Balding Blog

Hello,

I am a 25 year old woman and I have been losing my hair since the age of 12. All of the women in my family have been affected, but I am the first to lose it as such a young age and actually have it the worst. I am generally bald in the front and have thin hair everywhere else, but it’s not bald. I currently am using a weave, but I’ve noticed that is has actually become worse and I’d really like to lose the weave and have a natural hair line. Is New Hair catered for men only, and if not, can I be helped?

Desperate in Brooklyn

First of all, you should see a good doctor who knows about hair loss in women. Since you are in New York, I would recommend you set up an appointment with Dr. Robert Bernstein at (201) 585-1115. He has offices in Manhattan and New Jersey and can address your unique problem. It sounds like you do have genetic female hair loss, but first let’s get an expert to determine it. You must have a full check-up to determine if you have any metabolic diseases as well. For more questions and answers about female hair loss, please click here for previous blog entries.

I have been taking Propecia for about 8 years. My wife and I are anxious to have another child. I completely stopped taking Propecia for about 5 months when my wife and I started trying to have our first child two years ago as I was afraid of side affects. He is perfectly healthy. Was that necessary or advisable? Should I stop taking it while we try to conceive again? Thank you.

There are many answers to this question depending upon the doctor and his interest in practicing and giving advice on what could be sensitive medical legal issues which are at time at odds with what is in your best interests. Very little, if any, Propecia comes from the sperm into the woman’s womb. Merck (the manufacturer of Propecia) does not warn men wishing to have children to stop taking the medications for your situation. That, in itself, tells much of the answer to your question. Some doctors, however, tell their patients if they are worried to do the following:

1. stop taking the Propecia during the one week that fertility is present or stop it through the entire period from conception to the delivery of the baby
2. use a condom when your wife is pregnant
3. stop the drug completely during the entire pregnancy

I feel that the first part of #1 may be wise if you do not trust the drug company disclosures and to adopt #2 if you are really worried. These two steps are extreme, while #3 is almost crazy because you will abandon all of the benefits of the drug and get progressive hair loss during the 9 month pregnancy period, based upon no evidence that this is a problem. See my previous answer to this question here: Taking Propecia While Starting A Family.

I know you recently stated that you were reviewing the progress on transplants using body hair. Have you done any case studies? Do you believe this will be a viable alternative to those prone to scarring with donor hair taken traditionally from the scalp. Since many like me have a chest full of hair with, I’m assuming limited donor hair due to previous surgeries.

I have had three previous surgeries, none within the last six or seven years. My last surgery having been performed by Dr. Bernstein. I have had considerable hairloss since my last surgery. I am thinning to about a 5A. I have two linear keloid scars in the back of my scalp. Not to mention some cobblestoning in the front of the hairline, that is very difficult to hide with the increased balding. I would really like to have surgery soon, but I am worried about further scarring, and receiving transplants producing little or no real hair growth for my money and time. By the way, I am African American.

I would suggest that you consider another visit with Dr. Bernstein. With that said, body hair transplants are still unproven and are experimental procedures only, at this time. In African Americans, the risk of keloid scarring is higher than in Caucasians, and you have a higher risk of keloid scarring on the body than on the scalp. In addition, the recipient site will almost certainly develop white scars. In an African American, these scars may become very noticable, far more than in Caucasions. Read the past blog entries for my previous posts about body hair transplantation here, here, and here.

Im fifteen years old with a weird high hairline. It is goes into an ‘n’ shape like my hairline is receding. I’ve been made fun so much and I need to find a surgery quick!

There is never a ‘quick’ answer for a 15 year old. If you are like my daughter was in her teens, yesterday is never soon enough, but if you have a high hairline, it can be treated (see previous blog answer on this subject in High Hairlines in Women). If you bring your parents in to a competent plastic surgeon’s office or a hair specialist like me, we can discuss what can and should be done to deal with your concerns. At the same time, a specialist’s opinion is valuable in itself.

Hello. I am 24 year old male, who believes I am suffering from diffuse unpatterned alopecia. My hair is thinning evenly over the top and the side of my head to from the classic horseshoe pattern of a Norwood class VII. I have been taking Propecia since January and i do not believe its working as the thinning has progressed. My dermatologist did not seem to concerned and told me to continue taking it for the full year before asking for any other options. Are there any other effective options available? I have read about Avodart and minoxidil, or the possibily of a chemical imbalance, but I do not know if they are effective for this condition.

I believe that DUPA can be reversed with Propecia. I see this in about half of the patients who are taking it. For those like you, it may be worthwhile, after trying Propecia for a year, to consider Avodart, but I have said many things about this drug which you should review.

I have experenced hair loss after each one of my pregnecies. I have three kids,while I was pregnant my hair was fine. I have seeked medical advise, I was told stop having kids. Can you tell me if hair loss after pegnancy will ever correct itself, in other words will it grow back?

Some doctor’s amaze me with ridiculous comments like, “Stop having kids”. Hair loss with pregnancy is common and most women who experience it, like you, will see the process reverse within the first year after birth of the child. Have as many kids as you want. The hair loss, unfortulately, may recur with each pregnancy on a non-permanent basis, unless you have genetic female balding.

I answered a similar question about a week ago, found here.

Hello Doc,

I’ve wrote once before. I appreciate your reply. My question is I now have been using propecia for 1 1/2 months now. Sincerely, my hair thickness has degraded significantly. It has shed to a point where my scalp is visable in many areas. Maybe I am one of the small % of the crowd, but definate loss is more since AFTER initiation of treatment. Also, with reading in many different sites and encyclopedias, prostate cancer % is decreased in men, but tumors or certain cancers are more agressive. Also toying with testosterone and estrogen levels is not recommended. There are tons of products out there, I think most are scams fishing for suckers. I found this product called Procerin. It sounds safer to me. I value your professional feedback. If you don’t recommend this product, and I feel propecia isn’t the answer for me, please tell me the best product to use without scary sounding side effects? Thank you for helping…

I originally commented on Procerin a few months ago (found here).

I have read various articles about Procerin on the web, and there is an unsubstantiated claim that it is a DHT blocker. It might be right, but I can’t say for sure, as it is not FDA approved for that claim and good science for Procerin is just not there to give me comfort that claims can be substantiated. Your problems may not be related to Propecia, but you can always stop the drug and see what happens. I suggest that you take (whatever you do), one step at a time. Stop the Propecia if you want to see what happens. I would hope that any ill effects will be reversible in a month or two if you go back on it. Do not bind yourself to a medication you are not comfortable with. If you believe in Procerin, then try it after being off Propecia 6 weeks or so. Then see what happens. There may be competitive inhibitors to the DHT production sites that Procerin might impact (if it is a DHT blocker, that is), competing with the likes of saw palmetto and other DHT blockers at the actual active site in the body. I have written much about Propecia in this blog, so you can find out other things I have said about it by clicking here. I frankly do not know and do not know how to find out the answers to your questions, however.

Good luck.

Hi Dr. Rassman,

About 3 months ago, I wrote to you concerning my situation at 7 months post-op. I had diffuse thinning in the frontal area and was a norwood 3 prior to surgery, and had 1700 grafts put in. At 7 months I was looking thinner than before my surgery, and could only find a few new hairs that were growing in, all very small (less than 1/2 inch).

Now, at 10 months these hairs (i can find only about 10) all seem to be the exact same size as they were at 7 months, and I have seen no new growth. This is very frustrating for me and I was wondering what your thoughts were. I took your advice and went to see one of your colleagues in San Jose, and he told me that I should wait until a year has passed to judge my results. But why do these hairs seem to be growing in so incredibly slowly if at all? If you could just mention what some of the possibilities may be I would greatly appreciate it.

Thanks for your time.

To keep the blog readers up to speed, your original question (and my answer) can be found here: Transplant Failure To Grow.

You should see growth by this time. I would suggest that you make an appointment to see me personally. I will try to judge what has happened. Please try to get the preoperative pictures from your doctor so that I can make a judgment as to how much original hair was there at the time of the transplant. That will help a great deal because sometimes when people report these complaints, they lost much of their natural hair and the loss may cancel out the gain. Alternatively, the growth of the transplants can be estimated by someone experienced in this field.

I’m curious how many years away you are from being able to implant cloned follicles?

I’m a 28 year-old with significant thinning in the temple region and mild thinning elsewhere. I have been taking Propecia for about 3 years trying to delay the need for a transplant. So far, it’s working somewhat. My hope (fingers crossed) is that if I can stave off the inevitable for a couple more years, you’ll have the technology to clone my follicles. I’m nervous about donor area scars and the ability to create density. I assume that when you’re able to clone follicles, you will have solved my biggest worries.

Thanks for you help.

The topic of hair cloning comes up quite often, but there really isn’t anything new to report. Similar questions I’ve previously answered in this blog can be found in the hair cloning section.

I do not expect that hair cloning will be available for commercial use in the next 10 years. The political problems alone might take that long even if we had the solution in our hands today. As it presently exists, the science may be 10 years away and that could be an optimistic view. For you to wait until cloning becomes available will mean that you will have to live with your progressive balding for as long as it takes. Most men want hair when they are younger, so going bald may not be a good answer for you.

Today, I met with a man who had a single hair transplant in 1998. He was fairly bald (Class 6 pattern) and had amazing results (unusually good hair). He told me that the hair transplant was the best investment he has ever made. Had he waited for cloning, he would not have been able to enjoy the hair these past 7 years.

34y/o female, on birth control, no visible medical conditions that I am aware. Started losing hair about 7 years ago once graduated from college and ended a three year engagemenet under stressful lconditions. Hair loss has progressedandrecentlynoticed the amount of thinning as I had a head full of thick hair. Now thinner, and every night shwer, there is always some hair in drain. Ihave tired multivitamins, Kevis, Advecia, and Hairgenesis….the vitamins helped but still falling out. I dont knowwha tto do….I am 5’2″, weight about 115-120 pounds. I was addicted to laxatives at one time but have since recovered. Could I have a vit. deficiancy? hormone problem dueto birth control? My thyroid checked out fine. I dont want to be 40 and bald. I have no children, no otehr medications.

It is hard to know exactly what the cause and solutions might be via email without first meeting you. My suggestion would be to please read my many answers to women with hair loss. I discuss the medical work-up required for women, plus the causes for it. A good doctor to check you out and a good hair doctor will go along way to help you focusing upon your hair loss problem. I am sorry to sound evasive, but hair loss in women is a difficult differential diagnosis.