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My son will be 12 this August, I have been noticing lately on his pillow in the morning, there is some lose hair on it, I would say about 12 strands. I have never noticed this before and I would like to know if this is normal or something I should be concerned about. I was wondering if this could be related to puberty, his voice is starting to change or if it is coincidental? Thanks for your time.

It is normal to lose 100 to even as many as 200 hairs a day. Furthermore hair grows in cycles (see below) and you may notice more hair falling out at different phases and seasons of the month. In other words, hair growth and hair loss can be a cyclical phenomenon. Other factors certainly contribute to hair loss such as hormonal changes, malnutrition, etc. While your son’s hormonal changes of puberty may be coinciding with the hair loss, it is my opinion that 12 strands a day is perfectly normal.

Hair follicle cells have three phases of growth:

1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
3. Resting phase (Telogen phase) which lasts about 1- 6 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

I started finasteride but my hair loss had progressed a bit over the past few months in the temple recession and has thinned on the top and crown as well. A little over a month ago my GP prescribed me 5mg finasteride to be cut into fourths and taken daily. I cut the pills into 8ths and started taking them every 3 days initially. After three weeks, I could tel my nipples were swollen and looked bigger. I also had penile numbness, and I could not maintain an erection at all. After stopping finasteride, I was back to normal within a week. I am really sad that I was unfortunate enough to get side effects from finasteride… Now it seems my only options are to try topical finasteride, or to wait until I am old enough and my hair loss has halted to get a hair transplant.

We need to talk. Topical finasteride is a reasonable alternative which I can prescribe for you over a telephone consultation.

What are your thoughts on this “new” topical Finasteride formulation which claims that, “The effectiveness appears to be equal to oral Finasteride, but serum levels are 1/18th that of the oral route.”

My problem with this is the function of Finasteride. Doesn’t Finasteride work to effectively inhibit the formation of DHT? If the serum levels of Finasteride are 1/18th, then DHT is still being formed in the rest of the body as normal, which will eventually circulate to the scalp. Do you think it’s possible that somehow this topical route actually effectively inhibits DHT in the scalp properly? Or do you think this study is not well done (it was done by the creators of the gel, so there’s obvious conflicts of interest)?

If the only prescribed strength is 2.5% gel, which is equivalent to 1.5mg orally, how would one reduce the dose of this as you mentioned in this blog post: https://newhair.com/what-dose-do-you-usually-recommend-for-people-who-want-to-take-reduced-dose-of-finasteride/

I really don’t know. You want to reduce the topical dose, but I don’t know evidence that this works. Frankly, we are flying blind here.

The use of your turban with the pulling that is created from the tight wrap is the most likely cause of the hair loss. If the loss has been there for more than 8 months, it is probably permanent and the only good treatment is a hair transplant. We see this commonly in Sikh men and have treated this successfully with hair transplants many times.

Male, 19, Sikh… formerly had long hair, suffering from Traction Alopecia and created an account specially just to post on here and take your guys’ opinion on what should I do regarding this. Feel free to recommend anything although I think minoxidil would greatly help me. from tressless

I am wondering if the areas on the head which lose hair first in Male Pattern Hair Loss are the areas of the head which naturally release the most body heat (e.g. the temples/crown). Is there more blood flow near the skin surface in these areas?

Great thought, but no. Your hair loss pattern is genetic and it really has nothing to do with blood flow. If you lost hair and became bald (let’s say in the crown) then any hair loss will probably occur in the hairy area where the blood supply is more robust.

I have been developing hair loss in my crown after I had a frontal hair transplant 9 months ago. Why is this happening to me?

Hair loss is a progressive process, so hair loss in men is not unusual after having a hair transplant. It can accelerate the hair loss process that is destined to happen anyway. Your hair loss is unique because it appears to be in the nape of the neck, unless that area was involved in the donor area work. Go back and see your doctor and consider taking medications like Finasteride.