Balding Blog

Hi Dr. Rassman,

I’m writing you to ask whether significant hair loss over the course of a couple months can be due to just MPB? Last august, I had a nearly full head of hair, but I admit it was a little thin on top. THEN, I started medical school and my hair is now thin both in front (along the hairline) and even more so at the crown. Did the stress, lack of sleep and not-so-great diet I’ve been eating simply exacerbate the balding process, or could there be another problem?

I’ve actually already seen a dermatologist regarding my hair-loss, but he didn’t ask me about the time frame whatsoever, so I figure there’d be no harm in asking you for a second opinion. He recommended I start taking finasteride and using minidoxil daily, which I’ve been doing for about a month now. Excuse my complete lack of medical knowledge on this, but I’m just a first-year, so we haven’t touched upon it yet.

All the best

There was a story I remember learning when I was in medical school, that a few years before I attended one medical student practically lived off of Twinkies and junk food. He developed scurvy from malnutrition. That is an extreme form of poor diet and I will assume your diet is a bit healthier.

With respect to my recommendation, I really do not have one to give you other than to follow your doctor’s advice. You need a medical diagnosis and a treatment plan and someone to follow up with you to see if that treatment plan is working.

In general, stress may accelerate the genetic process, but it is not a direct cause and effect type of relationship. I don’t know how old you are, but it could be quite possible that the timing of your MPB starting is coincidental to the start of your schooling.

Almost every day I get emails (because of my internet presence) from patients who had surgery and find their doctors don’t seem to answer their concerns and questions. Many of these men see an abrupt change in the doctor when compared to before their surgery. I guess it is like being sold a used car and the salesman is all over you, attentive to your every need, until…. that is, you purchase the car and have problems. As they already got your money they don’t to have to be responsive anymore.

Being a good doctor means taking care of the patient and all of his/her needs before, during and AFTER the hair transplant. I find, however, that I am stepping up to help those whose doctors just don’t seem to care about them after their surgery. This may be more of a problem as Medical Tourism is becoming very common (I get both types of post-surgery emails). If for example, you go to Turkey and have a surgical procedure, then go back to your home country, local doctors will have no interest in you and the doctors in Turkey (assuming that they were doctors – which is often not the case) certainly have no structure put together to help you in your home country.

My advice for anyone reading this post is to meet and speak with patients who had surgery with that ‘doctor’ you are considering before you make the decision to go with that doctor or that clinic. Their patients will always share with you what their experience was, so this way you hear it first hand and will avoid the problems if you listen to what you are told.

Dear Balding Blog,
I recently went through a very stressful experience and now 1 month later, I noticed that my hairline has matured or possibly receded around the temple areas. There are many factors I have considered (stress, wearing my hair in a side part, maturation of the hairline), do you think I should begin to take action and see a doctor?

Without knowing how old you are or any of your medical or family history, it would be impossible for me to say what you might be experiencing. So yes, if you’re concerned you should see a doctor for an in-person examination to help determine what is causing you recent loss. At the very least, you should get your stress under control.

New hair replaces the dormant hair in the normal anagen/telogen cycle anywhere from 2-6 months dependent upon the age and sex of the person

Dr. Rassman,
Thank you for providing this informative blog.

I have a question, I have been taking Propecia for 8 years now. But in just the last 3 months I lost hair noticeably in the entire area from the mid section to the front hairline. I think this is the result of stress, lack of proper sleep and not using Minoxidil since the beginning of the year. Can I “hope” that if I start Minoxidil 5% (I had used 2% for over 12 years), reduce stress and get more sleep, I may see some of that hair back? My experience so far is that once I lose hair, it’s gone, I just try to keep what is there.

I’m 48, male, and have had 5 transplant procedures over the last 14 years.

Thank you!

There’s no clear cause for the rapid hair loss you’ve seen in the last 3 months. Since you have had multiple hair transplant surgeries, perhaps you should follow up with your transplant doctor and get a good examination.

The hair loss could be stress related, but it can be anything. You can try getting your stress under control to see if that helps slow the loss down, but I cannot provide more input from such limited description.