Dear Sir,
I am 23, high sex drive male & been working out for past 2 years. No hair loss what so ever, acne, pimples or anything. But for past 6 months I’ve been away from gym due to frequent traveling and now I’ve high acne, excessive hair shedding to an extent that you can see my hair all over the house and family really wants me to stay away from their stuff because it will get “polluted” with my hair. My temple regions are totally bald now but what concerns me more is bald area on left side is roughly double in size to right.

Please devise you opinion on my condition. I have a feeling that sudden acquittal of weight training has cause my hair loss since all that free test. Wasn’t being consumed for muscle building. Also my scalp itches a lot sometimes.

Best Regards

I don’t think stopping weight training can cause hair loss. Many bodybuilders experience hair loss after they use anabolic steroids. It is likely that your hair loss has a genetic source, but there are other factors that can accelerate the speed of losing hair. When people lose hair from genetic causes, it is not unusual for the loss on one side to be further advanced over the other side. Coincidence of increased acne and rapid hair loss makes me suspicious of the possibility of increased androgen in your body. Androgen can have an external or internal source. If you use anabolic androgenic steroids, you need to stop them. If you have not used any of those steroids recently you need to see your doctor for further evaluations.

I am 6 months and 10 days after my second hair transplant and I am very satisfied with the result, I am starting to behave as if I had not done a transplant seeing myself very well, so I am no longer taking the typical precautions, for example today I have taken sun and unfortunately I have not put sunscreen on the head nor cap. The sun was strong enough today and I took it for about 2 hours, I am now seeing that a red blotch has formed on the upper part of the forehead just before the hairline, but NOT on the skin, that is right where the hair starts. skin, in that point, looks white perhaps because there are so many hairs now that have protected the head from the sun. This red stain on the upper part of the forehead clearly scares me a lot now though, even if it doesn’t burn. I am reddened in that point but I don’t feel burning. The questions I wanted to ask are: at 6 months, a possible sunburn of this type can make my hair fall out: the hair regrown until now with the second transplant? Or could it compromise the growth of future hair?
I would like to understand if at 6 months I can behave as if I had not done a transplant or if there are still precautions to take, thank you very much. I hope in your answer

Don’t worry. Just be more careful in the future to use a hat or a skin blocker. The skin from the transplanted hair came from the back of the head which never saw sun, so this skin has to get used to sun over time, so take it easy and use a blocker to allow the time for a transition.

June 10th marks 6 months since my 1200 FUE graft HT on my temples (lowered hairline as well slightly). The transplant hair is growing in slowly but surely. Unfortunately, I have significant shock loss on my native hair surrounding the transplant hair. Much of this has not grown back yet. Specifically, I have shock loss in the front hairline area and behind my right temple where grafts were placed.

I met with my doc last month, and she boosted me from Fin to Dut to help with growth (I have no sides from either-yay!) She also remained steadfast that all my shock loss hair will grow back, it just takes time. However, part of me wonders if I should really believe her, if she thinks it will really grow back or if she is just saying that.

Finasteride is best taken before the hair transplant as it often prevents the loss of the native hair. Unfortunately, after you lose your native hair and then take finasteride, the effect is heavily muted. I always offer my patients finasteride before I do a hair transplant to avoid this problem. You should wait a full 8 months to see the results of the transplant and then reassess your situation.

You have to give it between 12-18 months to see if it will reverse. Add topical minoxidil along with microneedling and you have a better chance of reversal

The only way a hair transplant is normal looking after it is performed, is to transplant the natural growing groups that hair normally grows in, in their anatomical groups, i.e. the follicular Unit. The average Caucasian averages about 2.2 hairs per follicular unit and the typical human has approximately 50,000 of these follicular units on their entire scalp. So if the average hair count per follicular unit is 2.2 hairs/follicular unit, then the typical Caucasian man has approximately 110,000 hairs on their scalp. For the typical Asian, the follicular count remains at ~50,000 but the average hair count per follicular unit drops to 1.9 hairs/follicular unit for a total hair count of ~95,000 hairs. This is an average, but the range could be wide ranging from 75,000 hairs – 120,000 in any given population.

This is a picture of a 6 hair follicular unit (rare in most people) but worth showing because it shows new hairs in their growth phase. Notice that two of the hairs are shorter than the other four (marked with arrows). These are new anagen hairs growing into this follicular unit increasing the visual hair count by 1/3rd from 4 to 6 hairs. That means that possibly a few months before this follicular unit was excised, it probably had only 4 hairs that were visible. The two new anagen hairs arose from stem cells within the follicular unit. It is likely, that if we allowed this to grow (and were able to follow the hair count in this follicular unit over a year or so), the hair count may actually drop as some of these longer hairs (terminal hairs) may actually turn into their sleep phase (telogen).

These two photos show two different men responding to finasteride, 6 months on the left and 4 months on the right. This shows the value of this drug for many young men.

The issue at hand is not the blood levels achieved. A dose of 5mgs runs heart risks not worth taking for a healthy man. The point is at what level will the hair effect happen. The answer is a 2.5mgs daily, good results are seen and it is safe from severe cardiac side effects which is very rarely reported.

The average Indian has a lower density than a Caucasian of about 1.9 hairs/follicular unit (the Caucasian average is 2.2 hairs/follicular unit), so unless his hair is very coarse, his donor area is clearly depleted. He may find that he doesn’t have enough hair to cover the donor area. Additionally, this man’s FUE was taken outside the donor area. His entire remnant Class 6 pattern was harvested. If he develops a Class 7 pattern of balding, then he will lose more than half of the hairs transplanted.