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This patient should not have a hair transplant as his disease, LPP, will kill any transplanted hairs. The previous hairs were replaced by scar tissue. This disease is evident by the shinny, scar ridden skin, the lack of vellus hairs around the hairy edge as it transitions into normal scalp. This disease is thought to be present more than most doctors realize and could be found in men in their late 20s or 30s. We have thought that women were more susceptible to having this disease in the past.

Dr. Rassman,

Below is a study that links alcohol and testosterone levels- Does an increase in testosterone levels necessarily accelerate hair loss in men who are predisposed to lose their hair? Thank you-

Study abstract: Alcohol Clin Exp Res. 2003 Apr;27(4):682-5. Testosterone increases in men after a low dose of alcohol.

We have known for some time that alcohol is metabolized by the liver, as is testosterone. I can not connect the dots between the casual drinker and the hair loss victim.

I’ve used Min and Fin for 18 months, and it’s worked well. It’s slowed recession to 85-97% – though it’s hard to be objective – and there’s some light Min regrowth around my hairline. If it kept working like this indefinitely, I’d be rapt. … and that’s what I’m wondering. Many users – and, IIRC, studies – report efficacy of both these medications to at least somewhat dip over time. But I’ve anecdotally seen people on other forums talk about 10-15 years of use.

So how many Fin users ( and/or Big 3 users ) have reported good results from the drugs that have simply maintained anywhere near the same level of results over 5-10+ years? In other words: who has kept near to what they started with and had decent-to-strong long-term results – and/or even gains?

I have seen the Finasteride work for as long as it has been on the market. I know that because one of my patients, 62, was on it since it was released, but decided to stop it and got “catch-up hair loss”. He was devastated. He went back on the drug, but did not get all of his hair back.

Alopecia areata is not always curable. It can come and go with treatment, stopping while being treated and then returning as you seem to disclose. This is not atypical for this disease, and it is something that you may have to learn to live with. The beard area can be treated very nicely with scalp micropigmentation.

I have seen this many times. Men often glue on bits of their hair just to thicken what they have on their heads. I have seen this from minimal to extensive. This man has done a wonderful job, but how does he maintain this? A wig might be the best answer to his look.

My New Glue On Hair Is Now Stuck On My Head! from tressless

The arrows show what are most likely end-stage miniaturized hairs. Vellus hairs are short hairs with small width but these hairs are long. You can ‘see through the forest‘ indicating that this is balding with miniaturization present. A hair transplant can restore the density and the forest will not be so ‘see-through’.

When I was younger, I always had very thick hair. Never a concern at all. Recently, I ran my fingers through my hair and noticed that I could see my scalp quite easily by pulling the hair vertically or to the side. I usually have a very short haircut, not military style but certainly less than an inch in length. I’ve been paying more attention to my hair lately because I’ve been growing it out, and that’s really the only reason I’ve noticed. It seems like the hair on the side is thinning more…I’m not really noticing a maturation pattern where it’s receding, just thinning.

My uncle on my mother’s side is almost entirely bald, my father has a bald spot on the back of his head and thin hair…so genetic predisposition is possible/probable. I’m wondering what I should do at this point. I may be over-reacting but I’d like to find out. I use gel/comb my hair regularly, but I’ve never seen hair fall out. I can run my hand through my hair several times without seeing any hair fall off.

I’ve also started wearing a hat recently, which is reasonably tight…and may only be coincidence. I’m just not sure what to do/who to see.

Thanks for your help/site…it’s much appreciated.

To determine if you are balding, you need to have your head mapped out for miniaturization which will show if your have developed or are developing a pattern of thinning that will eventually lead to frank balding. Any topicals you place for combing your hair may make it look fuller, but it will not change the process that is going on. Propecia is the best medication to slow or stop the hair loss and some times it even reverses it, but first you need a diagnosis. The hat will not make a difference in the hair loss, unless is is very tight and causes pulling of the hair.

This is a 60 year old male who is a patient of mine who I had not seen for 5 years. Over the past 5 years, his neck hair has significantly reduced as shown in the attached photo. I have told most of my patients to never harvest neck hair for two reasons: (1) it does not last their lifetime compared to regular scalp hair and (2) it leaves terrible scars. Too many doctors rush to get more grafts so that they can charge more money in performing a hair transplant so they will harvest the neck hair and have these two problems as a person ages.