Balding Blog

Dr. Rassman,

Below is a study that links alcohol and testosterone levels- Does an increase in testosterone levels necessarily accelerate hair loss in men who are predisposed to lose their hair? Thank you-

Study abstract: Alcohol Clin Exp Res. 2003 Apr;27(4):682-5. Testosterone increases in men after a low dose of alcohol.

We have known for some time that alcohol is metabolized by the liver, as is testosterone. I can not connect the dots between the casual drinker and the hair loss victim.

In my weekly MIT Review, the following statement was found: “Since the 1980’s, there have been few advancements in treatments for hair loss and thinning. Thanks to Revela’s proprietary new search engine, we now have a revolutionary new formulae. The Secret? The worlds first new molecule, discovered by AI, to help encourage follicle health regardless of the cause of hair loss. ProCenilyl ™, helps activate dormant hair follicles to stimulate growth. In clinical trials, 97% of users saw fuller hair and brows in as little as 6 weeks. Just message a few drops into your scalp, it is that simple.”

I never heard of this before, so I am a doubter as this was a sponsored advertisement.

Dr.Rassman, you’ve written much about dermatitis and hair loss. It seems that in your opinion even the worst case of sebhorrheic dermatitis (excessive plaque, high levels of sebum, chronic flaking, bleeding etc.) doesn’t contribute directly to hair loss – especially of the patterned kind. However many people out there believe the two to be linked, including many physicians. I just came across an article from a non-profit organization called the American Hair Loss Association detailing various hair fungi and scalp conditions.

In their discussion of dermatitis they claim that, and I quote, “Although all this inflammation is not specifically directed at the hair follicle, if hair follicles are in the vicinity of the inflammatory cells then they can still be adversely affected. Hair follicles find inflamed skin an unhealthy environment in which to grow. Thus seborrheic dermatitis may non-specifically cause diffuse hair loss.” Is this a reputable source and how would you respond to this claim?

*The full article can be found here: AHLA – Infectious Agents

Flaking of the skin from seborrheic dermatitis itself does not cause hair loss, but if the scalp is picked and the flakes are pulled off, then hair loss can be a result of that process (meaning the hair will come off with the plaque). If a person picks on it regularly, that person can develop traction alopecia or even a condition called dermatillomania, a form of OCD.

I usually point out to our readers that the most common cause of hair loss (in men) is related to genetics. The differentiating factor for male pattern (genetic) hair loss from other types of hair loss is the “pattern” of the loss… but there are other causes of hair loss aside from genetics. Hair loss can be from fungus, psoriasis, anemia, immunologic, infections, stress, etc and many of these conditions may appear like a form of dermatitis. These types of hair loss can be diffuse or patchy, but there is not necessarily a cause and effect between the skin condition and the hair loss.

The American Hair Loss Association is a good, well meaning organization. I just do not agree with the opinion that they expressed connecting seborrhea to hair loss directly. I’m not sure where they got their information about that.

Hello,

I was hoping you could explain to me what exactly is “aggressive” MPB versus “normal” MPB? How would you diagnose or differentiate between the two?

Thanks

You may be relating the rapidity of the loss that occurs with genetic balding. Some people bald faster than others and this is mostly a genetic process. To make sense out of your question, I would have to see you and examine you myself.

I read some comments around here on posts from people who are 17, 18 years old. Many say that there is not much that can be done in those cases, and that one should simply accept that all is lost. I’m 18 and I think my baldness is aggressive. My hairline has always been high, but at 16 I saw it was receding a bit. Two years later, I have a nw2.5-ish hairline, and it turns out that my alopecia is retrograde. However, my hair is very thick on top. On the sides and back, not much, due to the fact that it is retrograde.

One year ago, I realized that things were getting a lot worse. From May to December, I can say that I went from quite-good-hair to obviously balding. I started topical minoxidil in November, and I’ve been using it to this day. Finasteride only started being part of my regimen three months ago (almost four), at the end of January. I’m losing about 100 hairs a day in the shower, but I can say that my hair is still the same as it was at the beginning of the year. Considering how aggressive the progression was, I don’t know what my hair would look like now if I hadn’t done anything to combat the baldness.

I’ve heard reports of guys saying that they started going bald around the time I did, that they had started treatment, but at 24-27 years old ended up losing all their hair. Therefore, I would like to know if it is true that attempting to combat aggressive baldness at a young age is in vain.

I have seen men 17-18 whose fathers had a Class 7 pattern by the age of 22 and they are now looking just like their dads. I am not sure that today’s medications can stop this balding process, but it is worth a try. Most men can get a hair transplant and prevent the balding appearance; however, most reputable hair surgeons will not tackle a 17-year-old even with parental consent because of maturity and financial issues. Too many young men can’t handle the decisions on hair transplants at 18.

This is a great read: https://www.newyorker.com/news/news-desk/is-the-age-old-quest-for-a-baldness-cure-reaching-its-end?mbid=social_facebook

Never (for a man) get a hair transplant before the age of 25 because the balding pattern does not declare itself until at least this age. You should build a Master Plan with a great doctor so that your hair transplant plans are carefully considered and reflect your specific short and long term needs.