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Here is a quote I just found on a health & fitness website:

“Over-masturbation or over-ejaculation converts too much testosterone into dihydrotestosterone(DHT). High levels of DHT overload the body causing baldness and possible prostate enlargement. Reducing the frequency of masturbation or ejaculation will help maintain low levels of DHT and avoid hair loss.”

So should I really believe this stuff and, well, ‘keep it in my pants’? I’ve never heard of ejaculation elevating DHT before, so any comment would be appreciated.

Older studies show masturbation cuts prostate problem risks, but a more recent study shows that it could possibly increase prostate troubles for younger men. Yet the study suggests that older men should have frequent sex or masturbate more frequently. Some male health experts believe that men should either have sex once a day or masturbate once a day, but the evidence is really not scientific.

Every man has DHT, yet not every man loses hair. For those that are susceptible, DHT is a cause of hair loss. But even if ejaculating caused a DHT increase, you’d have to be genetically inclined to lose hair for it to actually cause hair loss. Why does this not make sense to people? Masturbating doesn’t cause hair loss. Genetics does. If you never masturbated or had sex in your entire life, you could still lose hair.

Hello Doctor,

Firstly I’d like to thank you very much for maintaining such a very informative blog.

I have read that in cases where 1mg finasteride has lost its “effectiveness” in patients over the years you have prescribed 2mg instead of avodart. In the majority of these cases do you see a halt to hair loss, or no change from 1mg. Thanks for your time.

I haven’t seen much difference in results for those men that take 2mg finasteride from the start compared to those that take the recommended 1mg. I’m still not clear if it helps to take 2mg when 1mg seems to not be as effective as it once was (generally after years of taking it). I occasionally do advocate the double dose for those situations, but there isn’t actual evidence that this helps. There’s been only a small handful of patients that I’ve recommended this to within the past year, too soon to get a follow-up. In other words, there is no objective data on the results of changing the dose.

Hi Dr. Rassman,

I’ve had a hair transplant a month ago. Is it still possible for me to scratch my implanted FUE out?

Thank you

I would usually say no, but I have seen some strange results and methods of hair transplants over the years. Not all FUE (follicular unit extraction) is the same and not all hair transplants are the same. If you are able to pull out a graft one month after surgery, then it was never going to grow anyways. Under most circumstances though, the graft has already taken hold by then.

Hi Doc

I am a 22 male with fine blond hair, and ever since I can remember I have always had fine hair (used to be able to pull out chunks of my hair) however since the age of 16 I have become obsessed with my receding hairline. Don’t get me wrong, I accept the fact I’m going bald and just waiting for the day to come where it becomes TOO noticeable so I can get the clippers on them. What I don’t understand is …. why now? I cant even grow a beard.

Surely it cant be normal for my hair to be falling out and I cant even grow a proper beard? I got stumble on the chin and upper lip but nothing else….. I am starting to think maybe I have a underlying illness that I don’t know about. Could it be because I am a smoker and that why my hair is falling out? Is it normal for someone to be going bald that hasn’t properly finished puberty yet? or maybe I am just being paranoid? I don’t know.

Any advice would be greatly appreciated

Kind Regards

Sorry to hear of your hair loss. It seems you have accepted that inevitable. Unfortunately, if you are destined to go completely bald (Norwood 6 or 7) it usually starts very early, possibly as you described.

Growing a beard has nothing to do with scalp hair loss. It is in itself a genetic trait (like balding). Some men just never grow a beard. Also, smoking is bad for you (hey, I’m a doctor — what did you expect me to say?).

Dear Dr. Rassman,

Could you talk a little bit more about what you see over long-term with results with Propecia? Let’s start with the assumption that nine of 10 patients will have not lose hair from baseline at year 5.

At year 10, what percentage of patients would you say have a very noticeable decrease in hair, what percentage have a modest decrease in hair, and what percentage do not have any visible decrease in hair? I, for instance, have modest diffuse thinning–just barely visible to the naked eye. It has been diagnosed as MPB. I started on Propecia and minoxidil a few weeks ago, and am just looking for rough probabilities that 5 and 10 years from now, I will still have reasonably good hair coverage.

I know there are no hard and fast numbers and no clinical studies beyond the 5 year point, but any rough estimates would be great.

Your assumption that 9 of 10 patients will not lose hair from baseline is incorrect. Almost all patients will lose hair from baseline, because Propecia is not a cure! The rate of hair loss will be slower, but you still continue to lose some hair. Some will lose more hair and some will lose less hair, as it mainly depends on their genetic predisposition. That’s why I always tell folks here to get their miniaturization mapping done so that you have a baseline status at different regions of your scalp. This way you can track the progress of hair gain/loss.

As you know, the actual study was for only a 5 year time period, so I don’t have the data to be able to make any realistic estimates beyond that. A few years ago I posted a 10 year projection estimate here, just as an example. I really cannot give you probabilities on how good your results will be, just like I cannot predict the weather a year from now. If you have modest diffuse thinning on your front, top, and crown, I can expect the worst and say you may be an early Norwood Class 6… and that means you will likely go bald sometime in your life. With Propecia that will hopefully buy you a few years or maybe even a decade or more of good hair. But really, I haven’t examined you and I don’t know where your loss pattern will go.

Hey Doc,

This is such a great site and I learn so much from here. I had some questions for you. I see you mention that certain events can cause an onset of MPB. Can you elaborate on this, as far as how certain events can cause an early start of MPB. Also, is it possible that a person may never have developed MPB even if he has to genes for it, if that person would have never engaged in an activity that that you say can cause an onset of MPB.

Last question, I asked you once about perscription meds causing hair loss. You indicated that a women should regain her hair back with in a year if the hair loss was caused by the meds. How long would it take for a male to regrow hair that was lost due to perscription drugs?

Thanks!

No one really knows exactly how it happens, but stressful events (such as a major illness) can start a process of genetic hair loss. It can also be such that the genetic hair loss was in progress all along and that the stressful event just made the hair loss more evident (with rapid hair loss during the stressful times), but I doubt that it’s possible to avoid MPB by avoiding these stressful events.

Prescription medications may cause hair loss, but that may be the last item on the list of possible reasons for your thinning hair. For both men and women, one year is a good, safe rule of thumb to wait for regrowth of hair that was caused by medications. But in the real world things are not so simple and there may also be other factors involved for the hair loss.

(female)
i have alopecia areata and my hormone levels are up the creek . i am growing new hair , however why does it get so far and then fall out again ?

I do not know what you mean by your hormones being up a creek. Which hormones and what creek?

I am glad to read that you are growing new hair, which is to be expected for those who have alopecia areata. But it also may fall out again, also to be expected for those who have alopecia areata. This is something that happens with this disease, where it may spontaneously reverse and at times recur. For more info about alopecia areata, see the National Alopecia Areata Foundation.

Excellent blog - dispelling the myths and hysteria around the web. For that, I thank you.

I have a question about the classification of hair loss - i.e. the Norwood Scale. I have a high forehead and temples, I have always had a high forehead even as a child and my temples developed into an adult hair line in my late teens. Looking at the NHI site my hair line is similar to some of the Norwood class 3s. However, I know for a fact that it hasn’t changed in at least 10 years (i have photos) and I am pretty certain it is the same as when I was 20 (give or take a few hairs). I am now 33. The thickness has not obviously changed either. But according to Norwood I am losing my hair. Any thoughts?

Thank you in advance

If you have a hair hairline, it does not mean that you are balding. High hairlines are genetic in both males and females. If you wrinkle your brow, the highest crease is where your hairline was when you are 12 years old, but in the mature hairline, the mid-point rises about 1/2 inch in the mature hairline and that is not balding on the Norwood scale.

Assuming that you have balded to a Norwood class 3 and stayed there, it does not mean you are going to progress from a class 3 to 4 to 5 to 6. It is merely Dr. Norwood’s description of how men look.

Snippet from the article:

On May 25, 2007, Kevin Xu logged into his Gmail account and found a startling message from a man who could have been his biggest client.

From an office suite on the 28th floor of the Plaza Royale in Beijing, the baby-faced businessman had gone from selling shark cartilage and penicillin to Chinese hospitals and clinics to cashing in on the high-profit margins of the European and—he hoped—US pharmaceutical markets. Xu kept a list of 29 brand-name drugs he could deliver at cut-rate prices, from the baldness remedy Propecia to lifesavers like the antileukemia drug Gleevec.

Read the full article — TheScientist.com - The Counterfeiter

The article goes on to show how Kevin Xu was ultimately caught and convicted, but also delves into the fake pharmaceutical business. The rate of drug counterfeiting has gone up substantially in the past few years, and just goes to show how this stuff is more widespread than most believe. A fascinating read! Thanks to the reader that sent me the link!

Thanks for the informative site! I’ve searched for similar questions and answers, you’ve addressed delayed and no growth from transplants before, so hopefully this isn’t repeating too much from others. I’m 29 and had a hair transplant with a reputable IAHRS doctor seven months ago. 2400 grafts total were used, placed in the front 1/3 of my scalp to thicken my front and fill up my hairline.

It’s been seven months and the only growth that has occurred are a couple or so dozen hairs that didn’t shed during the two weeks following surgery. Those started growing further at about 3 months and are still growing, but it looks as though nothing else has even begun to pop through. The only possible explanation I can think of is concerning ridding my transplanted area of scabs post-op. 14 days after surgery, the scabs started to raise up and I went through with the balls of my fingers and gently rubbed them off, in some cases gently picked them a bit to rub them off (a few also peeled like dead sking does). There was no sign of trauma and with the scabs came the small hairs. So I shed about 90% or so of the hairs at 14 days. I discussed this with my doctor and he said there shouldn’t have been graft damage and any grafts coming out would’ve been followed by bleeding.

Is there any explanation(s) for this delayed or potentially little growth from my transplant? I’ve read articles about some transplants having delayed growth for up to a year due to different types of hair cycles. Could the rubbing and slight picking off of scabs after 14 days taken the grafts out or traumatized them to lay dormant longer? I’m sending before and after photos. Thanks!

You sent a lot of photos, but unfortunately most of them were from a distance and poor quality, so they don’t help me see much. The two best photos are shown below (click to enlarge) — the left photo is from 1 day post, the right photo is from 7 months post surgery. There does not appear to be any growth and I would expect that something should have shown by now.

Sometimes transplanted hairs can take up to 12 months before it grows, but usually there is some growth by 7 months. You should see some results between 5-6 months post surgery. I would give it up to a few more months, but definitely follow up with your hair transplant surgeon. I really do not like the unusual zig-zag hairline the doctor placed, as evident in the 1 day post-procedure photo.

There are MANY factors that go into a successful hair transplant surgery. Each and every hair graft/follicle can easily dry up and die if not handled and transplanted by a professional medical team. That is why choosing the right doctor and the right medical group is very important. In other words, it is not like buying a car from a dealer who can get you the cheapest out the door price. Despite what the consumers may think, not all hair transplants are equal (even if they advertise the latest techniques).