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I’m a 19 year old male and just recently I discovered my temple points are almost completely gone on both sides. Other than that, I have complete full head of hair. Is thinning in that area necessarily an indicator of future male pattern baldness or is it just something that happens with age? Thank You

This may be a forerunner of more advanced balding, because temple peaks disappearing isn’t typical maturation. What does your family line show?

I would want to examine your hair. During the examination, I would want to do a hair bulk analysis to see if you are correct in that there is no balding or thinning present at this time.

I’m a 34 year old male and there’s not much left on top. I tried using the original rogaine several years ago, hated it after one application, and decided to go bald gracefully. However, I was recently talking with a woman who had used it successfully post-pregnancy, I’ve thought about giving the newer foam a try just for the heck of it to see what happens. Everything I read and see are from cases where guys are not nearly as advanced in balding as I am, so I was curious to hear your thoughts on what could be reasonable expectations for somebody like me. Thanks for your time.

Rogaine Foam should be as good as regular Rogaine, but some people feel that the foam has the advantage since it is easier to apply. If you have very advanced balding, you may still see some benefit from Rogaine, but your chances for success aren’t great in completely bald areas. Feel free to try it out and see for yourself.

Hi,

I’m 24 yrs old, and I’ve been on propecia for about 1 yr and 3 months. At around the 9th month mark I realized the sexual side effects are real and I couldn’t perform. Therefore I decided to experiment with dosage and frequencies. I tried 1mg eod but I still got numbed genital and low libido after 3 months or so. Recently (about 2 weeks ago) I’ve cut my dosage to 0.5mg/day, I can tell it’s better so far, but some days I would experience those side effects once again. How long does it take for me to conclude that I have to further reduce my dosage? Should I stop for a week before beginning my new regimen? Do most patients not experience side effects at 0.25mg/day?! Should I try 0.5mg eod or 0.25mg/day first?

Thanks & Regards

Ask your prescribing doctor his/her opinion. As harmless as it may seem, changing drug dosages on your own is not in your best interest. You need to be under the care of a physician who can recommend different dosages and come up with an overall plan of how to deal with the side effects. More importantly, your physician can give you a complete physical to make sure there are no other causes of your erection / libido issues.

Sexual side effects from Propecia occurs in 1 to 2 percent of men. It is reversible, as you are noticing. There are focused groups on the Internet that claim the sexual side effects are on occasion not reversible (the debate rages on in the comments section of this post), but I personally have not seen a case like that in my career.

With respect to the effectiveness of Propecia at lower dose, I believe 1/2 the dose (0.5mg finasteride) is about 70% as effective.

I have a few questions. I started taking propecia in July 2010 and a few months ago switched to the generic 5mg finasteride (cut in 1/4s).

1. Is it ok to use a nicotine patch while I’m taking finasteride?
2. My doctor recently suggested I start using rogaine 5% in addition to finasteride. I would like to keep what hair I have and regrow some if possible, but I have read alot about shedding which makes me nervous. I know the shed hair should regrow but it still gets me worried. How prevalent is shedding in your experience with patients you’ve recommended rogaine to?
3. Also, out of curiousity, what NW pattern are you?

1. A nicotine patch can be worn while you take finasteride. I don’t know of any contraindication.

2. Hair shedding after starting Rogaine happens, but not very frequently in the patients who I have seen that use it. The good news is that the shedding doesn’t last forever and rarely, if ever, produces permanent hair loss.

3. I was a Norwood Class 3 Vertex (3V) without the frontal component, making my hair loss purely in the crown.

Snippet from the article:

A growing number of Koreans in their 20s and 30s are suffering hair loss due to stress, according to findings of the Health Insurance Policy Research Institute under the National Health Insurance Corporation.

According to the research institute, 88,004 people in their 20s and 30s received hair loss treatment at hospitals in 2009, which was 48.4 percent of the 181,707 patients treated for hair loss that year.

For the last five years, the number of people experiencing hair loss increased, especially for people in their 20s and 30s, research institute statistics showed.

Read the rest — Stress causing more young Koreans to lose hair

This article pinpoints young Koreans as suffering from stress-related hair loss, because it happens to be a Korean newspaper… but I’m not sure how the statistics compare to other cultures or races, or if these numbers even reflect just Koreans in particular.

I’m having trouble finding the study they’re referencing. Any help?

I had chemo last year. I didn’t lose my hair but it did thin out, especially at the sides. In december I got hair extensions, after the hairdresser assured me my hair was strong enough. My scalp was slightly red & itchy at the sides and front where the extensions were, but now suddenly my hair at the sides has thinned out even more and I’m almost bald in places. Obviously I’m going to have the extensions removed asap but will my hair grow back? I read recently that if the hair/scalp is traumatised the hair may not grow back. Help!

Hair extensions can produce traction alopecia (hair loss from constant pulling), which may or may not be permanent. Only time will tell. You may need to wait 6-12 months to know if the damage is permanent.

Doctor Rassman, I’m curious as to your thoughts on the following article. I just learned of the development process for Propecia and was shocked to find they intentionally engineered the drug to match the hormone profile of pseudo-hermaphroditic children because they had smaller prostates and a lack of male pattern baldness. I can’t see any patient willingly taking this drug if they were aware of its origins. The entire concept seems drawn up by a completely mad scientist.

Only page 1 is necessary to read, the rest is just sycophantic quotations regarding Merck’s profits.

Link: Keeping the Pipeline Filled at Merck

I agree that what you read seems strange, but this isn’t only limited to Propecia/Proscar (finasteride). These types of discoveries in medication development are common.

Scientists often look to nature and outstanding traits/illnesses to understand certain diseases. When scientists found a group of a population with no prostate issues and no male pattern hair loss, they made a connection that it may have something to do with being pseudo-hermaphroditic, which led to the realization DHT had something to do with it. But the converse is NOT true: Just because you have low DHT does not mean you will be pseudo-hermaphroditic. Just because you take a drug to lower your DHT does not mean you will be pseudo-hermaphroditic. The hermaphroditic issues ONLY impact the fetus in the first trimester of pregnancy and not in boys or men. And even then, the dosage for this to occur in pregnancy is not understood.

Back to pharmaceutical discoveries — many drug origins are from strange findings. The common drug penicillin was discovered from molds. The widely used anti-wrinkle treatment Botox is from the poisonous toxin botulism. The flu shot many people get yearly is derived from viruses. The mascara that women put on their eyelashes are derived from earth worms. The first hormone replacement therapy drug to treat symptoms of menopause was made from the urine of pregnant horses. Certain blood pressure medications were derived from venoms of snakes. Coumadin is a rat poison that is used to thin the blood for certain patients to save their lives. My point is: medications can be very strange.

Dr. Rassman,

With the advent of the Scalp Micro-pigmentation procedure, I’m wondering if it actually allows for more FUE harvesting from the donor area. What I mean to say is that one could only have a certain level of FUE grafting before you depleted the donor and left noticable empty spot in the back of the head.

I’m now wondering (if one so chose to)if you can in theory remove more grafts of real hair and simply fill-in the depleted donor area? This of course is assuming the patient wanted a low-cropped/shaved hair style. However, I’m not crazy about the shiny razor-shaved look. I prefer some natural looking stubble on top.

I understand you may think grafting hair on top of your head and shaving it might defeat the purpose, but that’s the look I like. Thanks for your time.

We have had one patient get follicular unit extraction (FUE) on top of the pigmented balding scalp to produce the feeling and appearance of stubble. It works.

You indicated you aren’t far from our Los Angeles office, so if you’re interested in setting up an appointment for a consultation, you can call our office at 310-553-9113… or attend one of our free monthly open house events. The next open house is coming up on Saturday, April 9th.

Hello doc,

Just wanted to thank you and your team for providing everybody with a website where we can come and get the proper information we need when dealing with our hair loss problems. I have two questions:

1. If you are on proscar (cutting it in quarters) and you get sick or get a cold, would it take longer for a person to heal or get better because of the proscar?

2. We have a somewhat famous hair transplant clinic in the area that I live in, and one of his male models the HT doctor employees is a colleague of my one friends. It turns out that this male model HASN’T had a hair transplant EVER (he does have some recession on the temple area but for the most part has long lucious hair). I do not know why this doctor uses him because its all fake. I’m in the advertising business and if I were to advertise a false or fake product I would lose my job and could be sued. So why would this doctor use a person who has not even gotten a transplant, and risk losing his job/license?

Take care.

1. Finasteride does not prolong a cold. I don’t know how you’d link the two.

2. I agree that using fake patients is not a very ethical practice. You should report that doctor to the ISHRS (assuming he’s “famous”, he’s probably a member) and your local medical board. Medical boards should put him/her on notice and a non-response will almost certainly put his/her license at risk.

How can someone figure if their donor region has been depleted? Is it evident by the appearance and volume of the donor region; would someone who has a depleted donor region have somewhat of a see through look in that area? I have had two FUHT both around the same size, 1350 grafts each, totaling 2700 grafts. Both of the strips were about six inches long and 5/8 of an inch wide and were remove from the exact same region of my scalp, second strip removed from the previous scar. My doctor says he could easily get another strip totaling 1300 grafts if not more from on top of my now existing scar. I’m a little skeptical of this. Although my donor area still appears just as thick as it ever was, that seems like a lot of grafts from just that small region. I would have totaled 4000 grafts and barely even touched either of the sides of my donor region, having just used the back region. Is this plausible? Side note my donor density is slightly above average

Usually 2700 grafts will not deplete the donor area. You need to have expertise in examining a donor area to make that assessment. If you do not trust your doctor’s opinion, get a second opinion. The depleted donor area usually has a see-through appearance, especially when the hair is lifted up.