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Dr. Rassman:
Thank you for your service to this country when you served in the US Army. I am a 26 year old male who recently had a hair transplant procedure in late March which involved about 1,500 follicles (FUE). Immediately after the surgery I noticed tiny hairs throughout my frontal area where I have been experiencing thinning for the past few years. I was told by my doctor that these tiny hairs were normal and that they would likely fall out in 2-4 weeks. It has now been about 2.5 months since the procedure and I believe I still maintain about 80% of these tiny hairs. Is this a bad sign for future growth? Will these hairs retard growth? Please let me know. Thanks.

I’d ignore these hairs. If they are the same length as the day they were put in, they will eventually fall out and new hair will grow from the transplants. Some people keep these beard-like hairs for months after a hair transplant and there is nothing to read into this observation. They aren’t a sign of future growth in a positive or negative sense.

Hi Doctor

Can topical Minoxidil affect the sex desire, impotence or the erections ability of someone? Are there any facts, or have you heard something about that?

Thank you in advance.

Nope, sexual side effects are not from minoxidil. Chest pain, rash, increased heart rate… those are related to minoxidil. A full list of side effects can be found here.

Dear Dr Rassman,

I have been reading your posts for sometime. Thank you for your informative answers to many questions that I myself have had in the past but have never asked.

I am a 38 year old male who noticed diffuse thinning approximately 2 years ago. This was accompanied by a greasy scalp and some itching as well, particularly in the evening when the greasiness was at it’s worse. I had NEVER had a greasy scalp prior to this. My wife cuts my hair so she noticed my hair was definitely thinning for the past 2 years. I started propecia 8 months ago, nizoral 1% daily as well as polysorbate 80+tsal(3% salicylic acid shampoo) daily. I started to notice results after approximately 4 or 5 months. My wife has noticed that my hair has definitely thickened up and is no longer showing the “see through” that it used to in the past. She estimates that my hair has improved by 50% in terms of thickness and texture.

My question is…is it only the propecia which is causing this stabilization/regrowth or is the nizoral+polysorbate having some effect. I have DEFINITELY noticed that after approximately a month of using the 2 shampoos, my hair was no longer greasy as it used to be. I have read articles on the internet on polysorbate 80 and was wondering what the general consensus is on the material. Thanks!

I am not a fortune teller. You started 3 separate hair treatments and now you are stuck not knowing if one, two, or even all three were the reason you saw improvement. Still another possibility is that none of the treatments worked and it was just a matter of being patient while the hair regrew, because maybe you didn’t have genetic male pattern baldness to begin with. Maybe you had telogen effluvium and it was self-limiting and the hairs grew back on their own (as it typically takes 6 to 12 months).

In other words, I really do not know… and this is why I generally recommend only using one treatment at a time, or you’ll end up “addicted” to all of them, too worried that if you stop one you’ll lose the benefits. This is also the reason why I tell readers to start with a good diagnosis. See a doctor before starting medications. Scientifically document before and after with a miniaturization study. I suppose if you are brave, stop one of the three and see what happens.

As for polysorbate 80, I’ve commented on that before here.

Dr. Rassman, I noticed few before/after photos of Asian males. I am an Asian male that has typical Asian hair which sticks straight out. Is this not an ideal hair type for hair transplants? I would assume it would be hard to cover a scar. thanks!

On rare occasions, some Asians with coarse straight hair may have hair that points upward. This is not common, but when it happens, the hair from strip surgery may have to be longer if a scar greater than 3mm is created (~5% risk). Alternative for this, of course, is follicular unit extraction (FUE), where there is no linear scar present.

Most (better than 95%) Asians have results as shown in the referenced posts below and we perform a great number of such surgeries as a matter of routine. It is worth noting that we only post the patients that have signed photo releases, so if there are few Asian patients posted it is because they simply don’t wish to have their photos made public.

• Asian Hair Transplant Patient
• Transplanting Asian Hair

Since last year I have been experiencing hair loss. I am a 49 year old african american female who in December 2009 had a noticeable bald spot that began appearing at the left side of my crown. From December until January 2010 the spot began to move from one side to another and then became quite bad. I finally went to see a physician who diagnosed me with autoimmune disease and alopecia. He prescribe a topical steroid (betamethasone dipropiontate lotion) and encouraged to take biotin. The back of the hair has grown back and now between a nickle and a quarter spot still remains at the crown. I am experiencing hair growth and to the roots it is quite coarse.

Would you recommend that I put a kiddie relaxer in it to get some of the thickness straighten out?

If you are asking whether a hair relaxer will help or make your condition worse, I would guess “no” to both. If you are asking if a hair relaxer will help with your look, that’s a styling question and I would rather leave that up to you.

As far as I know, hair relaxer for kids contains the same chemicals as hair relaxer for adults, but it is just marketed differently. In other words, you still run the risk of causing chemical damage.

Ive read some on the red hair color dominant gene.

In your experience, is there any link as to that gene and baldness? Meaning - if I have a red hair gene that came from my fathers mother, am I more likely to get the bald gene from his side of the family as well?

Nope, there is no direct connection between hair color and balding. The genes are separate.

There is some interesting reading here about hair on Wikipedia.

Hey there everyone,

well I have a problem & I’m stressed about it. pardon me if I’m not good at writing, im doing my best at it. I’m turning 16 years old and I notice that I started Thinning hair when was 12 or 13. I really don’t know if my thinning hair problem has been better or worst. oh and by the way my thinning hair is on the top front and on kinda on the top back. i also notice that i have mixed thick & thin hairs. I always wake up in mornings wishing this would be over.

the past 3 weeks i’ve been starting to put tomato on my head (cutting the tomato in half and rubbing it all over my top scalp till it gets very wet), eating gelatin every day, since I heard that it helps to thicken hair which would like know, and also using this shampoo that supposedly gently cleans the blocked follicles to grow thick, which i also wanna know if its true. and lastly spraying aloe vera juice on my head at night.

I wanna know if any of the said helps me to grow back thick hair or what can i do to thicken back my hair? help. thank you.

Tomato juice works well to get rid of the stink if a skunk sprays you, something many people might not know. My dog went after a skunk one day and the tomato came to the rescue. As for your scalp and hair, unless your hair stinks, rubbing tomato on your scalp won’t make a difference. While there’s always room for Jello, gelatin also won’t help if you’re experiencing genetic hair loss. Aloe vera juice on your scalp won’t be much use unless you’ve got a sunburned scalp or some kind of wound.

These are all “fun” natural ways to try to make your hair grow, but they don’t work in the way that you want them to. If stopping hair loss was as simple as rubbing tomatoes on your head and eating Jello, there would be no bald men in the world.

Maybe a visit to a doctor is a better option. You’re still 15 years old, so get a parent involved and see a dermatologist to find out if what you’re seeing is indeed genetic hair loss or something else entirely.

Dear Docs,

Please look at the pictures in this thread at BaldingForum. I’d like to get a hair transplant shortly.

How often do you come across a juvenile Norwood 3 hairline? How soon can you schedule a procedure and i’m interested to consult on proposed hairlines.

I was born with a weak hairline and in my 30’s, i’d like something I NEVER had in my teens and twenties; A hairline that won’t be the butt of jokes. Luckily my hair is coarse and wavy with thickness.

I originally met Dr. Bernstein in 2000 at a seminar in Boston. For background information, my grandfathers’ on both sides had hair. My father and his brother are both bald. My older brother 3 years older has a full and thick head of hair with zero recession.

The photos you showed go from being a baby to being in your 20s, and its common for a baby’s hair to be sparse and grow in, so that photo doesn’t really tell me anything. I need to see photos of your hairline before puberty, because if you’re telling me that you had a Norwood 3 at 12 years old… well, I have never seen a 12 year old with a hairline like that (Norwood 3 for a juvenile hairline).

As far as scheduling procedures, I’d want to meet with you or at the very least have a telephone consultation prior to setting up a surgery. If you’d like to setup a consultation, please call my office at 800-NEW-HAIR (or 310-553-9113) and have someone on my staff fill you in on available times/dates.

Hi Doctor. I have been on a generic finasteride that I bought from Mexico (manufactured by SBL Pharmaceuticals) for about three weeks now. I think I’m suffering from sexual side effects. But I’m not sure if it’s due to psychological stress or finasteride. My question is can I beat the side effects of the pill if I stick with the daily regimen? My biggest problem is getting and maintaining an erection (I have also lost morning wood). Thanks for your reply.

I am not familiar with finasteride from Mexico (sounds like the same stuff I wrote about recently), but I will assume it is the same as Propecia (finasteride 1mg).

The side effect you are experiencing occurs in 1 to 2% of men who take finasteride, and are reversible once you stop taking it. The side effects could also go away if you continue taking it over a period of weeks or months, but you won’t know until you try.

Hello Dr: William Rassman,

First of all I should like to say I love your website and I highly appreciate your contribution to making a difference in the World.

My question: I am 23 years old and I have been going bald at the frontal area just like my Older brothers who are in their late twenties. Its a starting to form a V shape. I was wondering if I use rogaine 2% would it help to maintain my hairline and prevent further receding ?

Since I am in Canada 5% is only through prescription. I dont think I will go completely bald. My Mother side have the balding gene and her brothers are not completely bald.

Thank you

You can try Rogaine at the hairline, but it may be a losing battle.

I have seen many patients over the years on Propecia (finasteride) as well as Rogaine (minoxidil 2% or 5%), but they still go on to recede in the front as the hairline matures. In some rare cases I have seen it slow down.