily scalp (which is normal). There are many shampoos available for oily scalp. Sebum has no negative side effect, contrary to claims made by many people who promote cures for hair loss by attacking the sebum problem (which is not a problem for anyone other than the styling issues that occur from the oily nature of the hair).