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My Dad Was Completely Bald at 35 Years Old, and I’m 39 Now…

Hi Dr Rassmann,
currently i am a norwood 2 to 3, i am 39 years of age started to notice hairloss around 21 years of age, same as my father.i have been on proscar for 9 years all good with a touch more hairloss in crown area, recently changed to avodart. seems to be going ok. i have also recieved 2300 FUT in the last 10 years or so, with good results.My concern is this,my late father was close to a norwood 7,at 72 years of age, also had senile alopecia (thinning sides and back) mothers side no balding, well norwood 2 maybe her father couple of uncles, same as dads side.As i mentioned before me and dad started balding at same age 21, though dad was completely bald at 35.Dad had thick hair i have very fine hair.Have i made a mistake having hair surgery?

Although you gave me a great deal of information, I can not judge you enough without seeing you to tell you what I think. Generally, at 35 years old, some miniaturization will show up in the future balding area by now. Most Norwood Class 7 patients have their hair loss pattern complete by the age of 35, so I would expect that with regard to your fear of a future Class 7 pattern, it may not occur. With regard to your hair transplants, this should have been covered by you and your doctor when you built your Master Plan for hair loss. I would revisit it again and update it based upon where you are now and the degree of miniaturization found on your scalp. Senile alopecia may be genetic, so that is a real concern, but not for the short term (next 20 years of so). If you are happy with your transplants, then I doubt that you made a mistake (assuming that it corrected what you wanted to correct) and now can enjoy the value of the transplanted hair for the future.

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My dad has a Class 7 pattern so I guess that will be me too

my dad went completely bald, so i know my future. im curious as to whats the highest (average donor) capacity of grafts someone could extract, and how much grafts are needed to make the head appear full. I know that Caucasian people roughly have 100.000 hairs, i cant understand how some fue results with around 10.000 grafts show great results whereas others with 10.000 grafts look like shit basically. is it even worth it to go for a transplant if i know im going to be completely bald? cause then i end up with some hair on my top, cant wear the sides shorts cause of scars?

You need to find a doctor who can follow you and develop a Master Plan with you for your future hair loss, assuming that you will have it. You may not follow your father’s hair loss pattern but the earlier your find out, the better. Our blog site is loaded with information to answer your questions: Two recommended posts are here: 1- https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ 2- https://newhair.com/resources/#tab-id-4

I would be happy to work with you, especially if you can get to Southern California.

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My Crown Has Hair in the Middle, But Thinning In a Circle Around It

Hi,

I’m not sure if my crown is thinning or not…. but its a strange shape…around 2inches circle in diameter with a bit of hair in the middle. The hair around it is quite dense, especially when wet, although when dry because it parts in all different directions it looks thinner.

Is this a normal crown pattern (to have hair in the middle and a circular thinner area around it)? I’ve had it for at least the last 5 years and i dont think its changed. But i also do have a slightly thinned hairline…maybe nw2-3.

I have seen this type of “donuting” in men who have had transplants in the crown years ago, and then had to face balding around the transplanted hair. The progression of their hair loss causes the crown to continue thinning, besides the permanently transplanted hair in the middle.

I do not recall seeing it in a natural balding pattern, though.

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My Connection to Merck

Can you please make disclosures of your connections with manufacturers of Propecia?

I have no connection to Merck. I do not own any Merck stock and am not reimbursed in any way from them with regard to my medical activities. I do sell Propecia in my office, but it is sold at cost plus a handling and stocking fee of $4.32. I only sell Propecia as a service to our patients.

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My College-Age Daughter Was Prescribed Finateride

Dr. Rassman, my daughter is presently attending college in Houston Texas and was just diagnosed with Androgenic Alopecia. Her dermatologist came to that conclusion after she did a biopsy. What concerns me is, she prescribed a treatment of Minoxidil and 0.5 mg of Propecia daily. I understand the Minoxidil but I thought Propecia was for men only?

She did inform her of the pregnancy risks associated with taking the drug but it has me concerned and I asked her not to take it until I get more info. I’m not questioning this doctor’s diagnosis of the problem, just her remedy. Would you think an appointment with a proven hair loss professional would render any alternative advice? It seems this sort of hair loss in women is difficult to treat but I would think there are options available other than Propecia. Do you have any colleagues in the Houston area you might recommend? We may just wait a couple weeks and make an appointment at your office when she comes out for the summer. I appreciate your time.

Androgenic alopecia is not diagnosed with a scalp biopsy! More importantly Propecia (finasteride) is not to be taken by young women! It may cause birth defects if they get pregnant. There are a minority of women past their childbearing years who do take finasteride for very specific reasons, but even those women have equivocal results. Unfortunately, minoxidil is the only FDA approved hair loss treatment for women.

Perhaps your daughter should get a second opinion by another doctor. I don’t have any personal recommendations in your area, but you can check for physicians using the doctor search at ISHRS.org… or of course, contact our office for an appointment here in Los Angeles.


2011-05-07 06:46:41My College-Age Daughter Was Prescribed Finateride

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My colleagues are reporting that they are running out of masks

Although this caricature is funny, it is pointing out the problems that many clinics are experiencing with surgical masks. Fortunately, we have adequate supply, but unless more supply is going to be available, we may do some improvising.


2020-03-04 15:41:30My colleagues are reporting that they are running out of masks

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My Brother Was Bald By 22, My Dad Was Bald By 26 — I Think Propecia Helped Me Dodge a Bullet

First off, great job on the blog Dr. Rassman. It’s probably the most valuable information regarding hair loss on the internet.

I noticed the first “signs” of MPB when i was 22 (26 now). I thought the corners of my hairline started to recede. That coupled with my brother and father being bald I freaked out and decided to see a doctor. I sought the help of a reputed NYC area specialist (I’m not going to mention his name) and upon a hair miniaturization test and the divulging of my family history he advised I go on Propecia. He assured me though that the minituarization was only slightly present just in the front of the hairline.

I got on Propecia right away and 4 years later my hair looks exactly the same short of a little more recession in the hairline but I would say that I am STILL not 100% at the mature hairline point that you describe so thoroughly on this blog.

Because my brother was pretty much bald (full NW5) by the time he was 22 and my father also a full NW5 by age 26 is it somewhat safe to assume that I may have dodged the bullet since I am 26 and not even a full NW2 yet? If it makes any difference I also physically take after my mother and in her family baldness is not common.

It is also very much possible that Propecia may be responsible for me keeping all my hair but I would want to know if there is any way to find out for sure. I would not want to take a drug I don’t really need for all my life especially with all the recent commotion about this product.

Thank you.

Thank you for sharing your story. I guess the way to find out for sure if Propecia was responsible, you’d have to stop taking the medication and see if your hair falls out. Not exactly ideal, and not something I’d recommend.

There’s also the HairDX Finasteride Response test, but it won’t tell you if Propecia is the reason you still have hair on your head. It should tell you if you’re responding to finasteride, though.

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My Brother Has a Different Dad, And He’s the Only One That’s Balding

Hello, just a question from yet another freaked out 20 year old.

Ok, so neither side of my family has a history of balding. The only stand-out is my brother. He’s going bald, but he had a different father than me. Could his father’s genetics have played a role in his unfortunate fate?

Also, I’ve read that a “mature” hairline is a euphemism for receding hairline. What would you say about this? Thanks for your time.

Hair loss in most men is genetic, and it can come from either the mother’s side or the father’s side (or both).

As for the mature hairline, we have extensively written about what that is ( see here). It is not balding in the traditional sense and it is not a progressive recession of the hairline. Some men see their hairline mature and don’t see any patterned loss beyond that.

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My Boyfriend Is Concerned About His Hair

My boyfriend is 25 years old and has already started to go bald, he won’t leave the house without a hat. I can tell that it is really effecting his self-esteem. What can he do?

Your boyfriend has what appears to be early hair loss, an indication of male pattern hair loss. He should see a doctor who specializes in hair. He should meet with a doctor experienced in this field, get a HAIRCHECK test (invested capital for me ) to find out just how much hair loss he had and where it is, both what he can see and what he don’t see. Then with proper treatment, maybe he can stop the loss, possibly reverse it before he becomes bald


2020-01-24 14:47:49My Boyfriend Is Concerned About His Hair

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My boyfriend doesn’t realize he’s balding

My boyfriend is 22 and is quite noticeably balding on the top of his head. I’ve never said anything about it because I figured he was probably already aware and bringing it up would just come off as rude and hurtful. I really don’t care — sure, I like his hair, but that’s a very minuscule part of what makes him attractive to me.

Recently, though, he mentioned to me that he took creatine briefly while trying to bulk up for a role in a play where he had a shirtless scene. He said he stopped taking it pretty quickly after his doctor advised him to avoid that stuff. He said “I heard it can make you lose your hair and my hairline is already going a bit.”

Take a read of these post: https://baldingblog.com/combover-madness/ and here: https://baldingblog.com/goodbye-combover-hello-hair-with-photos/. Many men practice denial all the way from early thinning to complete balding as suggested here. Some eventually with the help of a wife or child, find out. I, for example, didn’t know my crown was bald until my oldest son (about 18 at the time) commented on my bald spot in the back of my head. When I became a hair transplant surgeon, my wife told me that it would be bad for business if I had a bald spot, so I fixed it. Some men just don’t pay attention while other deny it.


2020-05-04 12:53:51My boyfriend doesn’t realize he’s balding