About     Contact     Archives     Videos     Events     Hair Transplant

dear doc,
i am a 15 year old female and im starting to bald. its scaring me very much. i have a not so noticable widows peek and im thinning really bad rite there. also on the side of my head by my temples and a small patch on the back. if you could please please answer me back that would be great!!

I tried replying to you directly, but the email bounced back. Folks, if you want a better shot at a response, use a real email address please.

There’s many possible causes of female hair loss, including birth control, stress, malnutrition, iron levels, etc, etc. You can learn more about this here. You should talk to your doctor about this and get a parent involved. There’s no easy answer I can give you, unfortunately.

I had a coronal brow lift in Feb. 2009. I had a wider than desired scar. I also had a spot the size of a quarter of permanent hair loss. The plastic surgeon who performed the brow lift has tried to do a scar revision by excising the scar. But I am 3 weeks post revision and I see where all along the new revision scar I have hair loss. The line where he cut is pencil thin, but I have hair loss in front of the scar.

Is this going to be permanent like before? I thought that maybe the staples I had in initial surgery were the problem. But he used sutures to do revision and I still had hair loss. Why is it that every time my scalp gets cut I have hair loss in front of the scar? And what can be done to fix this?

Thank you

This is a real problem. You must wait out the course (about 4-6 months) and then you will know if the surgery succeeded. I suspect that you will see that the scar is the same or worse and the hair loss may not go away. I see many female patients with this problem and end up transplanting most of them with good results.

Hello Doctor,

How are ya? I’m 26 year old Male and have been using the Finasteride (5mg cut into 5 pieces) over past 2 years. I’m very happy with the results so far. Although the side effects are very mild, I wish it could reach absolute Zero. I had miniaturization of 65% in frontal region two years ago, I use to see my scalp under normal sun light and it was very awful. Now i believe my miniaturization is less than 65% (not sure as i have not consulted NHI) and follicles are more thicker and stronger, However i can see my scalp under certain circumstances (when its Wet/Windy/bright light)

I’ll be get getting married in 2 years and i’m considering hair transplant for thicker, natural looking hair. I wanna consult you or Dr.Jae Pak so that i can get better idea (i stay in TX and have to plan my travel, i’ll be SF from 9/30 - 10/4 but will be missing the open house event on 10/7, I couldnt get an appointment within that time).

My question to you is, Would it possible to reduce frontal hair line, as i have M shaped hairline? Also would it be possible to do a transplant in between existing hair follicles? (i have a thin frontal region) Also if i do continue using Finasteride would it be possible to reduce the shock loss to 0%?

I have another question about the fees for the hair transplant. The website says Dr.Jae Pak charges $6.00/graft for the first 2500 grafts and $2.50/graft over 2500. Simple math its gonna cost me $6000 for 1000 grafts and $6250 for 2500 grafts. what if dont require 2500 grafts to cover my bald region? choosing 2500 grafts is good value for money. Also during the transplant how do you count exactly 2500 grafts? to put an another way how can i make sure you transplant 2500 grafts.

Thanks in Advance.

You got the math wrong. It would be $6/graft up to 2500 grafts. On graft #2501, 2502, 2503, and any beyond the 2500th graft, it would be $2.50 per graft. It’s a discount for larger surgeries after you reach a certain graft number, but it doesn’t make all the grafts cheaper once you reach a threshold. So if you schedule surgery with Dr. Pak for 2500 grafts at $6 each, it would be $15,000; for 2502 grafts, it would be $15,005. If your schedule is flexible, NHI also has Standby pricing at $5/graft (plus the large session discount of $2.50/graft for those grafts above 2500).

I’m sure we can lower the hairline, but without seeing you first I can’t make any suggestions on where your hairline should be. Shock loss can be reduced with finasteride use before surgery, but I don’t know that it can make sure that every single existing hair stays in. Your hair normally cycles anyway.

As for graft counting and making sure you get what you paid for, see here: Hair Transplant Doctors That Charge By the Session vs By the Graft.

I’ve worn hairpieces for years and have been generally satisfied with them. As I’ve aged (now in my 60’s) my side hair has also thinned considerably–but it’s still there and I wonder if anything can stimulate its growth? I don’t expect crown hair, of course, but thicker side hair would make wearing a hairpiece much easier and more natural, as there’d be a better base to “comb into”.

Any thoughts or suggestions will be much appreciated. Thank you.

Usually you cannot thicken or regrow hair on the sides unless you have a hair transplant to add the hairs to those areas. Sometimes minoxidil might work. These are generalizations though, and your case may or may not be amendable to either of these two approaches. You should speak with a hair transplant doctor to get a better idea of what your options are.

There are significant number of patients who do have hair transplants to augment their hair piece. Some have hair transplants to the frontal hairline so that at the start of the hairpiece it would look more natural.

Dr. Rassman,
Thank you for providing this informative blog.

I have a question, I have been taking Propecia for 8 years now. But in just the last 3 months I lost hair noticeably in the entire area from the mid section to the front hairline. I think this is the result of stress, lack of proper sleep and not using Minoxidil since the beginning of the year. Can I “hope” that if I start Minoxidil 5% (I had used 2% for over 12 years), reduce stress and get more sleep, I may see some of that hair back? My experience so far is that once I lose hair, it’s gone, I just try to keep what is there.

I’m 48, male, and have had 5 transplant procedures over the last 14 years.

Thank you!

There’s no clear cause for the rapid hair loss you’ve seen in the last 3 months. Since you have had multiple hair transplant surgeries, perhaps you should follow up with your transplant doctor and get a good examination.

The hair loss could be stress related, but it can be anything. You can try getting your stress under control to see if that helps slow the loss down, but I cannot provide more input from such limited description.

Hello,

I just started taking finasteride for two months now and I am thinking of adding minoxidil to my regime. After 12 months I plan just to maintain taking finasteride. If the minoxidil added extra hair growth will I loss that hair if I discontinue minoxidil but remain on finasteride?

Thank you

Yes, unfortunately any benefits (hair growth) you saw from minoxidil will disappear if you stop using it. Finasteride (Propecia) won’t maintain hair grown from minoxidil… and vice versa. Some patients elect to use both medications, but they’re lifelong commitments.

I am well-aware, as an avid reader of your blog, that there is no shampoo that will help to treat hair loss. This question is different. Are there any shampoos, or ingredients within shampoos, that you would recommend against. In other words, is there a particular ingredient that may cause damage to hair, or increase hair loss in some fashion? Thanks very much for your time and wonderful site.

I do not know of any shampoos to actively avoid. Over the years, I’ve read unverified reports from readers that suggest Head and Shoulders causes their hair to fall out, but if that were the case I’d expect there would be warnings and news items all over the place about it. It’s a very popular shampoo, but there’s a very active comments section at this old post.

I’ve also received emails from readers over the years asking about hair loss from sodium lauryl sulfate (SLS) found in many shampoos, but I’ve pointed out before that it seems to be propaganda used by some companies just to sell SLS-free shampoo.

I don’t think there’s anything in commercial shampoos found on store shelves that will cause you problems, unless perhaps you’re allergic to something. I generally recommend that everyone try different shampoos and use the one that they like the most. I don’t have any particular shampoo preference over another.

Hi,
I’m a 22 year old male and I have noticed my hairline receding and thinning out for about 2 years now. About a year ago I started using 5% rogaine on my temples and vertex and it seemed to slow down my receding hairline and I experienced some regrowth on the vertex but they were very thin hairs.

On April 20th, 2010 I was prescribed propecia and have been on it ever since (about 3 months into treatment I was running low on $ and pills so I took a pill about every other day for 1 1/2 week, but have been taking propecia religiously ever since), I also stopped taking applying rogaine the same day.

I am writing because today marks month 5 and I am still consistently shedding 200+ hairs a day. I wake up with hairs all over my pillow. I wash my hair with shampoo/conditioner and my hands are covered in hair. I dry my hair after the shower and hair is on the towel. I’m at the point to where I don’t know what to do. I would currently classify myself as a norwood III, with thinning on my vertex and I have a weird thin patch that shows scalp at the midpoint on top of my head.

From reading this site and others, I know that shedding like this in month 5 is not normal. I know there is not much you can say w/o pictures but I was curious as to your opinion, or if you have seen any cases like this.

Thank you

Perhaps you’re not a good responder to Propecia. I don’t know what you’re seeing, so it’s difficult to offer much about that. You’re right about severe thinning not being normal 5 months after starting the medication. You should follow up with your prescribing doctor about it.

One thing I am sure of, Propecia doesn’t keep any growth you saw from the Rogaine, so you’re likely seeing the Rogaine-grown hair fall out since you stopped using it. You might consider getting back on Rogaine if that worked for you in the past.

In general though, you need to understand that there is no cure for hair loss and that even medications such as Propecia or Rogaine have limitations.

I am 28 years old. i started losing hair at the age of 22. 2 years before that on the top of my head red spots appeared and a diffuse pain in the roots of my hair(only on the upper area of the head). the quality of the hair on the top of my head changed noticeably. i went to a doctor, and he said it was the beginning of MPB. The pain is still here after 6 years. i tried a lot of different strategies to make it stop. the funny thing is that i still have my hair but the pain in the roots it’s still here too. when i scratch my head with my fingers the pain stops for some hours.

is it any possibility for this strange thing to happening due to bad blood circulation? Plus the skin on the top of my skull has become much harder. thanks in advance.

I do not know the source of your pain, but it does not seem related to the hair itself as you reported not losing any hair over the 6 years since being told you had early MPB. It may be a skin, scalp, or nerve problem.

There’s a large list of diseases that have scalp pain as a symptom, so I would get a second opinion from a doctor (perhaps a neurologist) that can examine your scalp to hopefully determine a cause.

Hey doctors!

Here’s a pretty funny looking invention that claims to prevent hair loss by putting hot water on your head. I know you’re both inventors and wanted to get your thoughts on this one.

Link: A Hot Tub On Your Head

I always like to see new inventions, and the more absurd, the better. I quite enjoyed seeing the Hot Cap, but it is better for general entertainment than for your hair. Removing sebum doesn’t prevent genetic hair loss, but this is creative nonetheless.