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Male Balding and DHT

I have just started balding and I’ve just found out about DHT and hormones affecting hair loss. What can I do to remove DHT in my scalp without shampoos specifically for hair loss? Will Pine Tar shampoo work?

The cause of hair loss in men is almost always due to genetic causes, and it is known as male pattern baldness (MPB) or androgenic alopecia (AGA). Scientists have discovered that genetic balding is linked to a hormone called dihydrotestosterone (DHT), a byproduct of testosterone. While everybody (men and women, balding and non-balding) has DHT, it is the men who have the genetic trait of balding that will lose hair in a specific “male pattern”… and DHT must be present. The hair follicle makes DHT. It may have nothing to do with DHT blood levels, but you must have the genetic predisposition for hair loss.

There are medications, such as Propecia, which block the impact of DHT on the hair follicle and it may stop or reverse the balding process, but it is not a cure. To date, there is no cure for hair loss. Pine tar shampoo won’t stop, slow down, or reverse genetic hair loss.


2009-11-03 15:06:39Male Balding and DHT

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Antiandrogens

Dear Sir,
I am 32 years old male suffering from male pattern baldness. I ask you can I take antiandrogens for treatment of baldness? Looking forward to receive your answer.

Antiandrogen is a group of medications that block different forms of male hormones. What we generally recommend for treatment of male pattern baldness is finasteride, which is also classified as an anti-androgen in some sources. Finasteride blocks production of DHT (dihydroxytestosterone), which is one of the forms of testosterone that can affect hair growth in prone patients.

The typical antiandrogens can block testosterone. Although these medications are used for treatment of prostate cancer, they are not recommended for treatment of hair loss because of their numerous side effects. If you are a man using these antiandrogens for other medical conditions, they may positively affect your hair but may kill your sex life so you should not use them merely for treatment of male pattern baldness.

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Man grows hair from scalp burn

I have been asked how this can happen. We are now doing extensive research into wound healing and the appearance of hair after a wound has healed. This man grew hair from the sides of his burn wound (my assessment of the photos) and this new skin brought along with it hair follicles that clearly were different than his balding follicles which had disappeared prior to the burn. In our experimental work, we have created such wounds and found hair growth not-infrequently. This is the theory behind microneedling that is now performed regularly by many men with good results. The wound created by the microneedling go down to the depth of the stem cells (1-1.5mm below the skin) and with persistent wounding, hair is stimulated through the impact on the stem cells reached by the needling. This was shown in the previous post on this blog.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351888/pdf/bmjcred00266-0059a.pdf


2020-06-14 11:14:56Man grows hair from scalp burn

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Any Propecia Interaction with L-Montus?

Dear doctor, I would like to know whether Propecia interacts with L-Montus.

I have been using Propecia for almost 1 year and it really did wonders to my hair. My hair texture is thickened and it covered almost all my thinning areas. Thanks for all the education you provide through this website.

I wasn’t familiar with the name L-Montus, so I researched it and found that it’s a nasal congestion medication made by Indian pharmaceutical company Fourrts. The medication is actually levocetirizine and montelukast.

Montelukast is more commonly known as Singulair, and levocetirizine is more commonly known as Xyzal. I don’t see any interaction problems for these medications with Propecia (finasteride), but double check with your prescribing physician.


2011-01-06 10:05:10Any Propecia Interaction with L-Montus?

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How Many Grafts Will I Need? I Am 29 Years Old. (Photo)

You have a Class 6 balding pattern with a persistent forelock. If the forelock holds up until you are 35+, then a general estimate of at least 2,500 grafts would be appropriate because the middle of the frontal hairline will not have to be transplanted on the first round. But if the forelock disappears after the transplant, then a hole may appear where the forelock was. This area will HAVE TO BE TRANSPLANTED because if it is not, then your hairline will have a visible hole in it. I always tell my patients that genetic balding is a progressive process, and this discussion is such an example. Even the hair in the existing balding pattern will eventually fall out, possibly requiring still another surgery. In some family lines, forelocks tend to last. If it lasts until you are 35, then you may fall into that category.


2018-06-22 06:21:08How Many Grafts Will I Need? I Am 29 Years Old. (Photo)

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Appropriate Propecia Dosage

I was prosribed propecia two months ago to have every other day. My hairloss already seems to be beginning to stabilize over this short time. Hopefully I might get some regrowth in the coming months! I was told the 5 alpha reductase reduction with propecia is still just as effective as if I was taking it every day. However I have read elsewhere that you need to take it every day. While I don’t doubt the advice of my medical professional, I have read here, and elsewhere that I need to take it every day to get maximum benefit. Are there two schools of thought as to the appropriate dosage? Or is it that, as the onset of my MBP is very recent my medical advisor is of the view that I would get an effective response on a less frequent dosage. He claims to have many patients who get a good response taking propecial every other day. Thanks for your help

The recommended Propecia dosage is one tablet once a day.

Some doctors may prescribe half a tablet once a day or one tablet every other day, however these are not the official recommended dosages. One reason is that official clinical research has found that the once a day dosing gave the maximum benefit from male pattern hair loss. Another more important reason is that the half life (the time it takes for half of the drug to be eliminated by the body) is only 5 to 6 hours. So theoretically on the days you do not take Propecia, your thinning hair will have no benefit from the drug. You should always follow the advice of your primary doctor and discuss these concerns with him or her, especially before stopping or changing any drug regimen.

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Massive Scaring in the Donor Area from Multiple Strip Surgeries and Donor Site Depletion Repaired with SMP (Photo)

This patient had multiple strip hair transplants, and the surgeons who did this did not keep all of the scars in one place. As a result, the patient ended up with a terrible scarring complication, as shown in these photos.

Dr. Tony Rustio from Brazil (trained in SMP by me) repaired this man with Scalp Micropigmentation (as shown in the photo below to the right). Great job Dr. Ruston. The redness you see here in the patient reflects that the photos were taken on the day of the last SMP procedure. The the redness can be expected to be gone in a day or so. Here are more similar patients from our website: https://scalpmicropigmentation.com/scar-covering/

massive donor scarringRepair with SMP of masive scarring in donor

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Are Hair Transplants Permanent?

Yes, hair transplants are permanent. Yesterday, I saw two patients that came in who had hair transplants in 1994 with me. Both said that they would have been bald, had they not had a hair transplant. One man had a full head of hair in the front (from the transplants but was losing his crown hair, the second guy had lost much of his native hair and wanted it thicker. So, even guys in their 60s (both men were in their early 60s) want more hair to look younger.


2020-06-25 10:58:56Are Hair Transplants Permanent?

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Mature Hairline Measurements

Dear Dr Rassman,

I know you’re probably sick of hearing questions about this but here goes… I read in one of your more recent posts that ‘a mature hairline is usually about one finger width above your highest forehead wrinkle.’

Doesn’t this seem to contradict earlier measurements which suggest it can rise as high as an inch and a half in the corners? Or in this post are you referring to the center? If the corners receded by only a finger width (which is like half an inch) wouldn’t that be more like a NW 1.5?

The problem I am having with my hairline at the moment is that the sides are moving up (probably by just over an inch) but the center isn’t really moving. This is creating a weird angle. I actually want some of the middle to recede to even it out!

I have seen you describe this as ‘persistent forelock’ — but is a persistent forelock a greater indication of MPB than maturation?

In fact, the part of the center which persists actually seems to be more to the right, and the whole right side of my hairline is still thicker than the left. So maybe this isn’t a persistent central forelock and actually indicates the point remaining which still touches the highest forehead crease should fall out?

Just on a side note it seems as though a lot of males have a juvenile hairline whose central point is actually higher than the corners, kind of like David Schwimmer from Friends. So when their hairlines mature some of the corners recede and their hairline still looks straight. However, my central point was probably a tad lower than the corners (furrowing my brow shows a slight ‘dip’ in the middle’) and I still have hair touching the lowest line in that dip.

Thanks

This really is not that complicated. If you think you are losing hair and you want to do something about it, see a doctor. Even if you have a juvenile hairline or a “weird” hairline and you are bothered by it, you can address it with hair transplant surgery. If you can live with it, then leave it alone. If you think it will get worse, then have it examined by a doctor.

There is no point breaking straws and going over a definition of a juvenile hairline or a NW 1.5 versus NW 1.75 versus NW 2, etc. Nobody has a perfectly even hairline.

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Are there long term effects of finasteride and dutasteride?

https://pubmed.ncbi.nlm.nih.gov/32202088/

Of course, taking medications for life as one must for finasteride and dutasteride for hair loss has never been evaluated for long term safety (decades). The authors raise the alarm, but we need data here. There is a balancing act, to get the immediate benefits of these drugs vs suffer long term ill defined harm yet to be made clear. I don’t know the answer but I thought my readers should be aware that this is a relevant issue for those on long-term use of these drug. In a study of finasteride use over 20 years ago published in the New England Journal of Medicine with men over 55, there was a decreased incidence of prostate cancer in those who took finasteride by 25% compared to a control group. As prostate cancer is the leading cancer in men, this was an impressive finding.


2021-08-18 10:33:16Are there long term effects of finasteride and dutasteride?