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Hello Doctor,

I’m 24 (male) and noticed my hair thinning around my temples and a bit in the very front less than a year ago. At first, I wasn’t accustomed to the new hairline and worried that I was beginning MPB. I was unaware of the “maturing hairline” between ages 19 and 29 and feel better knowing this. However, I recently noticed what seems to be minaturization in the front of my scalp. My hairline is still defined, but the hair in the front seems finer and a bit more separated (to me). I notice about 15-20 hairs coming out after washing and more coming out throughout the day. Could this be just a cycle, part of the maturing process, or the beginning of Type IIA. Also, I just began Rogaine Foam as a preventative measure and heard shampoo containing Panthenol without sodium laureth sulfate is good. Would Propecia be good to take or am I overreacting? Your thoughts?

Generally, I like to get a map of your scalp hair to examine for miniaturization and only prescribe Propecia (finasteride 1mg) if there is miniaturization present (meaning, if genetic balding is present). If there is no genetic balding, then there is no point to the use of Propecia. I am not certain if Propecia stops the maturing hairline from happening, but it probably slows that process as well.

Dr.Rassman, I have had mild gynecomastia since child hood. Am I going to be more vulnerable to worsening it if I go on Propecia?

You can try it and if it makes your problem worse, you can stop it. Not much risk for the short term.

I am 21yrs old (male) Ever since i used the ‘Heads & Shoulders’ shampoo i started to get scalp pimples with sticky yeast on the pimples so im guessing that shampoo has a ingredient that im allergic to. My question is, if its just an allergy and i stop using that shampoo, will my scalp pimples and yeast disappear? or do i have to do something about it?

Of course, if you believe that the pimples and the shampoo are related, it is easy to stop the shampoo and find out. It should be obvious to you. Sorry, but at 21 years old, you have to start using the logical side of your brain.

(male) You wrote this in response to someone asking about agressive styling, “The only way blow drying can cause hair loss is if you actually leave the blow dryer too close to your scalp for a long period of time, causing burning to your scalp, thus possibly leading to hair loss.”

I think I may have done this to my hair. Is there any way to get it back? It is thining in only the particular places I used to blow dry it with a rather hot dryer to make it lay down flat. Is there any hope??

I am 39 years old and used to have very thick hair. I noticed thining a few years ago, but after I thought about it I relzed that it may be due to the hair dryer. There is no history of MPB in my family. HAve you heard of anything similar of do you have any sugestions?

Thanks for any help you could offer.

It is possible to damage your scalp and make your hair pay for it. We get reports all of the time by people who had hair stylists damage their hair with rough handling (like you) or as a result of dyes and chemicals. You need to be evaluated in-person by an expert to understand just what is happening. Maybe there is another cause of the thinning, and just maybe you are misjudging what you see.

Hi there. I am a 21 year old male that has experienced hair loss. I’ve always had wavy hair but at around 19 I started losing my hair and it reached Stage 2 on the Norwood scale. My hair stylist recommended Nioxin for me to use about 5 months after my hair started falling out. Since using Nioxin, my hair loss has either stopped or slowed down tremendously (not really sure) but no new hair has grown in. I have grown my hair longer and styled it so most people cannot tell that I have lost some of my hair. Since it has been 1.5 years since my first loss of hair, is there anything that I can take with Nioxin to help regrow my hair? What are my options? Thank you very much!

What you are calling a Norwood Class 2 pattern, I might call a maturing hairline, which is something common in young men of your age. The first 3/4 inch from the highest crease or the wrinkled brow is the juvenile component of the frontal look. Behind this first 3/4 inch starts what I call the mature hairline and if this is what you believe is a balding Class 2 pattern, then you are not balding at all — just developing the mature look.

If you are truly concerned about hair loss, you should want to see a doctor to have your scalp mapped for miniaturization. If genetic balding is present, Propecia (finasteride 1mg) would be a good choice, especially at your age. It is available by prescription only, but it is one of only 2 FDA approved medications for the treatment of hair loss (the other being minioxidil). As I have said previously about Nioxin, they make a good set of products that are popular but there does not appear to be anything in it to stop hair loss.

Dear Dr. Rassman:

I am curious to know what you think about taking 1/4 of a dose of Proscar twice daily as a way to counteract its short half-life thereby theoretically increasing its efficacy by increasing its duration sytemically?

There is no evidence that more finasteride is better than the 1mg dose. I do not see a problem with it provided that it does not increase any side effects.

My 6 yr old son has developed a small, oblong bald spot around 3 months ago. The spot has no signs of hair growth and is very smooth as if no hair was ever there. What could be the cause and should I take him for blood work?

You should have it look at by a good dermatologist. The possibilities are extensive, and infections are not uncommon. Ringworm (a fungal infection) is one of the more common causes in a six year old.

Hello Doctor,

I’m currently a 21 year old male with some signs of MPB. I would say that I currently am between a NW II and III and I do have a family history of MPB on my mother’s side.

My question is more for future reference as I know you advise against most people under the age of 25 to get hair transplants.

Now for the question, I’ve always had “fine” hair (much like my mother and her father). Would this affect my ability to get a hair transplant in the future since my donor area’s hair would be much finer and not cover as much as personal with “full” hair? Have you ever turned away a patient because of this?

Also, which technique of hair transplantation would you recommend for someone with “fine” hair? The FUE or the Strip procedures?

A transplant with fine hair will produce coverage that you have always had. The transplants bring you your hair, with all of its characteristics. Most people with fine hair have a see-through look when they at 12 years old, so a hair transplant will bring you back to the see-through appearance you had all of your life. Fine hair is not a contraindication for hair transplants. The harvesting mechanism should be up to you and your budget, the supply of the donor hair you have, and the size of the bald area you are transplanting. FUE is not a good surgery for extensive hair transplants in a very bald man, just because of the number of surgeries you have to go through to achieve the numbers of grafts.

Hello Dr – I read with interest your answer about MRI scans and how there is no link from them to hairloss as they use magnets. What then, would be your opinion on CT Scans? Could these cause hairloss and if so over what time period? i.e – a few days after the scan or a few years? Thank you for your time.

The amount of radiation that a CT scan (also known as a CAT scan) will administer is not sufficient to cause hair loss. It takes much, much more radiation to cause radiation sickness and have the side effects to cause hair loss.

For more information about CT scanning, please see: Wikipedia – Computed tomography

Hello Dr. Rassman,
My hair is extremely porous, yet certainly not over-processed. I colour the gray roots once every 4-6 weeks and do not blow dry or straighten. No matter how expensive the salon or the hair product, it’s always porous. In the Summer it loves the humidity and in the Fall and Winter it looks like string.

I am also at 6 months post-hair-transplant, and I am hoping for the best hair possible. Is there a relationship between female pattern baldness, which began in my teens, and porous hair? Can you recommend anything at all for my hair, which has been treated very carefully all my life. Thanks a million, and God Bless you! xoxo

I generally do not like to make recommendations for daily hair grooming and hair management. There is clearly dry and moist hair and the difference does reflect the porous nature of the individual hair shaft for that person. The transplants should behave as it did when the hair was located in their original ‘home’ in the back of your head. I would stick to the recommendations of a good stylist who works with individuals with different hair characteristics (porous and non-porous) every working hour of their lives.