Balding Blog – Page 1909

November 8, 2005

Too Young For Transplant at 23? – Hair Loss Information – Balding Blog

Hello Dr. William Rassman,
I’m 23 and i have been seeing thinning of hair well in the past two years. i have been on propecia for two years, which did stop my hair loss to a certain level but lately im noticing more hair loss even on propecia. i had an appointment at a hair transplant doctor in the past week to go see if i can get a hair transplant. I saw a counselor, not a doctor who told me that no surgeon will perform a hair transplant on me because of my age. Me being too young, he said i have to wait till i go all bald. Can you help me or suggest me of any products, any new advances medications?

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It is generally true that young men under 24 should not get a hair transplant, but it is a crazy thing to be told that you have to first go bald. Generally, I judge everyone differently, make few rules other than protect my patients from me, themselves and poor decisions. Because I am not a salesman, I make judgments all of the time about the maturity of the person I am talking with, their ability to understand what a Master Plan for their balding is going to be, and their response to drugs like Propecia. I find immature 50 year olds, and very mature 20 year olds. As I get to know the person, I would not say that someone of your age can not get a hair transplant. Medicine and surgery are a combination of art, science and compasion. You need all of the benefits of this with a caring doctor while making your Master Plan. Then and only then, can your candidacy be determined.

November 8, 2005

Hair Loss from Finasteride – Hair Loss Information – Balding Blog

Hello Dr.Rassman,
Like one of your readers I too am experiencing a drastic increase in the hair fall. I am on finesteride since last 3 months and I am shedding heavily. I am significantly more bald then I was 3 months ago and the rate of shedding is noticeably higher then any at other point in time in history. Should I stop or continue. I am in double mind. I tried minoxidil and there was exceptional growth in my frontline( like I had in my teen age) but the hair were fuzzy and not cosmetically elegant. No more than 3mm in length but pigmented. The side effects of itching and red skin and dark circle around eyes were too much for me to handle so I stopped it. Can you please do some research tell me please if I should continue with finesteride.? Thanks

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It is possible that you are going through hair loss that would have happened anyway. Hair loss has not been a reported side effect of Propecia. I would suggest that you stay the course for at least 8-12 months. If you elect to stop it, then do so carefully and consider restarting the Propecia within 1-2 months if the hair loss continues. I’ve answered a similar question a couple of weeks ago: Significant Hair Loss on Propecia.

November 8, 2005

Female Hair Loss in Temples – Balding Blog

I have thinning hair at my temples. I am in the Army and have to wear my hair up everyday while at work. My hairstylist says that my hair will grow back once I stop putting it up. However, I will be in the Army for the next 10 years and am thinking about hairloss treatments for my temple area? Any suggestions?

If your hair dresser is correct and you have traction alopecia (hair loss from traction), then you can expect little relief. Whatever is causing the hair loss must be addressed by stopping the pulling. There are other conditions, such as triangular alopecia, where people lose hair in the temples from genetic causes. This is part of the differential diagnosis that you needs to have made. See a good doctor and discuss these two conditions with him/her.

November 7, 2005

Losing Hair Rapidly at 15 Years Old – Hair Loss Information – Balding Blog

Hi, i am 15 years old and im losing my hair rapidly. The only part of my hair im losing are the temple areas so my hairline looks like a big “M” also im noticing that the sides of my hair are thinning and receding also. Im not sure what to do i dont think its hereditary because my dad started losing his hair at 35 and all his younger brothers still have there hair and his one older brother started losing his hair at 40 so i dont think thats the cause of my hairloss. Im not sure what to do its getting really bad. It’s already receded about an inch and 1/4 on both sides. I do my best to cover it as much as i can but it still hurts my self esteem alot and i need a solution so can you please give me your opinion thanks

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I am not sure we are talking about the same part of anatomy (temples or corners). Triangular Alopecia is a genetic condition that causes people to lose hair in the temples, while corner balding and recession reflects more of the typical male patterned genetic balding. You need to see a good doctor and have a proper diagnosis made. The doctor should make a good microscopic analysis of your entire scalp. Most doctors can project this evaluation on a TV monitor and show you how far the miniaturization extends. The amount and scope of the miniaturization will demonstrate the balding pattern as it may unfold. You are far too young for transplantation, but as you’ve noted that you are based in the Los Angeles area, if you’re interested you can have a parent/guardian call 800-NEW-HAIR to set up a free consultation in my Los Angeles office, so that I may properly evaluate you.

November 7, 2005

Lyme Disease and Hair Loss – Hair Loss Information – Balding Blog

I have had Lyme disease and taken massive quantities of antibiotics. I am also 57 and taking a small amount of estradiol. I also recently (over a six month period) lost 12 pounds on a diet prescribed by my endocrinologist which eliminated foods I was allergic to (wheat and dairy). my hair has been falling out for about four months now. I thought it was due to the antibiotics, but I quit them three weeks ago and the hair loss is as bad as ever, particularly when I wash my hair-a handful! I am down to half my normal head of hair (and have also lost it on other parts of my body). Do you know of a good Alopecia doctor in Los Angeles who could help me. And, of course, what are your thoughts?

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I am in Los Angeles, so I’d like you to please pay me a visit. I can add other doctors to the mix that have the specialties to deal with some of the problems we identify. It sounds like many of the elements you discussed can contribute to your hair loss. Medications, hormones, weight loss, and some types of allergies all are known factors that by themselves can produce hair loss, but first, you need to have a good, caring doctor who will look at you as a person first, and with a desired head of hair second. I might not be the right one for the entire management, but certainly I am good to have on the team.

Call my office at 800-NEW-HAIR to set up an appointment with me. The consultation is free.

November 7, 2005

Scalp Reduction Slot Deformity – Hair Loss Information – Balding Blog

I had scalp reductions many years ago, about 7 such surgeries. I have this long narrow straight defect in my head that looks crazy from the back. Many people think that I had brain surgery and ask me about my brain operation. Can this be fixed?

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Thousands of men have had the bald spots of the scalp removed in a procedure called a scalp reduction. There was a naÃ¯ve view by many doctors that bald areas could simply be excised surgically. When this was attempted, the surgeon might be able to remove about 1 inch per procedure and therefore some patients would have many procedures done to tackle extensive balding of the ‘Top and Crown’ that might be as much as 7 inches wide. What the patient found out, however, was that after 7 surgical procedures, they might have only reduced the bald area by 3 inches or so. The match did not add up.

That meant that the bald areas came back by stretching (“stretch-back” was the term used), and the patient was subjected to a never ending battle to remove all of the bald spot. Rarely was this ever successful for any large bald spot, but what was successful was the appearance of a slot in the back of the excision area which joined the two sides of hair that normally was on the side of the head, growing towards the ears. It was like a aprt in the middle of the head with a bald slot in the center of this slot that often measured 1/2 inch wide or so. This abnormal hair direction moved to the top of the head accentuating the slot deformity that appeared.

There have been many attempts to get this fixed, but only one surgery really works well. It is a triple flap procedure where scalp is moved around on the two sides of the slot. The hair direction is changed. The scalp reductions themselves are well exemplified in this article by Dr. Patrick Frechet, where the slot deformity as well as Dr. Frechet’s newer methods to remove the bald areas are shown.

You might want to go to France and consider having him do the surgery, as he is one of the few doctors world-wide that can achieve consistent results from this surgery with minimal risk of scalp necrosis (a common problem in inexperienced hands).

For more information, please see:

November 7, 2005

Propecia and Rogaine – Hair Loss Information by Dr. William Rassman

HI DOC,
Thanks for the wonderful blog. Can you please post your opinion on the combination treatment of Propecia and Rogaine ?

Applying rogain twice a day is cumbersome for me. But I have started on Propecia since past 2 weeks. My derm tells me combo is a the best. I dont think I will be able to continue on Rogaine for longer than 3 months. Can I leave it after 3 months since I am already on propecia? how do you think it will impact my hair? Also How bout the option of 5% minoxidil once a day combine with propecia? My hair thinning/ some loss is 8 months old. Thank you!

The two medications have different mechanisms of action. Rogaine (Minoxidil) gets great results about 15% of the time, but does require twice daily use and has side effects of dryness and flaking. Some people get dizzy from the antihypertensive effects of this drug. Propecia (Finasteride) works in a much higher number of young men, so I tend to recommend it with little side effects. I’ve found that increased sex drive occurs in about 10% of men (it happened to me), a decreased sex drive in less than 2% of men, and a decrease in the occurance of prostate cancer in about 25% of men by a recent report.

I prefer starting on one first, usually Propecia, and then after a year if the goals are not met, I may start the patient on Minoxidil.

November 7, 2005

Hair Loss from Climate? – Balding Blog

ok, so far very few people have been able to answer my question. i have been living in dubai for 3 years and after a summer in london i’ve been experiencing hair loss every year. i am using bottled water as there is chlorine in tap water here. have been told that the hair loss is possibly due to the climate and air conditioning in the buildings. if so, then what can i do to stop this hair loss? my diet is the same and i use only good shampoos, etc and plus i take vitamins. in fact i do mostly everything i know to keep my hair in good condition. it is naturally dry. please help!!!!! many thanks

Hair loss is not caused by climate. If you use a head dress, then you could be producing traction from it and this would/could cause traction alopecia. Chlorine without toxicity, will not produce hair loss nor will any reasonable shampoo that is commercial. You need to be evaluated for male patterned hair loss (assuming you are a man and not a woman — sorry, you didn’t specify) and this would take a good microscopic assessment from various areas of your scalp to determine the degree of miniaturization of the hairs in those areas. If you have genetic balding there will be patterned hair loss (in men) and Propecia and much of the material on that drug reflected in this blog and on our website is appropriate for you to review.

Paid advertisements (not an endorsement):

November 4, 2005

Viviscal – Hair Loss Information – Balding Blog

Are you familiar with Viviscal tablets & are they effective???

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Ah yes, another fancy name of yet another “miracle” solution for hair loss. In looking up this product on the internet, I found the following comment on the site of a Viviscal reseller: “Although he was thrilled that I was growing out my hair, my boyfriend was skeptical about this ‘miracle pill’ I was taking, and was worried that I was taking something with a ‘secret’ ingredient. To calm his concerns, I showed him the box and he read over the ingredients, then agreed that the cartilaginous seafood extract, acerola extract, silica compounds, microcrystalline cellulose, magnesium stearate, and natural black currant flavor were more than likely safe. When I convinced him I wasn’t experiencing any negative side effects, he seemed much more at ease with Viviscal and began to realize that I would have longer hair sooner than he and I had previously estimated.”

Ok, where is the science in this? Is this the best testimonial that the reseller could come up with — “my boyfriend thinks it’s safe“??

Some months ago, NBC News’ Dateline show had a story on the results of five balding treatments. One of these treatments was Viviscal. Dateline had a physician evaluate each of the five candidates prior to beginning their treatments, and then again in six months. The person taking Viviscal was the one with no growth. So while this may not have been a perfect double blind scientific testing process, the Dateline show made a reasonable effort to compare the five methods of hair treatment. While Viviscal may not have harmful ingredients, why spend the money (about $600 per year) on an unproven food supplement?

On a side note, as I looked over their site, what initially caught my attention was that the male model shown in their site design is bald. That may have nothing to do with anything, other than the tastes and aesthetics of the web designer, but I thought it was a little strange to promote a hair product and showcasing someone with shaved head. The company seems to reflect more of an entire hair product line, rather than a treatment for hair loss. So when you ask if it is effective, I can only say that it may be effective as a good shampoo (I do not have any first hand knowledge) and the other products in the family line may be ones of personal choice. With the included ingredients (Water, Sodium Laureth Sulfate, Lauryl Glucoside, Cocamidopropyl Betaine, Pisces, Panthenol, Betaine, Lauryldimonium Hydgroxypropyl, Hydrolyzed Wheat, Protein, Sodium Chloride, Citric Acid, Propylene Glycol, Disodium Edta, Diazolidinyl Urea, Methylparaben, and Propylparaben), I do not believe that these components individually or in combination should accelerate hair growth or prevent hair loss.

November 4, 2005

Lexapro and Hair Loss – Hair Loss Information – Balding Blog

Do any anti-depressants such as lexapro cause hair loss?

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Antidepressants do cause hair loss (see Lexapro information on drugs.com). Stress is also a cause of hair loss on those who are impacted with the genetic balding defect. There is a chicken and egg scenario here; which comes first? Speak with your doctor about switching medications or in helping you deal with the stress of life that may be accelerating your hair loss if you are genetically prone.

Update: This link was brought to my attention — ultimate-cosmetics.com.