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(female)
Hi Doctor,
I am a 21 year old college student who lives in San Diego. Over the last couple of months I’ve noticed a excessive amount of my hair falling out (especially in the shower). I have always had beyond a full head of hair but lately, it just feels thinner and I have hair all over my carpet to prove it. My friends always make fun of me because i’m constantly shedding everywhere but lately its beyond too much. I have done some research and almost want to diagnose myself with iron deficiency anemia.

Recently, I am constantly tired, dizzy, have headaches, have shortness of breath (lately), don’t eat very much meat, don’t take vitamins, and last time I went to the doctor, they told me that my heart rate was way too high. Not to mention, live a stressful life, go out drinking way too often with friends and smoke cigarettes. I just made myself sound so TERRIBLE but i’m beginning to worry and no one at Kaiser seems to be losing sleep over what could possibly be wrong with me.

What do you think doctor?

Most doctors are trained to treat medical issues and bill the insurance company to make their living. It seems that hair loss is generally not a priority from a purely medical perspective. My cynicism aside, there really is no definitive cure for hair loss in women, but you need a diagnosis by a doctor who has experience in this field. In addition, there are many causes of hair loss in women and you need to understand where you stand with these causes. There is only one FDA approved hair loss medication for women… Rogaine (minoxidil).

Things that come to my mind as I read your post as possible contributing sources of hair loss:

1. You go “out drinking way too often”
2. You “smoke cigarettes”
3. You don’t eat well
4. You have too much stress
5. You say your heart rate is too high? Why?
6. You think you have iron deficiency anemia? Why?
7. You are constantly tired, dizzy, have headaches? Why?

Aside from hair loss issues, you do not sound too healthy. You need to go back to your doctors at Kaiser and get to the bottom of this!

In 2006 I had a partial hysterectomy (uterus only). This past July my doctor put me on 1 mg. of Divigel. I’ve noticed the past couple of months that my hair is falling out. I don’t know if it is the hormone replacement therapy or not. I should note that when I’ve had surgery or a stressful time in my life, I tend to shed, but the hair comes back. I’m wondering if my “empty nest” this fall or the Divigel is causing the hair loss. Any ideas?

Stresses (emotional, surgical, medical, etc) can all cause some degree of hair loss. It usually takes about one year or so before you notice the hairs regrow once the stress is under control. Or, it could be the medication you’re on. Divigel (estradiol gel) does list mild hair loss as a common side effect.

It is best to discuss your concerns with your doctor that is treating you. On top of the stress and medication, there may be other medical issues that you are not aware of as well. In the end, hair loss for women is very frustrating for doctors and patients alike. There is no one magic bullet or a defining cause. And worse yet, there is no definitive treatment (let alone, a cure). Good luck.

I’m sure that this question has been asked many times but are body hair and baldness related? My dad suffers from MPB and he inherited it from his maternal grandfather. He first noticed a receding hairline at 16. My dad also has a lot of body hair and matured quite early. I’ve been told that I carry a lot of my mother’s genes but I have a lot of body hair like my dad.I’ve noticed a very slight recession in my hairline and I asked my dad and he didn’t know if I was losing it and I went to my dermatologist and she wasn’t sure either. Any information that you can give me would be great.

Like your dad and your dermatologist, I am not sure if you’re losing your hair either. I haven’t seen photos or have any way to determine if you’re in the early stages of balding, your hairline is maturing, or if you’re just worrying about nothing. Since you’re worried about male pattern baldness, you should have your scalp examined for signs of miniaturization.

The the hard fact is, if you inherited the hair loss gene, you inherited the gene. It’s really not related to body hair. Body hair is another genetic trait as well in itself and to my knowledge, these two are not directly related to each other.

I am 26 years old male and i’ve applied minoxidil once a day since age 21, but only in the two sides of my hairline where i had a problem, not in the rest of my hair. My father is totally bald. My treatment was taking place with some breaks, like 8-9 months treatment, 2 months stopping treatment. When i was stopping the treatment, the hair that was grown from minoxidil were falling out, and then after re-starting the treatment they were starting to grow again.

i have no sign of baldness in my crown, where i’ve never applied minoxidil. i want to ask you that if i stop using it at all, what kind of hairloss should i expect?

If you’re going to keep starting and stopping the medication, I don’t see the point in using it. If you stop using the medication completely, I’d expect any benefits that the minoxidil gave you will soon disappear. I don’t know what your hair loss pattern is or how much the medication was helping, so I have no way of knowing what kind of hair loss you’ll see. But if minoxidil regrew hair, that hair will fall out when you stop using it. Why are you playing Russian Roulette with your hair?

Dr.Rassman,
I certainly look forward to reading your blog each day. In the past you stated that some individuals are convinced that topical Nizoral 2%, used in conjuction with Propecia, helps with hair growth. What are your thoughts about using Avodart with Nizoral instead? Also, do you think Avodart might have the same effect as Propecia in minimizing shock loss in a hair transplant?

Thank You!

I generally do not recommend Avodart (dutasteride), and so I really don’t have any experience with patients that use it to protect against shock loss following a hair transplant. In theory it should protect against shock loss similar to how Propecia does.

sir,
i have seen your ht results. truly fantastic. congrats.

now my problem is my dad’s bald but none of his brothers (4) are bald. i have had a big forehead and recession in temples from childhood which is hereditary even for my uncles. so i dont know whether i will have hairloss in future? i am 19 years old (nw 2) now. what shall i do?

also i dont know when to start propecia or rogaine. to add further, i heard propecia decreases cancer risk but if a person still gets it, then he will get a very dangerous form of cancer. is it true? plus will propecia cause male breast cancer? i dont know what to do but i want to keep my hair at least up to 55 or so. but i am scared about these info’s here about the side effects? could u please guide me. it would be so nice of you if you mail me answering to my queries and tell me what i shall do to keep my hair on.

At the age of 19 and a Class 2 Norwood scale balding, you are not a candidate for surgery. If you are really balding, then you will have the appearance of miniaturization in the hair on your head. In that case, the drug finasteride is the best way to stop the balding problem in men who are balding in the earliest stage. Get a good doctor to review your personal situation and please do not have a surgery under any circumstances.

I’ve been getting a lot of similar emails from teens that want to take medication before they need to, or want me to tell them if they’re going bald based on 2 sentences they email to me. I’m going to make this as easy as possible for everyone to digest, and there’s no better way than an itemized list…

1. You have a family history of hair loss, but that doesn’t necessarily mean you will experience loss to the same degree or at all. It can skip generations.
2. Some refer to the corners of the hairline as the temples. Corner recession could be the maturing of the hairline. Recession of the actual temples will usually not see benefit from medication and surgery will likely be required to restore them.
3. I can’t tell you when you should start on Propecia (finasteride), as it is a prescription medication and therefore must be prescribed by your physician. Generally speaking, you shouldn’t take medication as a preventive medication against hair loss anyway. Everyone is different, and some men will need the medication at 18 years old, while others will need it at 35. It depends on when you’re experiencing miniaturization and to what degree. A 25 year old man already showing thinning in the Norwood Class 7 pattern will not benefit from Propecia unless it is caught early and still it may not do much more than stop the loss from occurring.
4. Propecia side effects are real, but they are also quite rare. Internet reports are unverified and overblown (some people will post the same basic negative messages over and over under different usernames across different sites). The major health concerns that you brought up (prostate and breast cancer) are worth considering, but more information needs to be collected. Studies into these types of issues might have been minimal, but the FDA lists the medication as safe and effective, and I’ve seen the effectiveness first hand (and have posted many photo results on this site).
5. Get a good, caring doctor who has an interest in hair loss. Most often they build their expertise in the surgery of hair transplants, but there are many good doctors who care enough about their patients that they will not be trigger happy and rush you into a surgery before you are ready. Check the physician search at ISHRS to get started.

Hi Doc, I have to say, this is really nice what you’re doing in this site. My question is this…

I was using minoxidil for a year and I suddenly stopped. I had hair fall immediately and now my hair is very thin. How does someone stop or taper minoxidil treatment?

Currently I am on propecia medication. Do you think I’m still going to grow back my hair with propecia?

Minoxidil and Propecia are medications you need to take for life. If you stop either medication you will lose the benefits that each provided. Patients for one reason or another (knowing these risks) who want to stop taking the medication wean off from them over the course of several months to decrease the perception of sudden hair loss, but make no mistake, you will lose the same amount of hair. It just may not appear as drastic.

Propecia will likely not grow back all the hair you lost. Sorry, I know the news is not good.

Hi,
I have been taking 1mg of Propecia once every other day for the last month. Initially there were no issues - I could take the drug and by midday I would even forget that I had taken it as I wasn’t paying particular attention or worrying about side effects or waiting for them to occur.

However, in the last week or so I have noticed just one side effect - my ejaculate appears less white and less ’sticky’ than it was just a month ago. There are alot of conflicting reports on the internet and my prescribing doctor (who is also a HT surgeon here in the UK) said that side effects usually diminish with continued use. Have you had any experience with this side effect through your work and has this proved to be the case?

I’m only 18, but a NW3 - my self-esteem can’t take any more hair loss, I am becoming concerned about this side effect however with regards to being able to conceive in say 10-15 years from now. Is this side effect really as serious as I am making out?

Thanks very much - your time is really appreciated.

One of the side effects of Propecia (finasteride 1mg) can be less volume or less viscous ejaculate. This does not change your virility or sperm count. If you are worried about this please see your doctor for a check up. The problem may disappear over time.

I have been taking CellCept for 6 weeks and I noticed hair loss, I have stopped taking it now but this was 8 weeks ago and I have seen no improvement.

Can you advise if it will grow back?

I’ve answered this question about CellCept before and have nothing new to report since then.

If it grows back it would take over a year, though it often does not grow back to its original fullness, particularly in the area where genetic balding is active.

If Testosterone levels do go up by about 15% by taking finasteride could this drug increase muscle mass?

Doubtful. The slight increase in testosterone is very minor and only temporary.