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I wonder how persistent the forelock is. My father - 55 now, has a receded hairline (V) shaped. It has thinned in the frontal region in recent years, but no real crown thinning.

My question: I’m 24, and already have a deep V shaped hairline, but I wonder how permanent it will remain? Or, whether the forelock can be expected to disappear as well.

Also, what extend does baldness proceed? Who makes it to a norwood 7 pattern?

You need a good diagnosis, including miniaturization mapping and a solid measurement of the hair bulk in the top and crown of your head. The same can be done for the forelock to let you know if you are actually losing hair in the forelock now. As a generality, if the forelock remains strong by the time you are 30 years old, then you may keep it into the years to come. As for percentages of men that make it to the advanced balding stages, see here.

At 24 years old, you need good metrics that should be repeated every year, and with what you report (your deep V hairline) you should consider finasteride. Talk to your doctor, as it is a prescription medication.

Does anyone think the new drug called astressin-B has any possible benefits to regrow hair? I am surprised no one has asked any question about the new finding made last month. Researchers claim that mice grew hair when injected with the drug astressin-B, how far is this true and how long would it take for the treatment to be available.

Thanks

Actually, we did write about this last month.

Quick recap — researchers discovered that a compound (astressin-B) that blocks the action of a stress hormone called corticotrophin-releasing factor (CRF) was able to regrow hair in genetically altered mice. There isn’t enough information available to discuss anything beyond what was published. It is all hopeful, but the FDA process will take years before safety and effectiveness is proven in humans.

Dear Doctor,

Really Love the website. I wanted to know, I have read up on HGH and some of the positive side effects which were listed, are hair growth and thickness on the scalp. I was wondering these method hasn’t been used to treat hair loss.
Thank u.

Human growth hormone (HGH) is not something that should be taken lightly. I have met many men who have elected to take it and it is definitely effective at making the person who takes it feel more energy, younger, and have more vitality. While HGH may have many benefits (including some reported hair regrowth), there are also patients that suffer heart attacks. The final conclusions on safety are not out as far as I am concerned.

I am not religious so take what I’m about to say as my logical mind in action, but I believe that if we were intended to have the energy of a 20 year old when we are 60, then our bodies would continue to secrete growth hormone late into life. Since I believe in Darwin’s laws, older men with vigor would probably compete better for women, and survive in the bush better as they would be more stealth, but alas, that is not how we are built so I suspect that there are plenty of down sides. I am not an expert on the subject, so read on the various sites for HGH and interpret what you want.

A recent article I read in the LA Times a few weeks back discussed negative side effects of HGH, which can promote cancer. With the hype of Propecia and its side effects, HGH would not be recommended. Remember, there is always a risks and benefits of any drug use. My point is HGH is not a bad drug. It has its purpose and use. I just wouldn’t recommend it for treating balding.

Snippet from the article:

The latest in laser-based hair rejuvenation is the iGrow, a stylish new wearable device from Apira Science that packs 21 laser diodes and 30 LED lights. According to the company, that matches the output of most clinical hair lasers, and it should result in “thicker, fuller and healthier” hair in just a “few short months.” But that’s not all. The iGrow also includes a remote that has been programmed for both men and women, and it has a built-in set of headphones that you can use with your own iPod or MP3 player

Read the rest at Engadget — iGrow promises to regrow hair with lasers, accessorize any wardrobe

And it looks so classy! Any regular reader to this site knows how I feel about the laser hair therapies that make big claims with little to back it up, but this one goes a step further by including headphones and an Apple computer style iPhone/iPad/iPod naming convention.

CNet also points out that the maker of this product is covering their tracks by adding the fine print on the bottom of their site for their other laser product that states, “The REVAGE 670 has not been cleared by the FDA for medical use and any references are purely investigational.” I’m sure the iGrow falls into that same category.

Hello Dr., I took Propecia a few years ago for a period of 8 months and had good results, but also had significant thinning of body hair (legs, arms, chest, & back). I quit taking it because of financial reasons, but 6 months ago I got back on generic finasteride (1.25mg) and now have no perceptible body hair loss, maybe slight thinning on my back. How could I have such a different response this time? Should I assume that the generic finasteride is not working? (I got it from my local CVS pharmacy.) Thanks

I have heard on rare occasions that for some men that take Propecia (finasteride 1mg) their body hair thins out. This isn’t a usual side effect, though. I am not denying that you have noticed a relationship between Propecia and body hair loss, but that does not mean the drug is or isn’t working. If you are splitting the finasteride 5mg into quarter sections to make it 1.25mg, that is nearly equivalent to Propecia (finasteride 1mg), and there shouldn’t be a significant difference.

I have no way to explain the side effects (or lack thereof) that you’re seeing. The presence or absence of side effects do not indicate if the drug is effective.

i am a 62year old african american and i have universal alopecia. I am a female i was wondering if there is anything out there that could grow my hair back or could i get a hair transplant. I haven’t tried anything for it, i only wear wigs.

For men, I might recommend scalp micro-pigmentation (SMP), as this can give the appearance of a closely cropped traditionally male hairstyle… but for women, unless this type of style is an option for you, I wouldn’t recommend it. There is unfortunately nothing available (aside from wigs) today. You couldn’t get a hair transplant, as you have no hair to move.

Hey Doc,
I had an FUE procedure last week of 2400 grafts. The procedure lasted 9 hours (10 if you include lunch, etc.).

My question is as follows: How can one verify that the doctor (a well respected FUE doctor)actually gave you the number of grafts that you paid for? The work seems fine, but it just doesn’t seem like there are 2400 scabs on my head representing the number of grafts, and im now skeptical that i really got that amount. I do not have much of a way to verify my hunch as its too difficult to count.

I know the obvious answer is to pick an honest surgeon. But beyond that — any thoughts, tricks or advice for those of us whose eyeballs seem to underestimate the number of grafts on our heads? Is it tpically more or less than it looks like to the human eye?

Thanks!

If you feel the need to verify that you got what you paid for or what the doctor represented to you in regard to the follicular unit extraction (FUE) transplant, then you can get a second opinion. I have done that on a number of patients, but if the transplant was more than a week old, my accuracy in counting them is compromised. What I do is count the wounds (holes) on the back of your head.

If you had 2400 grafts, then you should have 2400 holes reflecting the FUE extraction sites. If the doctor charged by the number of follicular units, sometimes a single FUE site can have more than one unit if the doctor used a large punch or if your density is very high. Or maybe less than 2400 were taken, but the grafts were split (see here for more on that). I am not saying this is what happened, but I am giving you a skeptic’s point of view, reflecting your uncertainty.

Finally, if you trust the doctor ask for your surgical records and count sheets, which may show the doctor’s actual numbers (where the technicians keep track of all the “successful” FUE grafts pulled out and all the “unsuccessful” FUE grafts pulled out). This is what we do on every FUE case.

According to clinical studies, finasteride generally works primarily on the vertex, much less well on the midscalp, and not much at all on the front of the head. I’ve seen suggestions that this might be so because the processes that result in frontal hair loss are different than those at work in the crown. (That is, perhaps it’s something other than DHT, or in addition to DHT, that drives hair loss in the frontal and midscalp portions of the head.) Do you think there’s anything to this theory?

From Wikipedia — “in modern science the term ‘theory’, or ’scientific theory’ is generally understood to refer to a proposed explanation of empirical phenomena, made in a way consistent with scientific method.”

Unfortunately, there really isn’t a scientific theory to explain the difference in hair loss in the frontal region and crown of mens’ scalps. Your hypotheses, which are theories that are not considered to have been satisfactorily tested or proven, may have some merit… but I do not know for sure.

In the end, it is genetics that cause male pattern baldness. That much we know. That theory is solid. At this point, I do not know why DHT (for those men who have the genes) affects mostly the crown. For that matter, I do not know why the back of the scalp in men are always spared from balding. Maybe there are other hormones involved.

Dear Dr. Rassman,

I’m very concerned over the article regarding the law suit being launched against Merck. I’m 31 and have been using Propecia for the past two years, which reversed crown thinning and has maintained a mostly full head of hair for me. I stay hopeful however that a better medication or procedure will come along for maintenance/regrowth over the next decade. Do you think that law suits like this are going to kill the efforts, funding, and motivation to continue research for creating more options for hair loss sufferers?

Thanks for your time

There’s around 7 billion people in the world, about half of those are men… and in general, hair loss affects about 50% of the male population to some degree. So with such a huge potential market measured in billions, if there is opportunity the drug companies will likely work it. These companies are in the business of making money. Lawsuits won’t stop them from their research and development.

We live in a very litigious society and a lawsuit against Merck does not mean they’re guilty or at fault.

When you have chemo what happens to the hairs that are in the resting state after chemo finishes?

The hair starts to regrow as new hair buds enter the anagen phase of hair cycling.