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I am a 21 (about to be 22) year old male and I am currently in between a NW 2 and 3 on the balding scale. I’ve been taking propecia for about 4 months with decent results.

My question is, when I examine hair that has fallen out of my head, it appears that the hair is lighter colored at the base of the hair (near the bulb) than up around the middle and tip. Is this a sign that the hair has thinned or is it normal for hair to be lighter near the base?

You did not state your hair color. In blonde, gray or white haired people, the bulb is lighter. In hair that is near the end of its life, the pigment changes may be lighter in color as is hair that is about to go into telogen. If you are worried about balding, then get your hair mapped out for miniaturization to determine what is actually going on in your hair.

Thanks for your time. I took generic finasteride 1mg about 1.5 years ago for three months. I experienced no sides (only erectile dysfunction but I attribute this to porn habits over finasteride) during or after the treatment but decided to discontinue anyway as the stories I read online scared me out of taking the risk. However, now at 21, my hair has shed extensively and I am thinking of taking it back up again. My question is, if i didn’t experience any sides the first time round, is it likely that any sides/PFS are not going to occur/ much less likely to happen? I appreciate any response as I need to make a decision about finasteride once and for all.

If you really didn’t experience side effects from finasteride the first time you took it, you probably will not experience side effects now; however you said you had erectile dysfunction 1 1/2 years ago, so I would ask isn’t that a side effect? This means that you might experience it again.

This man took topical finasteride with minoxidil and applied it to the frontal hairline for 3 months and already has reversed some of the balding

Had surgery over a month ago and my hair is shedding/thinning like crazy! Could it be related?

Shedding after a surgery in a young man is almost always the result of shock loss. I always use finasteride to prevent this in men who are balding, and who are under my care. It is particularly important for men who are also under 30 if they have a surgery, because the incidence of shock loss is high. The hair lost from this rarely returns, and is often a result of the stress from the surgery. We see this very frequently after a hair transplant in a man in his 20s.

Hello. I have experienced thinning on my scalp and my transplant surgeon who did 2 of my eyebrow transplants & is now doing a third was going to put me on propecia, but I seriously doubt I have MPB. I think I have a bad case of traction alopecia because I believe I have sebhoraic dermatitis and in the past I used to scratch my head a lot and used a comb on it and I believe that is the cause of my recent thinning. it thinned at the time my scalp was extremely itchy and I have an intense itchiness in the thinning areas, however this was a few months ago. When i wet my hair it looks like it breaks into streaks. I read that you said that traction alopecia is reversible with most cases but since this was several months ago do you think there is still hope? How is traction alopecia reversed? I still have to see a dermatologist. My last question is, I have read that massaging your scalp with essential oils is good for your hair but I am afraid of massaging the thin areas since I don’t want to cause traction alopecia.

Seborrhea does not cause hair loss. Rubbing any oils into your scalp will only pull out the hairs that are already damaged from genetic causes. Once a person has real traction alopecia, is is usually permanent, but the pulled hair from one or two episodes of picking or scratching should reverse. Get a good doctor and establish a good working relationship with him/her.

Dr. Rassman,
Thanks for taking the time to review my circumstance. i am 35 yrs old and have been thinning for the last 5-6 years. I currently use minoxidil and the lost has seemed to stop. A dermatologist said it was MPb after a brief exam. There are a couple of reasons why i disagree with this. first there is not one case of any member of my family even thinning much less losing their hair. second my hair doesnt look like a typical MPB patient. i have a real good hairline and decent coverage all over the top its just thin, much thinner than the sides which are quiet full. i also visited a Hair center to discuss some options and the interviewer was agreed that it didnt fit the normal profile. I am wondering if it is a hormonal issue. I took accutane when i was younger if that has any bearing. Also around the time i started losing my hair i started to sweat a bit more than usual Any help would be greatly appreciated

Genetic variations are wide and family patterns do not always show balding. Now with that said, I would want to see you to map out the miniaturization in the head and then determine if this is one of the variations we see in genetic hair loss. Accutane clearly does participate in the process and if you are genetically prone, it may contribute to the genetic hair loss.

Send me pictures as a start (my email address is on the Contact page). You clearly need a diagnosis. Let me know which city you are in and if you are not near one of our offices, I may be able to refer you to someone who can help make a diagnosis.

You should go back and see your doctor. I always tell my patients that you can expect 80% growth in 8 months. The picture you showed does not reflect much hair growth on your left side. If your doctor is honorable, he will answer the following questions for you:

1. How would he explain the failure?
2. If he was to do it again, would the failure from the first time happen again? and
3. Will he do the surgery for free considering the full extent of the failure?

Failures like this are either due to:

1. The result of some dermatological disease that was present and undiagnosed at the time of the surgery (unlikely considering that there was good growth on the other side) or
2. A technical failure of the surgeon and/or his surgical team. If the person placing the grafts was rough in the handling of the grafts or kept the grafts outside of the body for over 20 seconds, the grafts could have died.

Differences between the two sides are often a reflection of the person placing the grafts. A lack of experience can make a world of difference when two different people are placing the grafts, one working on one side who is better than the person on the other side.

 

Hair loss is progressive and this man shows why. He had a hair transplant 15 years ago in the frontal area (marked in the photo as front), and he lost hair behind the hair transplant. He is now 49, so he was 36 when he had his hair transplant. Had he been 25, it is likely that he would have lost it faster than 15 years, and if his final balding pattern was not defined, then he might have lost far more hair at 25. At the age of 36, hair loss usually slows down and the hair loss patterns are more stable.