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Itchy Scalp Where Hair Is Thinning – Hair Loss Information – Balding Blog

Hello Dr. Rassman
Am 25 year old male whose fighting the deadliest enemy of all men, that is hair loss, which has attacked my frontal hair causing a diffused loss, yet my temples and crown seems fine. My point is that i have noticed alongside my falling hair, there is a persistent itching in my scalp especially within the regions where hair loss is occuring most, slight scalp redness can be seen upon close inspection. Is there any possiblity that the two are related?

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The first thing that comes to mind is ‘what came first, the itch or the hair loss’? It is possible that you have a skin problem and that the skin ‘itch’ is actually making your scalp flaky and red. If you scratch the itch, you can produce traction alopecia (in your case, it would be hair loss from pulling hairs with scratching), or you can have other skin disorders like Psoriasis (visit National Psoriasis Foundation). It is also highly possible that you have male patterned balding and you need a good doctor to determine if there is miniaturization corresponding to the genetic process in the frontal area.

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Female Bald Spot – Alopecia Areata? – Hair Loss Information – Balding Blog

Hey Dr. Rassman, I just found out this bald patch in my head and wondering if there’s anything i can do to prevent it from getting worst? I’m 27f and there’s no bald history in my family that I know of. My hair is thinning as well, and have not tried any products at all… what kind of re-grow hair products would you recommend?

Thanks.

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If you have a bald patch that appeared on your head, I would be concerned that you might have Alopecia Areata (search this site). First, get to see a good dermatologist. This can be a serious problem and it should not be washed away with topical solutions and hair care products.

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Hair Loss InformationPatchy Hair Loss Pattern – Hair Loss Information – Balding Blog

Dr. Rassman,
I’m a 21 year old male and I’m quite physical fit and eat properly without excessive drinking or smoking. For the past four months now I have been noticing some patchy hairloss on different parts of my head. One being on the left side and the other largest being on the right rear near my crown. At first it looked like perhaps alopecia but the patches were not round and also not smooth. Now the balding on the right side has turned into what looks like a circle, almost like a crop circle at least 3 to 4 inches in diameter and the left side it also a random pattern that is not fully smooth. I have also noticed a small circle on the back of my head down by my neck. I saw a dermatologist and apperantly she has never seen this before and now has me taking a bunch of blood test for HIV, syphilis, and lupus. I am most certain I dont have HIV or syphilis and I do not have any other symptons of lupus. Do you have any ideas what this unusual hair loss pattern could be? Thanks for the help.

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If you have a series of bald patches that appeared on your head, I would be concerned that you might have Alopecia Areata (search this site for “Alopecia Areata”). I am surprised that your dermatologist said that she’d never seen this before, as it is a common problem in the study of dermatology. This can be a serious matter and you may want to see another doctor if what you said is true. Read the website material and learn about this condition. Then when you meet with either your present doctor or the next dermatologist, bring this up as a diagnosis possibilities. You also must realize that I am taking what you say as what you reported here.

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Hair Loss InformationWigs and Hair Club for Men – Hair Loss Information – Balding Blog

Just wanting some info, I am thinking of doing hair club and getting a piece. Do you know the cost and is it cheaper than hair transplants? I would rather do something that will grow mine back, but I am skeptical and weary of trying something like this, especially if the cost is what is rumored.

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Costs for wigs (hair systems) are much higher than most people think. I met Sy Sperling and the executives of Hair Club for Men in the late 90s and I was informed that the average price that they got from people with ‘systems’ over a 5 year period was around $12,500. That price included the hair system and constant repairs, replacements, and adjustments with frequent visits to their offices. When washing one wig and letting it dry, you need a second to wear. These hair systems are expensive and they do wear out. These cost figures I presented here are not based upon anything other than the cost quotes given to me in about 1998. I suspect that with inflation, the costs will be higher today, but that is only speculation on my part. The problem with hair systems is that they tend to accelerate and/or cause hair loss (traction alopecia) from the glues and tapes that are used.

Most hair transplants can be obtained for less than that figure (for the early balding man) and the transplanted hair will last a lifetime and grow as long as you want it to be. If you also take Propecia, the progressive hair loss may stop. This approach is far less expensive and totally natural. Men with hair systems are always afraid of other people touching their head. If the hair is attached to the existing hair, then cleanliness becomes a problem and odor becomes very distinct when you get close to men who use them. When romance opportunities appear, you might have a no-touch / no smell zone around your head if you are wearing a wig. Most people who have these systems, hate this no-touch zone more than any other single factor in hair systems but few men realize the odor that surrounds the systems that are attached, particularly if they do not come off at night so that you can wash the scalp and remove the dead skin than normally sheds every day.

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Hair Loss InformationTamoxifen and Hair Loss in Women – Hair Loss Information – Balding Blog

Hello Doctor,
I have been taking Tamoxifen for 2 years after Breast Cancer treatment in 2003. I have noticed that my hair is thinner lately and am wondering if the drug is the cause? Any suggestions? Thanks!

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When hair is lost secondary to a drug like Tamoxifen, it is not unusual for it to come back with a different texture. You may not know the entire story until you undergo an entire hair cycle (2-6 years) or have the drug impact completely gone (2-6 months after stopping the Tamoxifen). No real suggestions, other than to get a good baseline on miniaturization and the distribution of miniaturized hair to, at the least, command the diagnosis of female genetic hair loss (just in case you are in that category of women with thinning hair).

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Hair Loss InformationIs Bosley the Best Hair Transplant Place? – Hair Loss Information – Balding Blog

Hey doc, I have just found your website and have enjoyed it tremendously. I am 23 and have noticed my hair thinning since I entered college at 18. I tried Propecia but grew impatient. I wish I would have stuck with it but I chose to stop. I have lost enough hair now that I am fairly thin on top and towards the front. I was curious if you would recommend a transplant for someone so young. I am on the bubble about this, but I think that for my mental well being and career that really it is my only option. I am constantly unhappy with my looks and miss dating a lot. Truly the only real thing holding my back is the price, I would do it tomorrow but I just truly do not have enough saved. I think I would need extensive graphs to restore what I have lost. I have only looked into Bosley because it is the most popular and respected name. Would you recommend them or should I look elsewhere? I am very afraid of a poor surgery where I come out looking like a fool for the rest of my life because of some doctors weak job on my head. Thank you so much for your time.

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You must be careful that you are not body dysmorphic. Dating and hair loss relate with regard to self-confidence certainly, but losing your hair should not be an excuse to stop living. Your points about career, mental well being, dating, happiness, (I can go on and on) are good reasons many people try to either hold on to their hair, or if they can not or have lost it, they can get it back with good medications or hair restoration surgery. Now with that said, you need to first get a diagnosis established, your scalp mapped out for miniaturization and the pattern of hair loss that you may develop. Many good medical hair restoration practices, such as Bosley or NHI, can supply a good working diagnosis for you. It is important that you find a hair restoration clinic that you feel comfortable with, and that you feel will give you the results you are looking for. I would not go somewhere based solely on marketing. Do your research.

There is much in this blog about how to shop for hair transplants (my lengthy post from earlier today, The Truth About Cheap Hair Transplants, is a good start), because budget minded people need to understand the entire shopping experience. With a diagnosis in hand, you may find out that you can reverse it (if you have it) with something as simple as Propecia (one pill a day), which works well for many young men. Be careful of the sale pressures to make you buy a hair transplant before you do your comparative shopping and before you know what is wrong with your hair. Knowledge is power, and you as a buyer are very powerful in determining your fate and the status of your hair for much of your life.

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Hair Loss InformationIs the Flap a “Cure for Baldness”? – Hair Loss Information – Balding Blog

There is a post out of the UK that says there is a cure for Baldness called the Fleming-Mayer Flap. Please see the link and give me back your comments. See “An end to baldness – for those who can stomach it“

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The original procedure was actually ‘invented’ by Dr. Jose Juri in South America. It was widely performed around the world with, at times, terrible consequences. Dr. Juri has been quoted by doctors I know as believing that this invention was a terrible mistake and I believe he apologized for the damage his procedure did to the many victims that the radical surgery produced.

As there is no cure for baldness, certainly a radical scalp moving procedure has many opportunities for problems. Worse, it can not cover all of the balding area, for that would take God’s hands, and not this technique.

  • A banana-shaped piece of hair-bearing skin is marked out on the side of the head
  • Incisions are made and the flap is loosened, always remaining attached to the head in order to maintain the blood supply
  • The bald area is cut out of the patient’s scalp and removed
  • The flap is twisted, flipped over the top of the head and sewn into place where the bald patch was. Surrounding skin is stretched lower down to compensate

I would not recommend this procedure for many people with ordinary male pattern balding. Even if their balding pattern does not look too bad at the time they have the procedure, as they get older, the flap will make them look freakish and I have treated many patients for deformities resulting from this type of surgery as they continued with an advancing balding pattern. The article you sent is very misleading; the flap is not a cure for baldness.

For more information about the flap procedure, please visit:

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Hair Loss InformationMulti-Bladed Knives and Dilators – Hair Loss Information – Balding Blog

I just visited a doctor who took me into a surgery and showed me nails in the head of a patient. He said that these kept the wounds open and makes the graft placement easier and produced less damage to the skin and hair. He also told me that he used a multibladed knife to harvest the grafts. I thought I read somewhere that these instruments cause damage. Can you explain what I am being told?

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These nails that you are describing are something that was invented by Dr. Manny Marritt in the mid-eighties to make the placement of smaller grafts easier. Within a year, he abandoned the use of these dilators as his staff built the skills to not need them anymore. He concluded that these dilators did not have great value to anyone other than the novice. I did try them early on in my practice, but I quickly abandoned their use within a month. For more information on dilators, including a photo of what they look like, please see this dilators page.

After I designed the 2 bladed knife with the offset of 30 degrees, I built a multi-bladed knife with variable settings to it. I eventually found that when I used the final design on the first 9 patients, the results were decent (I estimated the loss at about 15%). Then on the 10th patient, I had a follicular holocaust with a loss factor of 70%. Fortunately, on these first 10 patients, I only used it on a limited area, but the high transection rate on this 10th patient said to me that inconsistency was going to be the problem. If I could do it 9 times right and then 1 time wrong, the technique was flawed.

This clinical research was done by me in 1992-1993 when cutting was a manpower problem that I eventually solved with a larger and better trained staff. The multi-bladed knife was the wrong answer to this problem and that is my final opinion on the subject. With multi-bladed knives, the labor that the doctor saves does not offset the hair that is killed off. I believe anyone who uses such instruments today are subject to the same type of variables.

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Hair Loss InformationNatural Supplements for Hair Loss – Hair Loss Information – Balding Blog

hey doc… thanks for your reply. A few weeks ago I posted a question to you: Maturing Hair Line at 18 Years Old

what I would like to add is I’m of east Indian origin and my hairline is in the form of an U curve and is thinning badly. I will try Procepia eventually but I would like to know your opinion on natural suppliments. I’m taking multivitamins + 2 capsules of saw palmeeto every day. The thing I don’t like about procepia is that its a drug and most drugs produces side-effects…and I think that there are natural remedies for every ailment.

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I have answered this type of question many times. Natural remedies include every conceivable thing, some of which is safe (saw palmetto), some of which can kill (arsenic), some of which may be different by different suppliers (saw palmetto), some of which is effective (vitamins that are antioxidants), some of which are ineffective or have variable effectiveness (saw palmetto). I only picked saw palmetto, because it meets many of these opposing criteria, but it plain does not work.

There is all of this focus upon side effects. Remember, arsenic is a natural supplement and it kills; death is a side effect. Sexual side effects are known with saw palmetto, but the sexual side effects with Propecia only occur in 1 out of 100 people. Why assume that you will get the bad sexual side effect from Propecia, just because a drug company is honest and compelled by the FDA to tell you about it? The suppliers of saw palmetto do not have to disclose it; the drug company that makes Propecia does.

If you really care about your hair loss, why do you want to risk losing it or your health, when there are safe alternatives? I am afraid that I do not understand the logic here, but you are not alone with that type of thinking. Sorry if I am harsh, but I do not seem to get the message over to my readership and I really do not understand where I am failing to communicate.

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Hair Loss InformationDo Cage and Travolta Have Hair Transplants? – Hair Loss Information – Balding Blog

I heard nick cage and travolta have hair transplants ,does anyone know what doctor they used? I want to find the best hair transplanter? I heard brazil?

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I can not tell a good hair transplant patient from a normal person 95% of the time, even on a close up examination. The best hair transplant surgeons are those that use Follicular Units and adhere to the standards that have been set for Follicular Unit Transplantation. We have published those standards and they are available to read on the New Hair Institute website on the Medical Publications page.

As to your celebrity hair transplant questions, I can only speculate, as I have no first-hand experience with either actors. I would assume that Nicolas Cage was transplanted, because it appears that what he has on his head are the older type of smaller grafts, not the follicular units we use. Some times, people look transplanted even when they are not. If he was transplanted, then I did not do them (if I did, I could not comment on it because it would violate doctor/patient confidentiality). With regard to John Travolta, I have not done transplants on him either, so my best guess is that he found another great hair transplant surgeon, or never had them transplanted in the first place. I have only seen these two actors in films and some interviews that were public, so I might change my mind if I examined either of them in person and they then asked me to make that information public, a doubtful scenario at best.