Hi Doctor Rassman. I had a hair transplant a few years back by a very respectable doctor, and while I’m generally quite pleased with the results, my hairline is a bit asymmetrical. How normal is it for a natural hairline to be higher on one side?

Thanks!

In nature, the hairlines of non-balding males are usually symmetrical, but occasionally they are not. I do not have statistics on this. In the balding hairline that is receding, it is common for one side to recede higher and faster than the other side.

I have, even under the best of conditions, noticed the hairline slightly off balance after the transplant. I routinely draw the hairline and then have the patient (and if he’d like, his family and my surgical staff) provide input and between all of us, we usually hit it correctly. Just this week, I saw a patient who had the hairline higher by 1/8th inch on one side. Here’s his photos — click to enlarge:

Before (left) / After (right):

The after photo is 8 months since I did a single surgery of 2328 grafts. Upon seeing the slight unevenness, I offered to fix it the following day at no charge. He was visiting California from across the country and I wanted to address it before he went home. It took 249 grafts on the one side to balance it out. I won’t have photos of the final hairline for a while since the procedure was just done, but here is the area I’m talking about:

I’m currently a 3 on the Norwood scale and I see some miniaturization in my crown. Someday I’ll probably reach a 6 on the Norwood scale like my father did, but lets say for some reason I were to progress as far as a 7, when would that miniaturization be present? Would a doctor be able to find it now even though I’m only a 3?

I am not a psychic and I cannot predict the future. If I could, I’d be 100% correct with my Oscar picks. Alas, I was not.

Not everyone loses hair at the same rate from a Norwood 3 to a 6. More importantly, you may never progress to Norwood class 6 or 7. Maybe you will just be a Norwood class 3 or 3V. The Norwood Classification is not meant to be seen as a progression of balding. It just describes the many variations of how bald men look. You can, however, influence what type of balding pattern you will get by treating it with medication (finasteride) which may halt your hair loss. It almost certainly will slow down the rate of progression if you will follow in your father’s footsteps.

Hi i had a question about propecia. I used this (generic Finasteride) for nearly a year, however i never had any regrowth of hair. I seemed to maintain my hair to an extent, but i still was thinning. I’m curious do you think the medication was stopping my hairloss from progressing or is it more likely that the propecia just was not doing anything and i was buying more pills in fear of losing my hair? I stopped taking it for about a few weeks now and I’m not too sure if the hairloss that will continue from here is going to be from lack of medication or just the medication didnt work?

It was likely that the Propecia (or generic equivalent) was keeping your hair loss from progressing. Not everyone will see regrowth, but just halting the loss is considered effective. If you stop taking the medication, you should expect to see the loss continue in a few months time. If you don’t see more hair loss within a year, then you’ll have your answer.

It doesn’t sound like you had any kind of exam before or during your treatment, so I really don’t know how you can compare the before and after results. You’re taking a gamble by stopping the medication, but it is ultimately your call to make.

(female) I’d had a bald spot since birth, possibly a birthmark and possibly a scar from my extraction. At 20 I had an stapled excision. Now I’m curious, Is hair meant to grow in the area where the staples were, or will there always be a bald line? Is there anything I can do to improve my chances?

The general concept you should understand is that if you have a scar where hair previously existed, regrowth in that area more than likely won’t occur on its own (though it can depend on how the closure method was done). However, transplanting hair into the scar should see growth just as it would if we put it on the frontal hairline area or on the tip of your nose. I’ve performed hair transplants procedures into scarred areas from head trauma, but I’m not sure how big of a bald spot you’re talking about and whether it’d even be worth having a transplant to fix it.

Hello Doc. I was wondering if long term use of benadryl could cause hair loss or hair thinning. I usually take two 25 mg tablets before i go to bed. Sometimes I take three. Also, could taking a large dosage of benadryl have any adverse effects on hair? I was wondering this because i accidentally took two doses(total of 4 25mg pills)in the span of an hour. This is a really great website. Thanks.

I’ve not heard of any connection between Benadryl (diphenhydramine) and hair loss. Antihistamines like diphenhydramine are not known to cause any kind of hair loss, even at higher dosages. There could always be exceptions, but I doubt you’ll see a problem.

I just read this article about hair loss on MSN — The Naked Truth About Baldness

They basically say that you shouldn’t bother medicating for MPB because the results aren’t worth it. They don’t even mention surgery as an alternative to medication. I was wondering if you believe this had any merit or if it is just lazy irresponsible writing.

The author of that article concludes the piece by saying, “From a medical point of view, there is no need to treat male pattern baldness. At best, the treatments are expensive and only partially effective.”

The medication treatments aren’t necessarily that expensive and effectiveness depends on the person. Surgical hair transplantation cost can vary depending on how much is required, but there have been some beautiful results. From a medical point of view, he is right — you do not need to treat male pattern baldness. It isn’t a life or death issue. But from a social point of view, I think millions of men would disagree as hair plays a very real and important role, defining our youth, virility, and sex appeal. Celebrities like Michael Jordan, Bruce Willis (pictured), and Jason Statham may be the exception, but hair is very important to most of us! That should be fairly evident by the thousands of emails I’ve answered on this site.

Male pattern hair loss is not a disease and there is no cure for it, though medication such as Propecia and Rogaine can slow the process down dramatically in some people, possibly even reversing it in younger men. Hair transplantation may not be worth it for some people (such as the writer of the quoted article), but the solutions are absolutely natural and undetectable when done in the hands of an artistic and competent hair surgeon.

My hair seems to fall out every year and then it grows back. I can comb my hair and the comb is full of hair. Right know my hair is falling out and I noticed a bald spot on the left side of my head. I read so of the other people’s concerns and you stated that your hair don’t fall out year to year. In my case it does I wrote it down and it always happen in Feb-April each year. Please tell me what I can do about this.

I would want to know if you are using a tight hat or if you have done anything different during this time period that might cause the hair loss you see. Normally, humans have asynchronous hair cycling, which means that we lose on average 100 hairs per day and regrow the same numbers of hairs. In a 3 1/2 year hair cycle, the entire 100,000 hairs will replace themselves.

Some doctors think that humans may have more hair loss in the spring and less during the winter when it is colder, but frankly, I don’t believe anyone really knows. I can not explain your problem, but if the hair did not come back on schedule, I would be more than concerned.

Hey so I’ve always noticed that the right side of my hairline goes up a little farther than my left side. I’ve also noticed that the temple “triangle” has been shaped differently. As long as I can remember (and looking back at photos from when I was in HS), my hairline has never been straight. My maternal grandfather had a full thick head of hair, but my grandmother’s father was bald (on my moms side).

Is it possible that I have just a funny hairline and that I’m not going bald? All around my head the hair seems to have a uniform thickness and I really only see some hair in my towel after I shower. How can I tell if my hairline is pushing back?

You’d have to take measurements and compare them over time to see if the hairline is receding, but having an asymmetrical hairline isn’t unusual and doesn’t necessarily mean you’re losing your hair.

As for seeing hair on the towel — that can be normal. We lose 100-150 hairs a day normally as new hairs grow in. With styling product in your hair, sometimes those hairs can get trapped on the scalp and a hot shower will break up the gel or whatever you might use and release those hairs… and the towel or the drain is usually where you’ll find them.

Photo source: Flickr

Snippet from the article:

Researchers have found that the gene p21 appears to block the healing power still enjoyed by some creatures including amphibians but lost through evolution to all other animals. By turning off p21, the process can be miraculously switched back on.

Academics from The Wistar Institute in Philadelphia found that mice lacking the p21 gene gain the ability to regenerate lost or damaged tissue. Unlike typical mammals, which heal wounds by forming a scar, these mice begin by forming a blastema, a structure associated with rapid cell growth.

Read the full article — Humans could regrow body parts like some amphibians

Essentially, their research shows that blocking this gene will cause cells to act like stem cells, which would allow them to create new tissue rather than just heal the damaged tissue. This, of course, is incredibly early research and has not been studied in humans. We’ll see where this goes.

Recently restarted Propecia on Dr. Bernstein’s advice. After one week, pulling out crown hair takes as much effort as hair in the permanent zone. Previously crown hair would come out with the slightest of force. Now it really hurts to pull crown hair like permanent zone hair. Does this mean it is working? Pity is, not much crown hair is left.

It probably means that the Propecia is working, though it might be a bit late for you though. I have reports from patients that have started the medication and saw their hair loss stop cold in just a few weeks. My advice — stop pulling on your hair.