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Hi Doctor,

I’ve been stressing a bit lately about my hairline. I’ve read that the hairline “matures” anywhere from the age of 17 - 29. My hair began to recede to a nw2 - nw2.5 at around the age of 17. I am 21 now and I haven’t encountered any further loss. The reason why I’m stressing I believe is, I’ve read somewhere that males encounter hair loss from the age of 21 mainly. Since it began to recede (4 years ago), it hasn’t moved one bit. The history of hair loss in my family is very minimal. My maternal grandfather was a nw4, which wasn’t entirely bald.

My dad and paternal grandfather have no hair loss what so ever. However looking at my paternal grandfathers hairline and my dads, it looks like my hairline resembles theirs exactly! My paternal grandfather and dad are a nw2.5 - nw3, with very sharp hair, with a widows peak. I have the exact same recession, with sharp hair, around a nw2.5. Is it possible form your understanding that I may keep this hairline for good?

Thanks doc.

I couldn’t say for sure if you’ll keep the hairline you currently have, but if your family line shows strong hairlines, you might luck out. The hair loss genes can come from either the paternal or maternal side, so you’re not completely out of the woods. There’s really no way for me to know for sure if you’ll keep that hairline forever, though.

What Norwood level would you place Gavin Rossdale at?

Based on some photos I found (here and here), he’s maybe a Norwood 2. Considering Gavin Rossdale is 45 years old, I wouldn’t expect his strong hairline or pronounced widow’s peak to move.

But you don’t need me to necessarily judge a person’s hairline. What do you think?

Snippet from the article:

Bloomberg News (5/26, Blum) reported that the use of illegal drugs “in the US is estimated to have cost the economy more than $193 billion in 2007, according to a government study” released yesterday by the Department of Justice’s National Drug Intelligence Center. According to the study, “the cost of illegal drug use is comparable with diabetes, which a 2008 government study said cost more than $174 billion each year.”

Read the rest — Study: Illegal Drug Use Cost US Economy More Than $193 Billion In 2007

Although this is not about hair, this is a very important study that shows us what almost every American knows. I have posted it here because I have a large audience and this is clearly an important subject to all of us. We should care about the thousands of victims American policy seems to be enabling. By posting it here, maybe I will catch the attention of some important politician.

We have lost the war on drugs and spending more money on it makes no sense. In Mexico alone, 40,000 people have died this year as a result of our national policy on drugs. What is the value of those lives? The amount of money that is quoted here does not reflect the real costs of drugs in lives lost, lives ruined, or the results in direct and indirect crime.

I feel that this should become a political issue in our future political campaigns and we should have the opportunity to fix the problem by making many of these drugs legal and taxing them, just as we do for alcohol and cigarettes. The drug cartels can not compete with legalized drugs that are taxed and the money we generate can be invested in our failing economy. It’s about time that the US Government stopped enabling the criminal elements in our society.

My father is NW6 and I have been losing hair since around age 21 and now at 26 it has picked up. I have been using propecia and rogaine for 4 years with good results but it seems the effectiveness has decreased in the past year.

My father has tons of body hair and I have practically none-so I was wondering if the gene responsible for body hair and for hair loss were linked—possibly leaving me with a different fate then him?

Also, at the 4 year mark the effectiveness of my medications is decreasing or my hair loss is catching up. I have read that increasing propecia dose will not help- would switching to dutasteride be a good option in your opinion?

Thank you for your informative site.

It feels like I write about this every other day in different ways. If you have genetic hair loss, there is nothing that will completely stop it. So while it might seem like the medication is losing effectiveness, its more likely that the activity of your hair loss is increasing. Like a tug of war, where the genes are starting to win.

Increasing the dose of medication is a big question mark, but it’s possible that changing from finasteride to dutasteride may help. These are decisions your doctor will have to make with you. Some people report a better response to dutasteride when finasteride is not effective, but dutasteride (also known as Avodart) isn’t approved for treating hair loss, so your doctor will need to be willing to prescribe it off-label. Ideal dutasteride dosage isn’t known for treating hair loss (it’s a prostate medication).

Snippet from the article:

“I have no problem saying this, but I’m losing my hair,” Chris Evans, 29, admitted to E! News at Sunday’s MTV Movie Awards.

Unfortunately, that poses a slight problem for the actor, who signed up for three Captain America movies and three Avengers films. “The fear is this [role] can span 10 years so I can be doing this character until I’m 40,” he explained. “I’m supposed to be like this superior human. He can’t be balding. How horrible would it be if this superior man has male pattern baldness?”

Read the full story — Chris Evans Admits: “I’m Losing My Hair!”

I’m not seeing any hair loss in the photos I’ve seen of this young man, but I doubt he has much to fear anyway, as hair loss hasn’t stopped leading men from wearing wigs in the past (see Sean Connery, John Travolta, etc etc). Besides, I think Captain America wears a mask that covers the entire top of his head…

I have been using 5% minoxidil for about 4 months and have been happy with the results, I have brown hair but want to dye it black will this cause hair loss or cause the minoxidil to not work properly?

Thanks

Hair dye will not cause hair loss unless is it improperly used or perhaps you have a bad allergic reaction. I wouldn’t think hair dye and minoxidil have any deleterious effects on your hair loss issue. To be safe, you could wait 24 hours to apply minoxidil after you dye your hair.

Note: This post comes from one of our favorite readers (he has requested to remain anonymous), who has also contributed posts in the past about FDA issues:

The FDA’s oversight of drugs that have not been evaluated for safety and efficacy in their prescribed formulations and are thought to pose (potential) hazards has been summarized in previous blogs. On May 25, 2011, the FDA recalled drugs from a manufacturer (Regrowth, LLC) selling products online. This action was taken due to their status as “unapproved drugs (that) may present potential health hazards” (see FDA.gov).

While the recall is for the manufacturer and not users of the drug(s), and it appears that no serious adverse effects have been listed, users should also be aware of the FDA’s action and the caution that other unproven products are sold online with unstudied risk/benefit profiles. The failure to recall these other products and stop their sale is less likely an acceptance of their appropriateness and more likely a reflection of the FDA as a underresourced regulatory agency that has to devote their time to many priorities. Although any given person may benefit from such products, the actual degree of benefit and short-and long-term risks, is unknown (i.e. ‘Buyer Beware’). It is also noteworthy that the drugs sold by Regrowth, LLC -as with many online ventures -were being distributed on a massive scale (to individuals in over 70 countries or regions).

Below is taken from the FDA website and verbatim language of this public notification:

I just turned 20 and since a month before i turned 18 year old, i started to shed hair. Yes my uncle and father have lost hair, but with receding hair lines. For these 2.5 years, my hair has gotten thinner with no visible bald spots on my crown and no receding hair line.

My dermatologist prescribed me with extina foam and clobex lotion which indeed seem to cause my scalp to thin even more and a visible spot from the front of my hair line to the back of my crown. My question is, is this worsening of hair loss the result of these medical tools or was this inevitable? Mind you just a few months back in Febuaray i had no visible spots on my scalp. Info would be great in searching for an answer.

It is interesting that you can pinpoint the exact timing of when your hair loss started. If you indeed have genetic male pattern baldness, you simply can’t completely stop the progressive nature of the process. Medications may be used to slow it down and surgery may be used to add hair, but nothing will reverse the time factor.

The only FDA approved and clinically proven treatments are Rogaine (minoxidil) and Propecia (finasteride). Extina Foam is ketoconazole, and while there may be some anecdotal evidence that ketoconazole helps with treating hair loss, it hasn’t been FDA approved as such. Clobex is a powerful steroid, so I would expect that it might just hasten the hair loss process, just as we see with oral steroids. I understand there are thousands of treatment products and the option to use them is you and your doctor’s prerogative to try.

Just would like to share with everyone a recent post by Wayne Rooney (professional soccer player with Manchester United) who recently admitted to a hair transplant procedure in the British Daily Mail

The FUE procedure shows a radical improvement in terms of density in the photos immediately after the procedure. I can only assume that the results with improve dramatically in the months to come. Based on the cost posted ($30,000 pounds), I would assume that 4000 grafts were transplanted. I thought that 2000 was a realistic number based on FUE. Wesley Sneijder (another professional soccer player with Inter Milan in Italy), also has the procedure done last year. For men in their twenties, FUE would appear to be the way to go if you can afford it. Especially if you like to keep your hair short as they do. Anyway, just thought that this would be an interesting story to share with your followers. Thanks for all your great and informative work!

I’ve seen quite a bit in the news about Wayne Rooney, and I must admit I had no idea who he was before learning he had a hair transplant. I don’t follow soccer. The hairline shown in the photo he posted looks like it was placed high and perfectly rounded with a few little zig-zags to break it up, but I guess we’ll have to wait and see once the results grow out.

Minoxidil with Progesterone - Can this work topically and is it safe?

I ask because it was recommended to me by one of the leading companies behind hair transplants in the UK. I can’t find any information on this elsewhere!

I can’t find any information either! Progesterone is not an approved treatment for androgenic alopecia by the FDA. I do know that progesterone is used in female hormone replacement therapy, but I don’t know what benefit it may have for treating male hair loss.