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Hi,

Any comments? any advice? about this article? please!! nutraingredients.com

Kind Regards

Here’s the first couple lines from the article, which basically sum up the points I want to make:
“Daily supplements of a patented tocotrienol (vitamin E) complex may increase hair growth in people with male pattern baldness by 42 per cent, suggests a new study from Carotech. The eight month randomized, placebo-controlled trial involved 28 volunteers with androgenetic alopecia (male pattern baldness), and was performed at the School of Pharmaceutical Sciences at the University of Science Malaysia.”

The study is limited because it was done with only 28 people participating. So I would think about 14 people got the actual vitamin E and the other 14 got the placebo. You don’t have to be a doctor to make your own assessment on this one, as this is poor science. In fact, one of the volunteers that was taking the placebo even saw hair growth!

Hi Dr. Rassman,

Your blog has been an absolutely indispensable resource for me in the last month, and I can’t thank you enough!

I am a 30 year-old male, and I recently noticed that my hairline in the front and sides has receded about a centimeter or two past what is considered the normal hairline (according to one of your previous posts). I went to a dermatologist and she confirmed that there was in fact some slight recession at the temples (beyond what is the mature hairline), and also some very slight thinning on top. She did this all by sight, and did not have a densitometer in her office (nor did she claim to use one). She then prescribed Propecia, and I have been taking it religiously for the past month.

I also had my hair mapped out during a free consultation at the Philadelphia Hair Club. The woman who examined my scalp pointed out that I had some very early miniaturization at different points on my head (top, crown), and even some in the permanent zone on the back of my head (which she said was probably due to stress). I honestly can’t remember if she noticed any miniaturization beyond my front hairline and temple prominences.

My father is 60 years old and is somewhere between a 5 & 6 on the Norwood scale. (Unfortunately, I don’t have any information about my paternal grandfather as my father was adopted.) My maternal grandfather was somewhere between a Norwood 6/7 when he passed away at age 85, and my maternal uncle is currently at about a Norwood 3 (vertex) at the age of 50. I don’t know if this is important, but I do resemble my uncle quite a bit in terms of appearance and body type.

If I am a good responder to Propecia, how long do you think I will be able to cheat mother nature and keep most of what I have right now (which is still a hell of a lot)?

Thank you.

If you’re a good responder, Propecia (or perhaps a future medication somewhere down the line) could help retain the hair you have for as long as you take it. The potential is there. Some men report seeing their hair loss pick up around the 5 year mark, but I’ve got patients that have taken it for well beyond that and their hair still looks great. It’s really not something I could guess about, but if you keep your fingers crossed…

I’m just wondering how long after a transplant can I shave my head? My hairline is fairly uneven, and I want to conceal the asymmetry by doing some shaping (the doctor didn’t seem to help this problem). How long after a surgery do I have to wait to do this?

Also, I had some scabs rub off in the middle of the night while sleeping at about 6 days post op. I woke up, and had half the scabs I had before bed. What are the chances that I have damaged the grafts?

You can easily shave your head once the scabs are gone. At 6 days, some people have the scabs normally fall out so I would doubt that you lost hair grafts unless you scratched them at night while you slept.

Hi I had a hair transplant in Mid July of 2008, it has now been close to 10 months since my hair transplant. I have been keeping track of the transplant with pictures it has gotten a little better in the front, still not the kinda of results I was hoping, but in the crown area there has been absolutely no growth. In fact the small hairs that were inserted never fell off nor did they grow, they are still there I can actually feel them when I run my fingers through. Is this normal that the hair sometimes doesn’t grow?

A hair transplant failure in the crown is something you need to discuss with your hair transplant surgeon. What you described should not be normal.

Hello doctor,

I am a 28 yr old male. My hair drastically started reducing its density starting two years ago. It is true that you notice you are losing hair when you lose almost half of it. I now keep it shaved and when hair grows out you can tell very well that my hair is much thinner starting from the crown down to the top/front of my head.

I have gone through a substantial amount of literature regarding baldness (you have a very well informed website btw), and although I am very excited about the new age treatments like hair multiplication and cloning (endless supply of donor hair), I am quite aware that all this is at its inception with much more work to be done.

My question to you is this. Since you are a man of science, and you have witnessed it advance in the area of treating baldness since the last two decades, do you believe, taking all the current advancements into consideration, that there will be a breakthrough in 10-15 years? Of course, I know that you cannot be prophetic in the matter but simply what your thoughts are. Because your guess will certainly be better than mine.

I am optimistic of a hair loss breakthrough in 10 to 15 years, but if you asked someone a decade ago, they likely would’ve said the same thing back then. A lot of people are getting tired of hearing the same old “cure in the next 10 years” talk, but I will continue to be optimistic even if that timeframe comes and goes. Baldness isn’t a life threatening illness, but it is a billion dollar business… so as long as people continue to lose hair and there’s a market to end that loss, there will be companies clamoring to come up with the next great treatment. As technology evolves, the concepts that some people came up with that were once considered ludicrous can finally start to become within reality’s reach. Don’t get me wrong — there are still plenty of ridiculous ideas that will never work to treat hair loss. We’ll just have to wait and see and try not to buy into the hype too much, because there’s been far too many letdowns over the years (like that flying car we’ve all been promised).

With respect to the current gold standard in hair restoration technology, hair transplant procedures have come a long way in the last 10-15 years where most doctors are performing the individual hair follicle transplants or follicular unit transplants that give wonderful results with issues that are virtually undetectable.

Hi, dr Rassman

I did a hair surgery for 5 years in my corners. I have been using propecia since that day. I must say that propecia works pretty good for me (I am 37). I will take that pill every day of my life and I will personally thank you for your advise to never quit using it. My crown is still there with hair. I have a lot of hair, but the most of them are thin. My theory is that propecia helps me to keep them even though they are thin. I hope propecia will help me to keep most of my hair the next 30 years. Of course I know the most of us loose more and more hair as we get older. I will strongly advise men who are loosing hair to use propecia and I am 100 % sure that this medication will work much longer than 5 years. My question is why can´t Merck make a 10 year study ? I mean propecia has been around now for a while.

Best Regards

It’s not that they “can’t” make the study, but why would they? Honestly (and this is pure speculation), my best guess as to why they haven’t released a 10 year study — there’s no need. The medication is already FDA approved, the side effect incidents are very low, and the cost involved to conduct such a study wouldn’t make up for the fact that the drug will be off patent in the coming years (meaning there will be a generic 1mg legally available in the US at some point). As they are a publicly traded company on the NYSE, I think their shareholders would frown on unnecessary costs involved with doing follow-up studies on a medication that is already widely popular and FDA approved. Money talks.

My question is with regards to Trichodynia. I’m not sure if I have it or not. But I’ve been having some minor pain off and on in the crown region of my head for 3 months. I have not lost any hair in that region (I’m a NW2) and have been on Propecia for 4 1/2 years. But I’m afraid of what might be causing this sensation, I hope it isn’t associated with hair loss in that area. Are there any treatments for this pain sensation??

The pain hasn’t progressively gotten worse or anything, but it did start overnight, it wasn’t gradual at all. Could it be an allergy of some sort?

In all fairness, how do you expect me to diagnose your condition this way? You need to see your doctor (perhaps a dermatologist) and get a good physical exam.

The minor pain you’re describing can be anything from normal male pattern baldness to a neurological disease. See what I mean? It’s such a broad spectrum of possibilities that I don’t want to get into discussions about treatments for a condition you might not even have. You can learn a little more about it at Wikipedia.

dr rassman,
i include in this question a quote you made in a recent post which i would appreciate if you could clarify:

“As hair in the maturing hairline undergoes apoptosis (cell death, possibly because the number of hair cycles in the juvenile hairline may be limited and reached), it could just fall out without going through miniaturization.”

Does this mean that if there is minaturization at the hairline change then this is MPB and not the natural development of the mature hairline? or can there be minaturization without MPB at the hairline? I would much appreciate it if you could comment further on this as this relates to the difficulties i have had in getting a professional opinion on my own hairline- as to whether its MPB or just the development of the mature hairline.

regards

If you have a maturing hairline, I would not expect to see miniaturization from the highest wrinkle of the furrowed brow. The leading edge of a maturing hairline, as a rule, does not show miniaturization. From the few cases I can reference (nephew and two of my sons), they lost their juvenile hairlines without miniaturization appearing, so I draw my conclusion based upon those three cases in my family.

my hair has been rapidly shedding since March within two months of being sick. I noticed little white bulbs at the end of the hair. The hair on top, sides and back become difussed, now all of my neck hair has receded. The Derm says I have TE. does it sound like TE? Derm explained hair cycle phases. Am I in the Telogen phase.. Hair stops growing and shedds? when does it stop shedding.?

Thank you

Telogen effluvium (TE) can occur after a stressful illness. It does sound like that’s what you’ve got, but without examining you for myself I couldn’t really say one way or the other with certainty. People with RE will often have a positive hair pull test. If you are going through TE, it will usually stop within 6 months after you are fully recovered from your illness. Learn more about TE at eMedicine.

Just wondering what is responsible for the pattern of “male patterned baldness” ?

Why does the hair at the back and sides of the head seem to be more resilient than the hair at the top ?

Thanks Doc.

It is called genetic male pattern baldness. Keyword is “genetic”. Genes are responsible for it, but as to the reason it works out that way, I haven’t a clue. I posted a theory about it before — Why Does the Back and Sides of the Head Not Lose Hair?