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Can frequent, obssesive pulling back of the hair cause traction alopecia at the hairline? I’m a 20 year old male who cannot go past a mirror without pulling my hair up to look at my hairline. If there is a comb available, I use that as well. I do this to the point where the left side of my hairline in particular feels sore. Would you have any pictures to illustrate this sort of traction alopecia?

If you have an obsessive compulsive disorder to constantly pull on your hair, that may cause permanent hair loss to the area (depending on the severity and length of the offending habit)… but just looking at yourself in the mirror and combing your hair back will likely not cause traction alopecia.

It may seem like a chicken/egg conundrum (which came first…), but most men who have frontal recession are likely experiencing male pattern baldness. Particularly men around your age, which is when it wouldn’t be uncommon for genetic hair loss to begin.

If you are indeed worried about your possible hair loss or an obsessive compulsive disorder, you would establish a diagnosis with your doctor.

I am 31 and have thinning on the top of my head as shown in the photo below. Can a hair transplant solve this problem for me now?

First, I would try drugs like finasteride and/or minoxidil. A hair transplant for such diffuse thinning doesn’t work well except make money for the surgeon. Set up a Personalized Master Plan with a good doctor and follow the plan

I recently filled a prescription for finasteride at Costco and noticed the manufacturing date was from a year ago (9/2014). The expiration date is 8/2016. Even though it hasn’t expired, should I be concerned that it might’ve been sitting around in a warehouse (either Costco’s or the manufacturer’s) for a year?

It’s Aug 2015 (not 2016) so your propecia has not expired yet. If you are concerned about the potency, just go back to the pharmacy for a new prescription. There is a reason why there is an expiration date and a manufacturing date. As long as you follow direction and use it before the expiration date, you should be fine.

I am 24 years old and now have advanced my balding to include the front and the crown. I don’t want to be bald like my dad who is probably has a Class 6 pattern of balding. He said he got most of it when by the time he was 35. What if I started taking Propecia when I was 18, would that have preserved my hair?

That is a great question. Most advanced balding pattern patients have their pattern established in their 20s. Despite that almost 20 years that Propecia has been on the market, we really do not know if the progression could have been stopped had you taken the drug when you were 18. There would have had to be controlled clinical trials where one group who had advanced balding in their families were put on Propecia and the other group not. In that situation, we would know the answer to your question, but no such study has ever been done.

I suspect, however, that had you taken the medication when you were 18, you would have slowed down the progression of the balding and most of such young men in the 18 year old bracket, would not develop their final balding pattern for many years. i doubt that the final pattern would have been thwarted, but for such men, delaying into their 30s could give them the benefits for possibly another decade of so. We will probably never really know the answer, but for many men who I placed on finasteride (Propecia) I have seen the process slow, stop or occasionally reverse. Better to do it than not to take the drug if you are one of these 18 year old men. At 24, it can’t hurt and probably will help.