Category: Hair Loss Causes

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Hair Assessment in Early Balding – Hair Loss Information – Balding Blog

Hi Doctor,

I am a 26 yr old male started thinning about 11 months ago sometime in december last year. My hair was really thick before so obviously I didnt realise I was thinning when it kicked in during the early stages.

Observations :
1. I notice about 18 -25 hair every morning on my pillow. Most of these hair are very fine and shorter than usual. Some of them have a white bulb at the end.
2. Even at work I notice about 4-5 hair falling on my desk/ keyboard everyday even when I gently rub my fingers on my scalp.
3. During a shower when I apply shampoo on my hair I get about 10 – 12 hair sticking on my hands/fingers even though I shampoo very gently. I wash my hair with shampoo and conditioner ( Clairol Herbal Essences/ Nizoral; was using Garnier Fructis earlier) about 5 times a week usually after a workout.
4. My Hair is thinning all over my scalp. Even on the back although since there is a higher density of hair so No scalp is visible.
5. Some of the common symptoms I have experienced in the past 8-9 months are itching, flaking/daindruff, A kind of burning sensation as if there is some heat generated from my body which is burning the hair roots on my scalp, and obvoiusly my hair is a lot thinner than a year back.
6. I do not see any receding of my hairline( thank god for that)but the area right behind my hairline/top has some noticeable bald spots where it seems like the hair thinned a lot and i have lost some hair.
7. Been on propecia for almost a month and do experience some pain in my balls of late (after ejaculation) however I dont think its reduced my sex drive or erections but I am determined to ride it out.
8. Overall When I examine my scalp minutely,I notice my hair still grows fast however the quality of hair is much more thinner than a year ago annd as a result a lot of scalp is noticeable. I probably have some hairloss too.
8. The worst part is I am not able to comb my hair like before and if I make it puff from the top/front My scalp is very visible from the front. I really woe the fact that I should have taken corrective measures early (when visible hair loss/thinning started about 10 months back but like most people I was in a denial mode and just would not digest the fact that I was loosing/thinning for good.

I have spent many sleepless nights on this issue in the past month and literally think bout it every 30 minutes.
I am a vegetarian and take about 100 grams of whey protein (courtesy GNC) per day for supplementation. I would say My professional life isnt that stressfull at all. The pics in the album were taken with a Kodak 4.0 MP digital camera under bright light.

1. I am applying Minoxidil twice a day but I am thinking bout changing it to once a day at night. I apply it mostly at the top and some on the vertex. Also its too flakey and makes it look like I have daindruff on my hair. Do you think this is a good move and is once a day 5% effective ?
2. From my pictures can you tell me whats my norwood scale ? I am thinning considerably from the top. The hair on the top of my scalp are very thin compared to last year. As a result They tend to clump together when I make them wet or when I apply hair gel. Sometimes in the morning when I gently rub a wet hand on to my scalp I get about 6-8 hair sticking into my hand. Will Propecia or Minoxidil make them thicker again ?
4. From the pictures how bad is my vertex ?
5. Realistically what are the chances I will retain my “Hair Glory” I had in Sept 2004 ? Or is it all downhill from now ?
6. Is there any way i can get the thickness measures with a densitometer in the North California area ?

Photo Album at [link removed for privacy]

Most of the pics in the first album were taken immediately out of the shower. these days I just stand under the shower and let the water wash the shampoo itself with out rinsing it off after applying. No towel dryng too. Notice how the thin hair clumps together from the force of the shower and my scalp is exposed. Or Am I balding on those areas ? looking at my current situation do you think I should continue using minoxidil 5% I started it 2 weeks back in panic I use it twice a day for now. Should I cut it back to once a day or totally eliminate it ?

I would appreciate your assessment of my situatiocn.
Best regards

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Your photographs are consistent with genetic hair loss, but there is no substitute for a good examination as I have said many times in this blog. You should not be your own doctor. The miniaturization mapped on your head will allow the doctor to determine the pattern of the hair loss. The Propecia you are taking will probably stop much of what you are seeing, but you do need to have the examination for miniaturization, or you will not ever truly know if you are actually benefiting from the drug, or if the problem was just temporary and drugs were not necessary. You discussed your hair glory, wanting to go back. I can not (nor can anyone else) predict your response to Propecia, although I have seen some men return to their ‘hair glory’. Responses depend upon the time you have been losing hair, the genetics of each patient and the timing with regard to starting the Propecia with regard to when you actually started losing your hair. The quicker a young man starts Propecia, the greater the overall effect I generally see. As to your question about using Minoxidil while also using Propecia, I’ve talked about this a few times before: here, here, and here. I am in Southern and Northern California, and would be happy to perform such an examination on your free of charge. I can not make a doctor recommendation in the North Carolina area, but you could take a look at the physician search on ISHRS.org. Be sure to do your research before chosing a doctor.

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Thinning Hair Since High School – Hair Loss Information – Balding Blog

Hi, Im 21 and I have had thin hair since atleast 9th grade. It has gotten progressively thinner since high school, but my hair line is not moving. Rather, I experience a general thinning all over like you see in old women. I know i get it from my mothers side because she also has really thin hair while my father has a healthy head of hair. What is my best option to stop this gradual thinning?? My dad is a doctor so he prescribed me Propecia which i used for 5 months with pretty much no results. I feel that most of the products on the market are aimed at male pattern baldness while there is nothing for men like me. Could you please recommend a course of action. Thanks alot.

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You need to get a proper diagnosis. Get your head mapped out for miniaturization and determine if you have Diffuse Unpatterned Alopecia (DUPA). This is a condition that is similar to female genetic hair loss, except that it occurs in men of all ages. Rather than write a book on your management, I suggest that you get your doctor (father) to connect with us. Have him start by reading the article I wrote titled Follicular Transplantation: Patient Evaluation and Surgical Planning?” and find DUPAwithin the text of the article.

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17 Year Old with Hair Loss – Hair Loss Information by Dr. William Rassman

Hi, I’m a 17 year old male and I first noticed my hair getting thin at 15. It was a general thinning but no specific spots. I never noticed a period of shedding I went to the doctor who thought it was MPD but did a biopsy to be sure. It turned out it wasn’t MPD. I was taking minocycline for acne at the time and stoped taking it because i thoght it might be causing the thinning. At that point it got a lttle worse and then stopped getting worse. I have have all the blood tests to check for everything, hormones, thyroid, and nothing was wrong. I have had nothing out of the ordinary happen and im a normal person in every other aspect. While it hasn’t gotten worse, it hasnt gotten any better. I’m afraid its an underlieing disease. Any ideas?

Male Pattern Balding (genetic hair loss) is possible in teenagers. Did the biopsy show any inflammation? It would be a good idea to send pictures or stop by in person for me to evaluate you and I would then determine the degree of hair miniaturization at every point in your scalp. That should show patterns consistent with genetic hair loss if this is the correct diagnosis. If you are taking any medication or herbal pills, that could be a cause as well. At 17 years old, you may have accelerated MPB which might benefit from Propecia.

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Hair Loss from Brow Lift – Hair Loss Information – Balding Blog

Dr. Rassman,

On Nov. 30th I had a contour thread lift of the brows. (contour threads: barbed sutures now used to pull eyebrows up – they don’t dissolve – made of polypropelene)

The incision on the left side of my scalp (just behind the hairline) had a touch of keloid or hypertrophic scarring but the right side is awful. I have a dime sized circular bald spot – very smooth. It’s so terrible. I’m in tears almost daily. It was infected and antibiotic ointment helped flatten it out but the hair is completely gone. There are no pores or anything.

I’m writing to you to see if you know (without benefit of seeing it) whether the hypertrophic process just creates skin that is fibrous and the hair follicles are still “alive” underneath, but can’t grow through or whether it kills the follicles. My plastic surgeon said he didn’t know what it was and that he could just cut it out, but from what I’ve read, a straight line incision is not the answer —- and aside from that, I was hoping to get my hair back.

Any feedback would be appreciated

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Photographs would help. I will give you some general comments about brow lifts, scars and hair loss. Scars and hair loss in brow lifts are not uncommon. My practice is skewed because I see many of these, probably a disproportionate number of them relative to what a normal plastic surgeon does. I get the complicated patients, which hopefully are only a small percentage of those that the plastic surgeon gets. Most of the time when hair is lost, the hair will return in 5-9 months. When it does not, then hair transplants can solve the problem nicely. Scars take on a series of categories, including: Hypertrophic scars (unusual in the first few weeks after surgery, keloids (very rare), widened scars (more common). Hypertrophic scars may require steroid shots and widened scars may require hair transplants if they are detectable months after the surgery. Cutting out the scar from a previous surgery often does not work, but without seeing it, if would be impossible for me to make that judgment.

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Eyebrow Hair Loss – Hair Loss Information – Balding Blog

Hi,
Please could you give me some advice on how I can encourage new eyebrow hair growth. My eyebrows have lately become very sparse. I am very concerned because no products have been working for me. I have used olive oil and bought Talika Eyebrow Lipocils and used the product, I used it for 28 days and it did not stimulate any new hair growth.
Please could you help me and send me some advice?
Thankyou.

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Eyebrow hair loss can be from a series of causes. The most common is from plucking the eyebrow in women who try to shape it and eventually develop traction alopecia resulting in permanent loss of the eyebrow hair. A series of genetic and autoimmune causes also exist, so you might want to see a specialist who can look for miniaturization or the side effects from plucking which are very characteristic. There are no magic potions for stimulating eyebrow hair, though Minoxidil might help. Hair transplants work very nicely but have the disadvantage of growing longer than the normal eyebrow hair which means that they must be cut a few times a week.

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Just Noticing My Thinning Crown After a Haircut – Hair Loss Information – Balding Blog

Please help. I am 26 years old and I have had long hair for about 10 years. I have been keeping my hair in a tight bun or braids all of the time. I also used to texturize and dye my hair frequently. I recently cut my hair off for a job and so now I have it kept short. For the first few months I thought my hair looked fine. Maybe I hadn’t paid much attention to it but I think I had. Now, four months since cutting my hair. I have noticed that my hair is extremely thin in the back of my head near my hairline. Its to the point where it looks bald. Will I ever be able to grow hair back there again? If I got a transplant would it leave nasty scars on my head if I wanted to shave my hair down low? Are there any treatments for me or have I damaged my hair for too long. Can I get a transplant over scar tissue? Should I be able to look at my balding spot and tell if I damaged my hair permanenly? Im not to sure how long it has been thin like this for. I have always had long hair to cover it up I guess. Do I have any hope. Thank you in advance

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Your story is not unusual as denial is a common reaction to aging in the young man who believes that he is forever immune to signs of aging or balding or ill health. I generally think that young people have a concept that their bodies are their castle with high walls which protect them from every malady know to man. Now, your keen eye shows the crack in the armor. I suspect that the insidious nature of the balding process has crept up on you and when you stood back and looked, there it was. Look at the various sections in this blog (particularly the Age category) to see what you can do. Get your hair mapped out for miniaturization to make a diagnosis and then see if you may benefit from Propecia or hair transplant options. Make a Master Plan before going headlong into a panic, be methodical in doing your research, get a copy of our book to review the various options and explore our website at newhair.com.

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DHT, Hair Lasers, Chemotherapy, and Finasteride – Hair Loss Information – Balding Blog

I have a few questions about androgenic alopecia and I’d be very happy if you could answer them for me:

1. What is a bigger factor for hairloss the quantity of DHT in the serum or in the scalp? If the scalp had levels of DHT at 0% would this stop hairloss? If that is the case is there a topical drug like Rogaine with finasterid instead of minoxydil and would it decrease scalp DHT levels better than oral tablets?

2. What is your opinion on the Lasercomb device that uses lasers to improve blood circulation in the scalp? Since minoxydil also improves blood circulation and is supposedly ineffective on the frontal area of the head would this device have the same downside?

3. Father of a friend of mine had cancer and had to undergo chemotherapy. My friend told me that chemotherapy improved his hair and even made it grow darker than before. Could there be any truth in this?

4. With propecia losing its effect over time I often see that people increase the dosages of finasteride up to 5mg per day. Would these higher doses really help or are you just putting your health at risk?

This is not really a question just observation on my part: everytime I see the after and before pictures of hair transplants the comparisons aren’t realy fair since the before picture usualy has more intensive lighting and hair combed straight forward or back and is often greasy while after picture has less intensive lighting and different position of lights and hair is combed to the side and it looks like it has just been washed. It would be nice if all pictures would be made with people having wet hair combed straight forward or back so people could really see the difference.

Thank you for your time and answers.

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Whew! You need a whole hour-long cosultation with a hair doctor to answer all of these questions, but I’ll try to give you some short answers in the meantime.

  1. DHT and genetics are the biggest factors in hair loss. DHT is a hormone that is present in your blood (which flows through the scalp but does not reside there). There are no topical formulations of Finasteride (the molecule is too big). Any topical medication for hair loss would need to be a small enough molecule to penetrate the skin and have an effect. Minixodil does penetrate – which is why it works. Rubbing Finasteride on your head will not help and it will waste the Finasteride.
  2. Do a search for “laser” here. To reiterate, there is no conclusive data on the effectiveness of laser therapy for hair growth.
  3. Chemotherapy can occasionally change the character (color, curliness, thickness, etc) of hair in addition to many other unusual side effects. However, the idea of taking chemotherapy just to improve your hair is ridiculous. Chemotherapy drugs can kill you, they are used when the alternative is death. Hair changes post chemotherapy are absolutely the truth, though.
  4. Propecia may lose its effectiveness over time (the data presently now goes out only 7 years), and some patients continue hair loss, hopefully at a slower rate. There is no evidence that higher doses will reverse this, but neither is there evidence that higher doses of finasteride pose an increased risk to health.

Finally, your observation is correct – there are methods of taking photos which will give the misleading impression of increased hair density/thickness/coverage. To really compare, similar photos need to be taken in similar lighting conditions with duplicated angles and styles. Wetting hair before and then showing dry hair after is an especially obvious tip-off that the comparison is invalid!

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Hair Loss Homeopathy – Hair Loss Information – Balding Blog

Dear Doc,
At 18, i used minoxidil solution for about 6 months.I had some help and then suddenly it stopped growing and started falling again.I stopped after six months and shifted to homeopathy. By then I had already lost a lot of hair.For the past 2 yrs i have been trying homeopathy but to no avail.I keep losing to male pattern baldness. No family history except for some thinning on moms hair.Pls help.

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It sounds like you are going through rapid genetic hair loss. If the minoxidil was working initially and then after 6 months you stopped it, you probably experienced shedding of hair from the minoxidil withdrawal of the dependent hairs that you built up on the drug. You need to have your scalp and hair mapped out for miniaturization and if the results of that mapping show male patterned genetic hair loss, then you should go on Propecia. You need to block DHT with a therapeutic dose of the correct medication. Homeopathy does not offer powerful DHT blockers that are proven as safe and effective as a good prescription of Propecia. For your own good, do not waste your time, for time amounts to irreversible hair loss in those with rapid hair loss. You are using a water pistol to put out a fire that is consuming your valuable hair resources. Take command of your problem.

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Bald After Radiation for Brain Tumor – Hair Loss Information – Balding Blog

Had breast cancer, surgery, chemo, radiation. Then had a brain tumor that they thought could be taken out without radiation (kills follicles, and absolutely left me BALD! I was a hairdresser that went to graduate school with beautiful long blond hair. I CAN NOT find another woman that is as bald as I am. My whole head is permantently BALD. I tried every product on the market and nothing helped because the follicles were killed by total head radiation. I can not work, stay away from longterm partner that I knew since 1973 that I was in love with. I don’t work, have no friends left (my move, because I could not stand their pity). Stopped going to my support groups, and have tremendous stress now. My son is alone too, diagnosed with diabetes after given a medication for bi-polar disorder. I was adopted, and my family has never called me. So I am left completely bald – wear wigs w/pajamas if I have to go out. Thank you for letting me write this since I feel like a grieving “bald” widow !

I was left totally bald 4 years ago from head radiation after removal of a brain tumor. I cannot find another woman as young as I am, or ever older that me, that this happened to. Totally stressed out and won’t go out of the house. Probably will lose my house. Have NO self esteem. Tried everything, creams, lotions with no results. Hair Club for Men and Women (HCMW) are hostile to women, could not afford permanent program. Have alot of wigs, but NO SELF CONFIDENCE/ SELF ESTEEM and have just about given up on the hope of a solution.
Thank you.

Have no pictures/ HCMW took pics of top and back ! I kept asking to talk to someone that had my extent of permanent hair loss that they kept telling me about – but did not for a year. Instead they had me talk to a potential client. Very sad.

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There is no cure for what you are describing. You had bouts of cancer and beat it. That should tell you that your glass is half full, not half empty. We are the writers, directors, and actors in our own lives. Sometime we need help to do that job and a good psychiatrist/psychologist or counselor may help you direct your ‘play’. Get the help you need and make your life come out they way you want it to be. I have seen many handicapped people who have overcome many liabilities. A relative of mine died from breast cancer and she went through hell trying to beat it. Her life was taken and yours was gifted to you. Do you think that there was a purpose to your survival? Take a look at National Alopecia Areata Foundation. What this should show you is that there are many people working on your type of problem and many people managing their lives with it. Their glass is half full.

I met a lady with alopecia universalis (no hair on any part of her body from genetic causes) who wore a wig and used make-up for eyebrows and lashes for her eyes. Her alopecia could not be detected at all (she chose to look like a hairy woman), and she was fashionable and dynamic in her social and professional life (radio show host and former spokesperson for the alopecia afflicted). She told me that she made a decision that her alopcia was just a handicap and she quickly came to deal with her life when she was young. Living life for life’s value was more important than obsessing over a problem for which there was no cure. She was victorious, something I wish for you.

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Hair Loss After Adult Chicken Pox – Hair Loss Information by Dr. William Rassman

When i was i think 19 i had chicken pox. i had a fever for about two weeks. after i recovered, one day when i woke up i saw my pillow had many hairs on it and when i combed my hair, many hairs fell out. before i had chicken pox my hair was very thick and long, but now is not so much bald but the thickness is gone. my hair in front of my head is in the shape of an M. and my hair in the top is not very thick now. im 22 now.

What you describe is very common. Significant illness or stress to your body can precipitate a “telogen effluvium”, also known as a “shedding phase” which is transient – it grows back. Now, several years later, the “M” shaped hairline you describe is consistent with male pattern balding – another common condition. These two conditions are likely unrelated. Hope that helps!

Balding Forum - Hair Loss Discussion

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