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My Doctor Diagnosed Me with MPB Right Away

Hey Doctor Rassman, I have a question regarding early MPB. I’m 19 years old and my hair recently started thinning at the hairline and my temples have very slightly receded. It’s not at a stage where the untrained eye would notice, and my friends who I’ve pointed it out to think I’m crazy, to give you a picture of how early it is right now. But my dermatologist diagnosed it as early stage MPB right away when I asked her about it and she prescribed me propecia. So my question is:

Does thinning/receding at such an early age usually indicate a more serious case of balding? Does it generally mean more aggressive balding as well as a eventual higher NW# pattern? I know it can all be so very random sometimes, but I’m just wondering what the average case comparable to mine usually ends up at, if there is such a thing.

Starting age of your hair loss doesn’t indicate degree of future balding. You could start early and get to your pattern quickly… then stop losing hair. It’s different for each person, obviously.


2009-03-31 13:42:29My Doctor Diagnosed Me with MPB Right Away

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My Doctor Advised Against Washing Recipient Area for 2 Days After Surgery

i had a procedure done at another clinic yesterday. they advised against washing the recepient (graph) sites for two days. essentially allowing scabs to heal and fall off two weeks later. I am in the public eye(professional speaker) and had to have a thorough celeaning today. So i di wash my scalp today against there written directions. i was able to see the removal of 75% of the one day old scabs and it looked like 8-10 graphs came out as well. I did not sit under the shower i used the cup pouring method and the gently rubbed the scabbs with my figertips..am i alright or did i maybe wash away my follicles unknowingly? again i saw about 8-10 in my scalp dislodged after the shower. did not look like many came out…no bleeding whatsoever by the way. your thoughts?

I always have the hair washed within the first day after surgery and offer that process in my office for our patients. The key to a fast recovery is to get the scabs washed off fast. The longer they stay in, the longer you must be gentle with the wash. In the hands of a professional wash, the wounds will be very clean by the very next day. We also wash it vigorously at the end of the procedure to get all of the crusts off quickly. Unfortunately, many doctors do not focus upon getting you looking spiffy in a day after the surgery.

This patient below came in one day after surgery and the pictures were taken immediately after he had his hair washed. The recipient area has an obvious pink hue against his white skin. His native hair was long enough (I told him not to cut his hair prior to the surgery) to cover the entire transplanted area when he combed it forward. White skin shows pink clearly and had his skin color been tan, the pink hue would not show much or at all. As you zoom into the picture, you can see the transplanted grafts and the hair contained in those grafts clearly without any crusts to increase the detection of the transplant in the bald scalp. People who have native hair with grafts transplanted between the hairs have automatic coverage from the native hair and the transplants can be completely hidden. Within a few days, the only evidence of a transplant will be the beard that appears in what is now the pink area. Click the photos to enlarge.


2006-09-16 10:59:19My Doctor Advised Against Washing Recipient Area for 2 Days After Surgery

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My Diet Has Become More Healthy Over the Past 2 Years, But My Hair Improves So Slow

I’m a 27 year old male. About 3 year ago, at the age of 24, I went to work abroad for a year. At the time of leaving home I had a full head of hair.

When I was abroad my diet deteriorated. During this time my hair became very unhealthy. It became brittle and it stared to fall out. I returned home 2 years ago and my diet has returned to normal. My hair’s condition has improved and it has stopped falling out.

Though it has improved, progress is very slow and it has not returned to its former condition.

Could you help me, please?

A normal diet should not have any significant impact on hair loss. If you were malnourished during your travels abroad, it may have had some impact. However, once you start the hair loss process, I have found that it is difficult to stop the hair loss process. Some have explained this phenomenon by analogizing to a light switch that is turned on, but can’t be turned off. You should have your scalp hair mapped for miniaturization to see it there is a pattern to this hair loss. You have a component of genetic hair loss which may not be related to the diet issue.


2007-05-22 11:33:07My Diet Has Become More Healthy Over the Past 2 Years, But My Hair Improves So Slow

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My dad and I didn’t respond to topical minoxidil

Yea doc said just not to use it. My father used minoxidil as well and he got lots of side effects just as I did. Very disappointing considering there’s barely any other options

If that was topical, he and you might be one of the 60% of men who will not respond to topical but will respond to the oral.

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My DHT Levels Dropped Significantly from 2 Weeks on Saw Palmetto

Thank you for writing this blog, it is a wonderful resource for so many people. My question is regarding Saw Palmetto. I had my serum DHT levels checked, then began a regimen of Saw Palmetto extract for two weeks and had my DHT tested again. The results showed that my DHT dropped from 62 to 22 during that period.

This is a pretty significant drop in DHT but I am wondering if there is more to the story from a hair loss perspective. Does an overall drop in serum DHT mean that it should have a similar effect to Finasteride in stopping hair loss or is there something else to the equation?

It is hard to believe only two weeks on a herb (saw palmetto) can have a significant decrease in DHT levels. I do not believe even finasteride can have that effect. I simply do not know the significance with respect to how it can be interpreted for hair loss treatment.

Please note that the human body and its functions are not as simple to just quantify with a blood test and hormone levels. For example, testosterone level may vary in your bloodstream throughout the day! It may be high in the morning and low at night, and this may even vary from individual to individual depending on their work habits, exercise habits, sleep habits, etc, etc. So DHT levels can vary as well. The conclusion or associations that you are trying to make is unclear.

DHT may be implicated in male pattern hair loss, but as we have said over and over again, just lowering your DHT level is not “THE” answer to MPB. Sorry to be a party pooper.


2010-11-29 09:53:06My DHT Levels Dropped Significantly from 2 Weeks on Saw Palmetto

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My DHT Levels are 5 Times Higher After Being on Propecia

Hi,

Before started propecia my dht levels were normal, now after 7 months i had great results but my dht levels are 5 times higher. have any of your patients reported this? or do you know anyone who happened this?

I think it could be a reaction of my body, everyone said to me to never take propecia again, but i’m really worried about my hair loss.

thanks!

It’s great to hear you had good clinical results from Propecia. This is just a blood test, but what I want to know is — what are your testosterone levels? Usually these go up initially and they drop down to normal levels within a few months.

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My Dermatologist Told Me I Only Needed Minoxidil for 3 Months to Stimulate Regrowth

I have just seen a dermatologist for the beginnings of female pattern hair loss. She has prescribed using 2% Minoxidil for 3 months to stimulate the hair regrowth I have noticed, but everything I have read about Minoxidil seems to say the stimulated growth will just stop as soon as I stop the product. The doctor said that wasn’t true. I don’t know what to do.

Your dermatologist is incorrect. Minoxidil should be used for life, or you will lose whatever benefits (regrowth) the medication provided. For best results, you should use it twice daily.

You can read more about minoxidil for women at the Rogaine site.

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My Dermatologist Stopped Prescribing Proscar for Hair Loss

I’m a male, age 27. When I began seeing a dermatologist 4-5 yrs ago, he prescribed finasteride 5 mg and had me cut it into quarters.

That went on for about a year or so, but then he said that there was some sort of regulation restricting physicians from doing this. Since then, I’ve been paying the higher cost of the daily 1 mg tablets. Was the doc telling the truth? I understand that the clinical indication calls for a 1 mg tablet, but are doctors really not allowed to prescribe the higher dosage with the understanding that the patient will do his part and cut the pill into the appropriate size?

thanks

Many doctors prescribe medicines for off label use. Proscar (finasteride 5mg) is a medication marketed for benign prostatic hypertrophy. Propecia (finasteride 1mg) is a medication marketed for androgenic hair loss (male pattern hair loss). They are the exact same drug with different strength dosing. That being said, if someone (or a computer, such as your insurance company) sees that you have been prescribed Proscar, they may think you have a prostate problem even if you were prescribed it for the intention of using it for hair loss. This is a story that is told by my Propecia drug representative – so there is obviously a bias there and I am not sure how true this story is — but it is plausible.

I give a choice to all my patients and do not favor one or the other, because they are the same medication in different dosages.

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My dermatologist says combining finasteride and minoxidil doesn’t improve results

I just got my first box of finasteride 1 mg today. I wanted to get minoxidil 5% as well, but I need a prescription for that where I live. However, my dermatologist said the action of finasteride and minoxidil isn’t synergic, and that I won’t get better results by adding topical minoxidil to oral finasteride. That’s the opposite of everything I’ve heard so far. Men do combine oral finasteride and topical minoxidil 5% exactly to get better results, don’t they?

I don’t agree with your dermatologist. These two medications have different modes of action so taking them in combination, especially for the crown, is more effective.


2019-03-27 09:42:12My dermatologist says combining finasteride and minoxidil doesn’t improve results

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My Dermatologist Said That Telogen Hair is Supposed to be Miniaturized

Hi Dr. Rassman,
I went to see a dermatologist today about my diffuse hair loss, and I asked him if the thinner hairs that are falling out now (as opposed to the thicker hairs that fell out before) necessarily pinpointed miniaturization. He said that a telogen hair is supposed to be miniaturized compared with a anagen hair. Now, I’ve done quite a bit of research on this topic, and I’ve never heard that a telogen hair was supposed to be miniaturized. Can you give some insight into why he might say this? Thanks so much!

I agree with you. Telogen hairs, when they fall out, are normal width. I have no idea why your dermatologist would say otherwise.