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Dear Dr,

From one of the last posts I saw about hair cloning it appears that there is a real possibility that it will never emmerge. You mentioned that the trials have been underwhelming and are not working how they were expected. Do you think that the compnaies invoved with developing hair cloning will wash their hands of it. Do you think we will ever see it working. Obviously, everyone is waiting for a genuine ‘cure’ for baldness and if it is not going to be hair cloning is there anything else on the horizon that might be it? Surely, we must be getting closer to that day and if so when do you think that day will be? Many thanks for your blog.

I think that hair cloning will be available at some point in the future, but certainly not in the immediate future. I feel like I’m the lone person willing to say that it is not ready for primetime yet (not even close), and I wonder why some people are just willing to believe every press release with a tiny nugget of information.

There are more promising options than just hair cloning alone such as stimulating the stem cells in the skin and epidermis, finding of compounds that are the missing link to hair growth (for example, some medication that might just grow back the follicular units that may be present throughout the bald head). While I think that any one solution is not at hand, the availability of multiple approaches just increases the odds that some solution will someday be at hand.

There are breakthroughs occurring at a rapid rate now on using stem cells to generate entire organs like the kidney, heart, and lungs. Hair is another such organ system that could benefit from such breakthroughs. I am optimistic that one of these breakthroughs will be evident in the next decade or so, but which one? Your guess is as good as mine.

I notice most females get transplanted hairs into diffusely thin areas and seem to get better results than men in those areas. In your experience, do men tend to get more shock loss than females? And if so why? Would a male who has female pattern balding (mostly diffuse thinning down the middle front area) have a higher chance for shock loss even if they are on Propecia versus a women with the same balding pattern?

Women are not always good hair transplant candidates because they usually have diffuse thinning, including in the “donor area” (rim of hair around the back and sides). Contrary to what you may have seen, women do not necessarily have better results than men. What you may be noticing is that women tend to keep their hair longer, curl their hair, layer their hair, or style their hair that is more conducive to disguising their hair loss.

There is no difference in shock loss for men (who are on Propecia) or women. Young men that are not on Propecia are the ones that get the worst shock loss, but both sexes can get it.

Hello. I noticed that I started thinning at the top of my head when I was about 23-24 years old. I lost quite a bit of hair but still had a reasonably decent amount of hair left. I am now almost 28 and have not really lost any more hair but haven’t really regrown it either. I have started Propecia to prevent any further loss but I was wondering if I have waited too long for any regrowth to happen. If my hair stays like this it’s ok but I do feel a little bitter at myself for not starting propecia earlier.

I would follow up with the doctor you are receiving Propecia from and get a good documentation of your current state of hair. This may be in the form of a photograph… or better yet, a miniaturization study to get an estimate of the percentage of miniaturization on certain areas of your scalp. Then you can judge if Propecia is worthwhile or at the least keep track of the hair loss progression. Lets try to take a scientific approach! Regrowth isn’t guaranteed for anyone taking the medication (some will just see the hair loss halt), so I wouldn’t beat yourself up about it.

Hi Doc,
Thank you for this site, it is a source of valuable info for a lot of people including me. Keep up the good work.

My question is, can tongkat ali affect the effectiveness of finasteride (Proscar) in stopping hair loss? I read that tongkat ali is a natural testosterone enhancer and can benefit the person using it with stronger libido, sexual performance enhancer, and can promote good physical well being. Will it make the finasteride less effective? According to some research it has not found any baldness side effect for people using tongkat ali. Thank you and more power to your work.

I’ve got no experience with this herbal, also known as eurycoma longifolia, so I turned to the internet for some info. According to this page, tongkat ali requires DHT to boost the libido, and finasteride blocks DHT. Therefore, you should not take both at the same time if you want the tongkat ali to work and if what I read on that site is actually true.

I don’t know if it’ll make finasteride less effective, but it seems that the finasteride would make the tongkat ali ineffective.

Not exactly hair loss related, but interesting nonetheless —

Snippet from the article:

Fact is, FDA has found lead in all 20 lipsticks tested, in significantly higher amounts than those that caused a minor media uproar when the Campaign for Safe Cosmetics (CSC) tested lipstick in 2007. The FDA detected lipstick lead concentrations up to 3.06 parts per million (ppm), more than 4 times the maximum (0.65 ppm) measured by CSC.

Read the full article — I’ll take my lipstick unleaded, please

Oh boy. Should we think twice about kissing a woman with lipstick on? I wouldn’t jump to conclusions that leaded lipstick is causing hair loss, but it is a little odd to me that the FDA is fine with traces of lead in lipstick, yet the EPA wants it out of our environment.

Hello,
I had a hair transplant in my crown area about 4 years ago. Although medically it was a success, cosmetically it did not adequately cover the bald spot and the bald spot is still obvious. I was fed up and tried shaving my head bald. This left the transplant scar clearly visible. The hair has grown back but I am now back to square one. I am not sure what to do. I think my options are to a) have more transplants in the crown, b) have hair transplants in the scar area and cut my hair short, or c) treat the scar. Are these my only options or are there other options. What would you recommend? I now feel I am in a catch-22, because I cannot cut my hair short, and I have noticeable hair loss.

Thanks

You probably didn’t get good counseling and were not given realistic expectations. Without seeing you, I can’t really give an opinion, as I do not know how “bald” you are. People have different views and I would need to see what you mean. Its all perspective. I could let you look at my (Rassman) transplanted crown and use my results as a yardstick of your expectations. If you have enough donor hair, you might be able to have more transplants to fill out the area.

Generally, it is very difficult to completely cover the bald spot on top of your head. Not because it is technically difficult, but because you might not have enough donor hair. You can transplant hair to the scar, but you will always have the scar there, although less visible. You can do a scar revision and this time the surgeon can use a trichophytic closure to hopefully make the scar even harder to detect (almost normal, but possibly not enough to shave your head). Another potential possibility is to use the FUE technique to extract hairs one-by-one and place them into the linear scar. Again, I can’t tell you what is actually possible without an exam first. For your crown, there are products like Toppik which work nicely to camouflage the area.

Dear Doctor. Thank you for this blog. It has helped me so many times!

I was wondering…Im only 21 and I’m already beginning to loose my hair. Actually my hair loss already began in the age of 19. But I was looking at some old pictures of dad when he was about 33-35 years old, and his baldness first kicked in around the age of 36. I really dont understand why I’m already beginning to loose my hair? Is it just bad luck, because you can’t look at your dad and foreseen when your hair loss will start? I was just thinking that 15 years is a lot before my dad’s hair loss started! Can there be another reason to my hair loss besides genes? I’m in good shape and I’m eating healty. I can litterly “pull” oyt my hair when strokeing my fingers trough it. Or when I’m washing it my hands are full hair. Thank you for your time!

Best regards

The most common cause of hair loss in young men is genetic. There could be other causes, but it is much more likely that it is your genes. The fact that there is hair loss in the family tree helps, but you won’t necessarily follow the exact same timeline of loss as your father.

A direct examination of your scalp with mapping for miniaturization will tell you the diagnosis. Then if you are positive for genetic hair loss, Propecia is a great (prescription-only) drug taken daily to address the loss problem as it will slow down the loss, possibly stop it, and if you really lost hair it might even reverse it at your age. See a good doctor.

Dear Dr Rassman,
I am a 30 year old male with thick curly hair but with early hairloss on my left frontal hairline. I have been on Propecia for 5 months now and I am still unsure of it’s effect. I have also been to see a HT clinic for a consultation on my options for the future. There they inspected (with the naked eye) my hair and said that most of my scalp hair was very strong and I would be a good candidate as I had thick hair with alot of double and triple follicles. They also said I could have my hairline reconstructed but that I should limit the amount of hair transplanted as I may need more to cover future loss.

My question is does the reference to double and triple follicles sound plausible or is this something that is common to most people and were they only saying it to push the idea of HT on me,especially considering they offered to reconstruct my hairline when my loss is still only at an early stage? I would greatly appreciate any advice you could give.
Regards

I think that the reference to double and triple hair follicles reflects the follicular unit count. Hair grows in groups of one, two, three, and four hairs each. Some people with terrific density have many three and four hair groups while many Asians will have mostly one and two hair groups. The more hair you have on your head (counts) the better off you will be for future hair transplants if you ever need them. I can’t really comment on whether you are a good candidate for surgery, as I haven’t seen you.

Dr. Rassman,

I am grateful for the information on this blog but after going through the forum, there doesn’t seem to be a case that is similar to mine. I am a 23 year old Asian male located in the Los Angeles area and on the top of my head is a circular spot which is nearly bald. I am 99% certain this circular spot is a callous that was developed by the many headstands and spinning I used to practice when I was 18-22.

The rest of my head is fine, I notice losing the usual hair but my crown appears to be thinning because the hair from the crown area is combed up to disguise the circular spot. Is a hair transplant the only way to deal with this callous on the top of my head and where can I go to get consultation on that procedure?

Please help, Dr. Rassman.

It sounds like you developed traction alopecia in the area that is callused. Hair transplants should solve the problem, but you must make sure that you stop standing on your head and spinning. If you want to continue to stand on your head, use a circular collar to keep the pressure evenly spread.

As you indicated you are local, you should visit me and let’s look at your problem (I’m in Los Angeles).

(female) Help! I have been taking Adderall (d amphetimine salts) and now my long blonde hair is falling out from the root. How can I prevent my once thick head of hair from falling out further? I take this med. for adult ADD and it is difficult to think about not being able to take it - it works so dramatically. I usually take 15 mg/day. I have tried Provigil to no avail. What actions can I take immediately?

There’s no simple solution. Unfortunately, I can not give you treatment advice since I am not your doctor and I have not examined you to form an opinion. The only action I can recommend is to discuss this with your prescribing physician. Alternately, you can also seek out a good hair expert physician near where you live. Look at the physician search at ISHRS.org to find a hair doc in your area.