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When I do a gentle pull test for my hair, I always seem to get about 10 or so hairs from the top front of my head,whereas I usually don’t get any (maybe one or so) from the sides and back. I’m wondering if this has anything to do with MPB or perhaps the hairs on the side and back come out at other times i.e. combing, hands through hair, etc.

Why are you pulling your hair? As the name implies, there is a pattern to male pattern baldness (MPB) — most of the hair is lost from the top and if it is impacted with miniaturization I would expect that you can easily pull out the hairs that are miniaturized. Hair impacted from genetic hair loss that is very early in the process should not pull out with the pull test. So if you have MPB, pulling your hair is not the way to go about diagnosing it. Mapping our your hair for miniaturization will tell you what you need to know for balding purposes.

https://www.wsj.com/articles/losing-your-hair-why-this-solution-is-no-longer-shameful-11582299915?mod=itp_wsj&mod=&mod=djemITP_h

HAIR UNAPPARENT The celebrities and pop-culture icons to the left have been Photoshopped to remove some or all of their hair. Can you still recognize them?

ILLUSTRATION: SEAN MCCABE; GETTY IMAGES (CELEBRITIES)

You have a classic movement to a maturing hairline. This movement is in process. You can see bits of your juvenile hairline still present which were originally a rounded hairline look. A mature hairline is V-shaped. The picture on the right shows what is a disappearing rounding to the hairline.

I have written extensively on this subject because too many doctors are in it for the money, not to benefit you. Forums like Hairloss Talk, the Bald Truth, and the IAHRS are sites that doctors pay to get on, so they are not objective overviews of quality.

For a better overview, read this summary: https://baldingblog.com/selecting-hair-transplant-doctor/

For all of you considering a hair transplant: DO NO MAKE YOUR DECISION BASED ON PROXIMITY OR COST from tressless

We need to talk about good medical practices. Many surgeons believe that FUE works well provided that in a person with an medium hair thickness and an average donor density, has no more than 3500 FUE grafts removed to avoide a see-through donor area. 3500 grafts for such a person will cover Class 3, 3a, 4a, 5a patterns of balding relatively easily. Once you get into class 4, 5, 6 and 7 patterns, then an FUT may be a better answer either as a sole harvesting technique or combined with FUE. As the hair thickness gets finer (less and less hair bulk/mass), the maximum number of FUE grafts drops because by maintaining the same harvesting number in a person with fine hair, the see-through donor area may become a problem. With coarser hair (more hair bulk/mass) and an average donor density, more FUE grafts can be safely harvested. As the original donor density drops, the see-through donor area risk rises so FUT might be a better choice as a see-through donor area is a real risk for low density donor areas in many men. High original donor densities with medium-coarse or coarser hair are good candidates for FUE in the more advanced Norwood Patterns. If you combined higher than normal donor density with a coarser hair, this person can easily have most of his head transplanted with FUE alone. I have never seen an FUE result in a Class 7 patient with fine hair or one with significantly reduced original donor density and not have a depleted donor area (see-through donor area). I believe that there is a role today for surgeons to be skilled in both FUE and FUT and based upon the above factors and the surgeons preferences, the right harvesting method for the right reasons will be selected.

Dear Doctor,

What is your opinion on “reports” that MPB was essentially unheard in Japan before WWII yet it’s common now? I’m specifically referring to this website (https://www.newstarget.com/z012893.html) which cites prevention magazine. The article starts with “For men, Dr. Klaper says that a low-fat diet may help slow down the balding process…” I’m concerned that my “western” diet might be contributing to my receding hairline. Thank you

Interesting reading! The author says, “We can blame the typical American diet for yet another unfavorable thing: Hair loss”. I don’t believe that there are any good studies that relate diet in various cultures to balding genetics. I know that wigs are hot businesses in Japan and Korea, but that does not tell much about the thrust of the article. The article speaks for itself. No further comments are needed by me. Thanks for the reference.

I’ve been on finasteride for over 2 years with good results. But now I’m experiencing some erection issues. The sex drive is there, but the erections are very weak and generally need manual stimulation. In your experience how long does it take for this to go away once stopping the medication? I was also on an SSRI, so it’s hard to say which medication is actually causing these issues. I’ve been off the SSRI for almost two months, and my sex drive came back quite quickly, probably within two weeks of stopping. I’ve been off of finasteride for two weeks now and haven’t really noticed any difference, so I’m getting a little nervous. Anyway, hope to hear from you and have a great holiday!

Give it time and then you will know. Some men have ED problems just as they get older and that is why Viagra and Cialis have done so well as a drug for treating ED. Heavily focusing on sexual performance often leads to some ED, a psychological effect but if your ED is caused by finasteride, then speak with your doctor about finasteride and your ED.