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Here’s a new quote from Microsoft founder Bill Gates:

“There is more money put into baldness drugs than into malaria,” Gates quipped, triggering laughter. “Now, baldness is a terrible thing and rich men are afflicted. That is why that priority has been set.”

From this article — Bill Gates playfully frees swarm of mosquitoes

To be fair to Bill Gates, malaria is life threatening, whereas hair loss is not….

I am often asked why hair transplant patients seem to always comb their hair back (particularly in the After photos on the web). The answer is that they do it because they love their hair and want to show their normal hairline. I think that secretly, they get a thrill from taking a chance that someone might identify that they have had a transplant and they challenge that risk. You can comb your hair any way you want after a hair transplant, but by combing it straight back they can show off the hairline that they didn’t have for many years.

Here is a great example of a patient who had 4196 grafts (before and after) over a two year period. Click the photos below to enlarge.

After:

Before:

Hello Doctor,

whats your opinion on this new study, related to topical finasteride?

Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia.

Thanks

In my opinion, it is a very poor study and you cannot come to a conclusion. It only confuses consumers such as yourself. It is incomplete.

1. Only 45 men were studied. You need thousands.
2. The study was only for 6 months. You need at least a year to see results even on oral finasteride.
3. They didn’t have a group of patients who took both placebos (no topical finasteride and no oral finasteride) and this is a critical flaw and it does not adhere to basic scientific methodology.
4. Just because there were no difference in the two groups does not mean both (oral finasteride and topical finasteride) are similar. Oral finasteride does not work well in 6 months

Here’s an article from CNN about Baba Chukuri, a “healer” in Nigeria that claims to have cures for nearly everything, including AIDS. Ridiculous, right? Well, there’s money in ridiculousness.

Snippet from the article:

[Dr Uford Inyang from Nigeria's Institute for Pharmaceutical Research and Development] believes the global herbal market to be worth up to $5 billion. If any of the treatments are found to work, the local healers can receive up to 10 percent of the profits in royalties.

None of Chukuri’s treatments have yet been scientifically proven to work.

Read the full text here.

Unsurprisingly, this story reminded me of all of the crap products out there people buy every single day to treat their hair loss. Most times the only thing these products “cure” is the emptiness of the wallets of some shyster, and the buyer winds up with even less hair and hope afterward. It’s a shame people fall for this stuff.

I am almost 22 and have had a shaved head for at least 3 years. I began going balf when I was 17 out of nowhere and the process was faster than lightning. By the time I was 18 or 19 I felt I had to shave my head because I looked ridiculous compared to my peers, since none of them (still) has any trouble growing hair. At 17 I saw a dermatologist who gave me a rather pathetic once over and concluded that it was normal male pattern baldness, just setting in at a rather unfortunate age. He recommended rogaine which I used for almost a year but to no effect.

I am now almost 22 and completely loathing my appearance, it really is the cause of some pretty severe chronic depression. Now I’m interested in absolutely any solution, but I’m told (or given the impression) that there really isn’t one. Even hair transplant, apparently, is not viable for someone as far advanced as I am. (Can that be true?)

And I’m NOT going to be the 22 year old who brings back the toupee. What are your thoughts?

Also, with regard to hair cloning, is there anything worth holding my breath for in the near future?

Thanks

You need to find a good, caring doctor to sit down with you after a thorough examination of your scalp and give you a Master Plan to work with. I couldn’t tell you if you’re a candidate for a hair transplant without at least seeing you… but even if your balding is as advanced as you hint, a hair transplant might still an option. I’ve transplanted men your age with very advanced balding (see here, here).

I would not hold my breath waiting for cloning. You might turn blue before you die.

Is there a link between past accutane use and DUPA? I took accutane when I was 17 and again at 22 for cystic acne. My hair started thinning at 23 and now at age 30, I was told by a doctor I have DUPA. If not the accutane, then maybe the DUPA is linked to the same reason I have had cystic acne for 15 years?

Anything is a possibility, but I doubt there are real causation relationships at play here. One may postulate that Accutane produced more diffuse hair loss mimicking DUPA (diffuse unpatterned alopecia), but you are trying to find answers and explanations to a problem and your guess is as good as mine. DUPA is not related to Accutane use to my knowledge, nor, I believe, that acne is related to hair loss.

Hello Doctor

Thank you for your blog. I just wanted some advice regarding my situation. I’m 24 year old male, who was on propecia for a year from may 2007 to feb 2008. I was quite impressed with the results, but the development of gyno made me go cold turkey. Unsurprisingly, my hair loss is getting worse, mostly at the front, receding and thinning. I’m looking to meet a doctor with regards to miniaturization, although I am putting off a hair transplant to avoid scarring in case I ever decide to shave my head (unlikely).

I was thinking of starting rogaine 5% foam. My problem is at the best of times my scalp is easily irritated, and I’ve heard the smell of the product is awful. Would you advise me to start it? Would my existing hairs become dependent on it or only the new hair?

If you really developed breasts or breast nodules or breast pain, you need to see a doctor. You can try minoxidil but that will not help your breast problem. As minoxidil is over the counter available, you can try it to find out if you react to it, but there will be no effect for at least 8 months to determine its value. The smell isn’t awful to my nose, but each person’s idea of stinky is unique to some extent.

Hi doc,
I appear to be losing miniaturized hairs throughout the permanent zone. The onset of which has coincided with extremely bad nutrition, bad sleeping patterns, and stress that needs to quelled by Xanex. What is happening here?

This is too complex of a case for the quick description you’ve emailed… and I am not your doctor. If you’re already taking prescription Xanax (alprazolam), you should discuss the hair loss with your doctor.

Hello. I have a 19 year old son who is an actor and his hair is thinning so much we can see his scalp. He takes singulair and advair for asthma and I was wondering if you know if any of these could be a cause. My husbands’ side of the family has a lot of bald men as well as his mom’s brothers. Not my family so much, except my mom and sis have pretty thin hair. He is really worried as he is an upcoming actor. Propecia is so expensive…Is there anyway to get it cheaper and how would one know if stress is the cause..Applying to colleges was very stressful and being a freshman as well. I know he could eat better and have told him to take vitamins. I just don’t know how to help him! Would appreciate any advice..

Genetic balding in men is commonly known as androgenic alopecia (AGA) or male pattern baldness (MPB). It does not matter if the mother or father or grandparents had a full head of hair. It does not always follow a specific family tree pattern. Keep in mind that even if you have hair loss, it does not necessarily mean you will go completely bald. It varies for many men. While there is no cure for AGA/MPB, there are medications and surgery which can help. As far as over-the-counter supplements, vitamins, shampoos, or other products, they promise a cure but they often fall way short. Consumers will spend millions if not billions each year on such promises of hair growth. In the end, even proven medical and surgical treatments have limitations.

I highly doubt asthma medications (Singulair, etc) or stress has much to do with your son’s hair thinning. If your son (not you) is bothered by the thinning, he should see a physician to discuss his options, such as Propecia (finasteride 1mg). Propecia is a brand name drug that is relatively expensive because of its U.S. Patent protection. Propecia is the only FDA approved oral medication for the treatment of AGA/MPB. Since Propecia is under patent protection, generic finasteride in 1mg strength is not available in the United States; however, generic finasteride in 5mg strength is. As such, in the interest of finances, some patients (after discussion with their physician) may choose to have a prescription of finasteride in 5mg strength and break it up in the equivalent dose as Propecia. Ideally this would be breaking up the pill in 5 pieces, but that is not practical and most patients break it up in 4 pieces.

I’ve been using Organin and Toppik for almost 3 years now and whenever I put it on, the stuff goes everywhere. Only now did it actually occur to me that this stuff might be lingering in the air or that I’m inhaling it without knowing it. In the time that I’ve used it I haven’t experienced anything out of the ordinary but my concern is if it’s going into my lungs and staying in there causing harm. Again, I haven’t felt anything. Just curious if it’s something to think about?

Thanks.

You almost must be careful when you apply such powders. If you’re concerned, you may want to use a surgical mask while you apply it, then you should be OK once it is fixed to the hair and scalp.

You are the first to ask such a question, but you should certainly forward your question to Spencer Forrest, the manufacturer of Toppik. You can find them here. I don’t know who manufactures Organin, but if you can find that info you should write to them as well. I don’t know how the fibers differ in each product (as far as composition/harmfulness), but they appear to act in a similar way as camouflaging agents.