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What is the cause of the itch/inflammation associated with Male Pattern Baldness?

I’ve addressed this before on BaldingBlog.com and you said there is no correlation between inflammation of the scalp/hair follicle and Male Pattern Baldness. If you go on to any Hair loss forum you will see that a lot of hair loss sufferers get inflammation in the areas where they are losing hair. I have all the common traits of MPB and get inflammation on my receding hairline and thinning crown. I’ve seen a slight decrease in inflammation on finasteride but had to quit finasteride due to side effects. Since then the inflammation has become worse and it itches throughout the day. My Doctors have no clue about inflammation caused by MPB and don’t have much of a clue about MPB either. Nizoral was reccomended by forum users online and not by my doctors , it has helped a lot. This isn’t right , it is aggravating and worsens MPB. Here is a article on MPB and inflammation: Hairloss-Research.org

I don’t understand why none of my doctors and many other forum user’s doctors know about inflammation and it’s correlation with MPB. I know a lot of MPB sufferers do not get MPB and therefore it seems that is something else. From looking at online forums and MPB sufferer’s stories I have seen that it happens to people with more aggressive Male Pattern Baldness which is mostly younger people. I’m 19 and I find this hard to deal with. I have to figure out about inflammation myself. There is clearly a correlation between the two.

More articles: AndrogeneticAlopecia.com and SearchWarp

I don’t know where to start. You will have to come to grips with your balding. If you can not use Propecia for side effects reasons, you will have a problem in controlling the hair loss. The inflammation that you talk about has been reported to me by some patients and I suspect that the decreased hair bulk make the scalp drier which can produce an itch. Nizoral is a popular antifungal shampoo, so if that is alleviating your itch problem, perhaps you’ve got something going on with your scalp other than just genetic balding.

Your comments above and your insights will be shared through this site. Thank you for telling your story.

Hi Dr. Rassman and Staff, thank you for your wonderful site. I am 19 years old and I went to get my scalp mapped out this past summer and the hair specialist told me I am a norwood 3 and probably going to end up a norwood 5. The question I have is, if i am already going bald at 19 how will I not become a norwood 7 and stay at a norwood 5? Could I possibly not become much balder for a while? Thanks

We inherit the pattern that we will evolve into. If your inherited pattern will max out at a Norwood Class 3, then even if you get older, there will be no advancement to a more advanced pattern. The problem is how to guess. At 19 years old, the degree of miniaturization you see is early and it may appear in other parts of the scalp. Possibly by the time you are 25, you might see a miniaturization pattern reflective of your final balding pattern. The reality is that there is no way to be sure, so if you are balding, Propecia (finasteride) is your only way of managing the progression of it.

Snippet from the article:

Grady Jackson, a defensive tackle with the Atlanta Falcons, said he used the weight-loss capsules. Kathie Lee Gifford was enthusiastic about them on the “Today” show. Retailers like GNC and the Vitamin Shoppe sold them, no prescription required.

But the Food and Drug Administration now says those weight-loss capsules, called StarCaps and promoted as natural dietary supplements using papaya, could be hazardous to your health. In violation of the law, the agency has found, the capsules also contained a potent pharmaceutical drug called bumetanide which can have serious side effects.

Read the full article at the NY Times

Just goes to show that not everything “natural” is good for you. At least it is being pulled from the market. This supplement contained bumetanide, which is a medication used to treat edema. Some of the possible side effects from bumetanide include nausea, cramps, impaired hearing, premature ejaculation, and a variety of other things (see list). Yikes!

Hello doctors,

I am 26 years old (male) and have been taking Propecia since age 24 (when I noticed my hairline starting to recede). When I last visited my family doctor (this was the first time he found out I was taking the drug), he was quite concerned that, at my age, I was taking it. He said that the long term effects of Propecia are not known, and that he would advise against me, being only 26, continuing on with the drug.

I have never noticed any negative side affects from the drug yet, but I wanted to get a few more opinions. Do you know of significant endocrine effects?

Thanks.

Propecia can be used safely from the age of 18 and up. If you wait on its use, the balding will progress far too much to have the types of benefits it has when it is started early. Sounds like your doctor needs to be educated. You haven’t seen any side effects, so I’m not sure where your doctor’s concerns are based in.

Hi I am wondering when is the best time to get a transplant I am 33 and use HSR to hide my balding on the top of my head the front is not really bad but the top is bad… HSR works great but I am sick of hair spray and not wanting to swim because it might wash out. Should I wait till your hair completly falls out till you try and get a transplant. Will it make my exsisting hair worse? My hair will not stop falling out so I really want a hair transplant and need some guidance.

Hair loss is best treated with transplants when it is early, provided that you are a candidate and over 25 years old (general rule, though I have transplanted younger). Meet with a good doctor — in your area, Dr. Bernstein in NYC is a good choice. He will go over the process with you.

I am a 52-year-old woman with diffuse hair loss. I’m using Toppik and thinking about starting Rogaine. My question: do I have to wash the Toppik out of my hair in the evening before I can put the Rogaine on?

The Toppik tends to “clump” on my scalp by the end of the day, so if I don’t wash it out, I’ll be rubbing the Rogaine on top of the Toppik fibers. But having to wash my hair twice a day (morning and evening) seems excessive.

Thanks for any advice.

It is best to use Toppik as the last thing you do. The Rogaine should be applied first and give it some time before the use of Toppik.

I have a hair transplant procedure scheduled with a ABHRS surgeon yet I’m starting to have some concerns due the HLH/HTN websites.

Concern 1) On the HTN/HLH website there are a handful of doctors mentioned often in the forums - shaprio, wong, hasson, fellar and ironically these are the same docs that do most of the advertising - any other doctors basically sounds inferior. I find it hard to believe so many doctors are being excluded and if you mention their name on the forums the immediate majority response is see one the “HLH/HTN” inner-circle of doctors… Are these sites more of a gimmick then a legit source of information and where do you recommend finding a valid source of information regarding a hair transplant surgeon?

Concern 2) How much weight to put on the ABHRS certification. One of the boards member I believe is closely tied to MHR/Bosley - and that company just gets flamed on the HLH/HTN forums?

Thanks In Advance For The Time!

The advertising websites like Hair Transplant Network (HTN) and Hair Loss Help (HLH) provide a forum for their doctors to “pitch” the public with a storyline about themselves. These sites do restrict doctors to those who they believe perform only follicular unit transplantation and those who are willing to pay a fee to get the endorsements of the HTN/HLH websites. Some physicians do not like the politics of these websites, and certainly the HTN/HLH forums can be harsh on doctors (particularly if they are not paying members). Members are not necessarily spared from harsh criticism just because they pay their monthly fee, though. I have seen firsthand that these forums will try to implement controls on its user audience, but if freedom of speech is what is claimed, clamping down on vocal forum users can be difficult. Some forum users have too much time on their hands, are malicious jerks, or just lonely people who use the forums to obtain an audience. Others like the comradery of the group and provide interesting feedback on a variety of disparate subjects, so their input can be illuminating. If I were to have one criticism of those sites, it would be that many forum participants are out of their league with regard to the medical jargon and what it means, or when the issues of complications of surgery come up, there is a naivety in forum participants that everything is black or white. You need to do your own research — view photos, meet patients — and use these forums as a starting point, but don’t just accept 100% of what is written. As for why some doctors seem to be in the inner circle, I think it has to do with participation. The more these doctors participate, the more fans they gather, and the more vocal those fans become about those doctors. As for me, I tend to devote most of my available time to this site.

With regard to the American Board of Hair Restoration Surgery (ABHRS) certification, what this shows is whether these doctors passed the oral and written examination, and gained a standard of knowledge. The problem with the ABHRS is that the training of a hair restoration doctor is a willy nilly process that does not prove if the doctor is capable of performing the surgery with knowledge or wisdom under any reasonable situations that reflect the reality of the field.

When I took (and passed) the American Board of Surgery examination, it was two years after a five year intensive period of practical training with mentors (expert surgeons) watching me every step of the way. I was judged competent by these professors because they watched me as I made decisions and they followed the outcomes of my patients by direct observations of my results. The ABHRS can not replicate that type of control, so that means to me that their certification may have limited value to book testing alone. There are no great systems out there for quality certification of skill and knowledge as they integrate with each other in the field of hair restoration surgery. As I have said over and over again here on BaldingBlog — let the buyer beware!

I am 31 years old. I have always had very dense hair until my 25-26, then I started to loose hair on top and crown while preserving hairline (diffuse pattern hair loss). I had two transplantations of 1000 and 2000 grafts. At the time waiting for the results of the second operation. My question is about estimating my future norwood scale. First of all how can I measure if I am a class 6 or 7? Secondly my rim hair from front to back seems to go down more. Is this common or sign of bad news? I heard that rim hair of 3 inches or less is norwood 7. Is this true? because 3 inches looks like very high.

Best Regards

The permanent rim usually measures about 2 1/2 inches high in the mid-back of the head, but that does not count neck hair. The rim is measured from the prominence of the bone in the back of the skull upward, and all hair below this in the back is considered neck hair. The rim on the side in the Class 7 patient can be a bit higher (3 inches or so).

Look carefully at the two pictures of the Norwood Classification as shown above. For some bulleted descriptions of each Norwood class, you can check the Assessing Hair Loss page at the NHI site. Also, you and your transplant doctor should have this discussion as part of your long term planning.

Hi:

I am a 30 year old male that started taking Propecia 10 years ago. For almost that entire time, I have been very happy with the results. However, starting just 6 months ago, I have noticed a considerable amount of daily shedding, especially in the shower. I have also noticed a great deal more of recession in the hairline. To help combat this, I have started applying Rogaine Foam, and taking Procerin tablets regularly.

I am sure I will have to wait a little longer to see if the added products help combat the shedding, but my question to you, is should I increase the Propecia dosage as well? Right now I am only taking 1mg. Hair Loss is common in my family, as my two older brothers are almost completely bald. I’d like to do what I can to avoid ending up there myself. If you could share your initial thoughts with me, I’d appreciate it.

Thanks

The 1mg dose recommendation is across the board, but it might be worth a try at 2mg as more and more doctors are now trying a slightly higher dose. Double check with your prescribing physician, but if you do not have side effects, go for it.

We really do not know how finasteride will alter the long term (15+ year) balding pattern. We are hopeful that it will slow the balding down, but the real question is, “Will you still eventually wind up at your final hair loss pattern?” Propecia has been on the market only about 12 years, so we don’t really have the experience over a 20 year time period.

I’ve heard somewhere that I man ALWAYS inherit his father’s hairline. Then if your balding or not is another thing, that could be inherit from both sides. But the hairline is always the fathers.

Is this true or could a man’s hairline also have his mothers shape or a mix between both? Best regards!

The shape of the hairline is determined largely by your sex. Female hairlines are concave (rounded corners) while male hairlines are convex (receded corners). The hairline, like the hair loss on the rest of the scalp, is inherited from either side.

Of interest, I remember one man who had a very, very low inherited hairline (about 1 inch from the eyebrow) and he told me that all of the men in his family have that unusual hairline.