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Class 4 pattern of hair loss in 18 year old (photo)

For 18 years of age, you already have an advanced Class 4 pattern of balding and based upon your family history, you may lose all of your hair. I would want to know who you take after in your family. You appear blonde (that is good) but you are a person who needs to see a doctor and develop a Master Plan because it looks like you are likely to lose all of your hair other than the permanent rim of hair around the back and sides of your head. There is no substitute for a one-on-one with a good doctor who specializes in genetic hair loss in men.


2020-12-07 12:23:36Class 4 pattern of hair loss in 18 year old (photo)

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Class 3 balding reversed by minoxidil in 3 months (photos)

First pictures was when he started the minoxidil, the second picture was one week later and the third picture was 3 months after he started using minoxidil. This is the most remarkable results I have ever seen from minoxidil alone. It tells us that this drug is worth trying as it does work for some people very well. This man posted his photos on Redit


2020-04-04 13:54:43Class 3 balding reversed by minoxidil in 3 months (photos)

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I Have a Class 3 Balding Pattern and Have an Interesting Story to Tell You About My Shopping Around

I met with Dr. X in a paid consultation which costed me $150. I am 33 years old and my father also had a Class 3 pattern of balding, so I clearly took after him. I tried the drug Propecia, but I had sexual side effects. I knew that only a hair transplant would work for me. So, I shopped around and finally ended up with Dr. X. During the consultation, he said I was a good candidate, but he would not do my surgery. I asked him why, and he said I took too much time asking too many questions about what he would do. He said, “My patients trust me and don’t ask questions.” I was floored so I guess we both decided that we were not meant to be doctor and patient.

Arrogant to say the least, but he was honest. Best that you and he never worked out, because doctors like will never support you if anything goes wrong.


2018-06-22 05:52:04I Have a Class 3 Balding Pattern and Have an Interesting Story to Tell You About My Shopping Around

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Class 3 at 26 years old

I started balding at 18 with a nw1.5 now i am 26 with a nw3 and it seems somewhat stable. Is it possible that my balding has stabilized and won’t get much worse?

Yes, that’s possible, but be prepared in case your balding pattern gets worse in time

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Clarify the Best Time to Take Propecia

I didn’t really understand your answer to the best time to take propecia. You said the best time is in the morning because you get the half life of the drug being 4 hours thus reducing
concentration. Wouldn’t you want full concentration for better effects?

Like I’ve said in past blog posts, the best time to take Propecia (finasteride 1mg) is in the morning when your testosterone levels are at the highest. In reality and practicality, the best time to take Propecia is anytime you can remember to take it on a consistent (daily) basis.

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Clarify Scarring Opinion

In an answer to a previous post, you wrote:
“Only about 5% of former patient developed noticeable scarring. Most of these scars are the result of the healing properties of the patient, although some are technique dependent.”

But another top hair restoration practice, Hasson & Wong, asserts a different view:
“The single most important factors in donor scarring is the ability of the surgeon to excise the strip and close the wound from the donor site correctly. The ability of the individual to “heal well” is much less important except for a very small percentage of individuals who either heal with keloid formation or have an abnormality of collagen formation.” (from their website)

My questions are, how can two leading medical groups in the field hold such seemingly polar-opposite opinions? And, do you base your assertion on anecdotal observations, or have formal studies been published on this topic?

Much of what I say about scars is based upon: (1) anecdotal observations that I am constantly researching on my patients, and (2) direct measurements on patients whose scars I have measured before and after repairs.

I do not agree with you that our two statement are polar. I always assume that doctors are all competent and the techniques are all consistent between doctors. I know that is not always true, but I generally like to believe that doctors try their best to do their best. When it comes to wound closure, it is not rocket science. I am a surgeon by training, so I am more qualified to make that statement then others who did not invest the years of training and experience that I have. With that said, both of us are in agreement. I suspect that Drs. Hassan and Wong are not making the same assumption on the uniformity of techniques in the first place.


2005-12-02 09:26:36Clarify Scarring Opinion

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Claims regrowth from FUE scars with new drug

A poster on Reddit suggested that a new drug verteporfin , would regrow hairs that were removed by FUE. The proof was shown here without before pictures of the same area after the FUE was performed. This is an incredible claim not backed up my this photo. Proper scientific investigation would have to be done. What this photo suggests is that the area on the left, didn’t have FUE. My comment is: prove me wrong.

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Chronic Thyroiditis and Hair Loss

Dear Dr William Rassman,

I’m a woman and I’m 30 years old. I’ve been losing my hair for 13 months, 150 hairs per day and a lot of them when I wash my hair. They have informed me that I have the telogen effluvium and a miniaturization of my hair. I have no problem with my health and hormones. Only a problem (Hashimoto thyroid), but the TSH is normal. What can I do for that? Can I expect that with the time, the hair loss will be stopped? Have I a risk to become bald? I have a lot of hairs, and 10 years ago I have had the same problem and the hair loss had been stopped 2 years later.

Thanks for your help.

The connection between Chronic thyroiditis (Hashimoto’s disease) and hair loss has been known for some time. Clearly, your thyroid needs to be under good management, then pulling back and looking at the hair loss under the guidance of a good dermatologist would probably be the best way to command what is going on with your hair. I doubt that you will go bald, and you probably will find that control of the hair loss will be like your last episode years earlier. Women almost never go bald, but they can push thinning at times. If it had reversed before, then you might safely assume that it will reverse to some degree again. The focus, as you so rightly concluded, is to stop/contain the hair loss. Like a chicken and an egg scenario, what came first? Chronic thyroiditis may have layered on top of the female balding genetics in your family line.

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My Cholesterol Went up Since I Have Been on Finasteride. Is There an Association? (From Reddit)

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China’s Last Eunuch Was Bald?

I read this news story about the last eunuch in China, named Sun Yaoting. At only 8 years old he was castrated… and looking at photos of him before his death in 1996 shows he was clearly bald. I thought castration was the “cure” for hair loss, not that anyone should ever go that far of course. So what’s the deal?

Here’s the news story: LA Times
Here’s the photo of him from the cover of a book: Book cover

Assuming that the castration was complete, there at least two explanations that come to mind:

  1. He had testosterone production from non-testicular sources. We known that women have testosterone and when they lose their estrogen support at menopause, they developing balding.
  2. This may show the phenomenon called apoptosis (a cell that has reached the end of its lifetime) and that the hair in the “patterned” areas had reached the end of their life.

I haven’t read the book and don’t know if there are photos throughout, but I would love to know what he looked like at age 40, 50, 60. Was he that bald at 40, 50, and 60 years old? We only have scant facts here, and I tried finding other photos online but just came up with that same one used on the book cover.