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I’m sorry for asking so many questions. But here is one that may be odd.

I’m a 22 year old male with blond hair, and I’ve noticed that many of my hairs are nearly white at the base of the shaft, and darker at the ends. I notice that the shafts are not shrinking in size. This I am sure is not due to balding because it is happening in hairs in the nape of my neck and back of my head and sides as well. It isn’t something that is worrying me but I’m just curious if this is normal or not. Am I going white at a young age, or is that a normal characteristic for hair? (Not all of my hairs are like this, however.)

I assume someone is telling you what they’re seeing or you’re using elaborate mirrors to see hair colors at the back of your neck… but I can’t say if it is normal or not. It may be normal for you. People have different hair colors and their hair colors may even change over time (from light to dark).

You could be getting white hairs at 22 years old, or maybe it’s just looking whiter under bright lighting. Sorry I can’t give a more definitive answer, but I really don’t know.

Hello Doc, SMP seems a very good option to me, since I’m probably heading to a Norwood 6/7. I love the cropped look!

In what extent is it possible to choose the darkness? Is it possible to have it darker than the remaining hair on the back and sides, so that it looks like the hair on top is a little bit longer/fuller that the hair on back and sides?

I would like to shave it every day, because I don’t think it looks good to have the 3D effect on my remaining hair and a 2D effect on the SMP. Thank you.

We can control the darkness of the color, but a darker Scalp MicroPigmentation (SMP) will not give you the look of longer hair. If you shave your head (perhaps with a short clip guard on), the ‘donor fringe’ cropped look is what we try to achieve.

Hello Doctor Rassman,

first of all thanks for your website and for all the precious information!

I have a question related to the haircheck methodology (re. a post on Aug. 8, 2011). Is the haircheck methodology related to miniaturization or is it a different methodology? I.e., would haircheck reveal an early stage of miniaturization, which would not be usually seen with the traditional magnifying camera that you and Dr. Pak use when visiting patients? I ask this because, when doctor Pak visited me in San Jose 2 months ago, he said that at 30y I don’t have any sign of miniaturization, but I still have the “impression” that the hair on the top of my hair has lost volume over the last year. Maybe just a little paranoia :-)?

Keep up the great work!

Best regards

I discussed your case with Dr Pak and he remembers you well. You have absolutely no sign of balding. There was less than 10% of miniaturized hairs all over your scalp. There was no balding pattern identifiable. If you would like, you can send us a photo and permission for us to post it. You are 30 years old with a Norwood 2 hairline.

You are one of those people who had so much hair when you were younger, that you probably never saw the skin on your scalp. As you aged, you probably had some thinning (not balding), and when your hair was cut short and you were under bright lights, the whites of your scalp could be seen. It was the perfect storm.

The bulk measurement can be used to assess the VOLUME of hair at certain areas (top or crown) of your scalp and make a relative comparison of that value to the measurement from the back (donor) area of your scalp. This test cannot be done if you have lots of product (gel, mouse, pomade, hair spray) on your hair, as it will add to the bulk, nor can it be done if you have very short hair, because we need to grab a section of your hair in each area of the scalp. The bulk measurement is like counting the number of hairs in a certain area (density) and multiplying it by the cross section area of each hairs.

The miniaturization mapping measurement can be used to assess the condition and distribution of miniaturized hairs around certain areas of your scalp. The proportion of miniaturized hairs to non-miniaturized hairs can be compared to your own donor hair to see if there a pattern to the miniaturization (thinning). In your particular case, you had absolutely no miniaturization all over your scalp.

By the way, thank you for the bottle of wine!

I am a 51 year old female who had a complete hysterectomy 10 years ago. My scalp has been itching ever since and I find hair on my pillow every morning. Fortunately, I also began with very thick hair. The itching is intense. I was diagnosed with a fragrance allergy, but using fragrance free products (everything) does not help at all. Dandruff shampoo made no difference. Prescription shampoo did not help. I hate to think I will have this condition for the rest of my life. I’ve tried cutting back on my hormone replacement hoping it would help, but it didn’t.

If I examined your scalp I might make sense of what you are telling me here, but there’s not much help I can offer you without seeing you and knowing more about your history. Just note that scratching your scalp harshly will eventually cause hair loss from traction alopecia.

Since treating a fragrance allergy didn’t resolve the itchy scalp, you should go back to your dermatologist for a follow-up. It’s possible the HRT is leading to the scalp itch, but this is something you should also be discussing with your doctor.

Snippet from the article:

While it might be too late to shoot a new box cover for the UK version of FIFA 12, Electronic Arts managed to give Manchester United striker Wayne Rooney’s in-game model a quick makeover to reflect his recently transplanted hairline.

Read the rest — EA Sports Pioneers the In-Game Hair Transplant

Wayne Rooney has apparently been candid about his hair transplant, so I guess it is only fitting that the video game character representing him was updated for his new look. I think the new hairline still looks a bit too high (based on the photo in the article), but I would know for sure if we got a picture of his wrinkled forehead when he looks up.

Can you explain to me what laser-assisted hair transplant surgery is? And why don’t more doctors do this? Advantages/disadvantages?

I read an article on your New Hair site from 1996 - here - that said the lasers weren’t sophisticated enough for this kind of procedure, but that was 15 years ago. What is your opinion now? Thanks

Lasers are wonderful devices, but I would not recommend their use in hair transplant procedures in any manner. When they were used, they produced significant burns adding to complications that rarely occur otherwise.

Hello Doctor,

Thought you would be interested in this new advisory from Health Canada regarding finasteride and breast cancer:

Link: Finasteride (Propecia, Proscar): Potential rare risk of breast cancer in men

I know this topic has been discussed before, but it looks like Canadian patients using finasteride (including me for 8 years) will see the new advisory in the leaflet…

The average age for male breast cancer is 71 years old. The number of cases I can find in the medical literature are very few. As the press release points out, of the small number of cases, “Most of the reports have been in association with the 5mg formulation”.

With the average age for our patients under 40, the lack of finding breast cancer is not surprising. I recall reading that up to 50 men taking 5mg finasteride (Proscar) and just 3 men taking 1mg finasteride (Propecia) had been reported to have breast cancer, though the link between the medication and the breast cancer wasn’t proven — nor could it be ruled out. If there’s updated information, I still suspect the total number is very low considering the number of men using the medication at any dose. Nevertheless, even with this rare risk, I will add include it in my discussions with patients.

As an aside, I wonder if these 3 men had the gene for breast cancer, which (in theory) could be provoked by finasteride. The best way for a typical young patient to evaluate this should be in his own family history. Those men with a family history of breast cancer in mothers, sisters, grandmothers, aunts… should be more aware of this risk, although still very remote.

I’m 26 I had 3 brain surgeries 5 years ago and have a large scar the shape of a horse shoe on the left side of my head. this is causing severe depression. I’d like to know who can I see and what I can do to cover this scar. my hair is no longer thick enough to cover the bald spot and I simply can’t wear a hat all the time. I’m looking for information on doctors in the boca raton area or near palm beach that can help.

thank you so much. this is my prayer to look normal again.

Scars from brain surgeries, as you describe, can be addressed with a hair transplant surgery or with Scalp MicroPigmentation (SMP). Treating brain surgery scars take some experience, as hair that is transplanted into the scar tissue may not fully grow. Be sure that the doctor you see has experience with transplanting into scars.

I would recommend that you not limit yourself to just your immediate area. See as many doctors as possible to get a good idea about what is possible and what the expectations should be. There are many hair transplant surgeons in Florida, and you can find doctors in your area by using the physician search at ISHRS.org. Just be sure to do your research and meet with doctors to form your own opinion on who has the best results.

Hi Doctor,

I was just wondering which is most reliable to check for hair loss, a camera or a mirror? I have a red scalp due to seborrheic dermatitis, and I have naturally blonde, straight hair.

If I use a mirror, you can hardly see my crown. If I use a camera, the red scalp stands out more. If I’m under a harsh light, using a mirror, then my scalp stands out more.

I’ve been to my doctor, and she’s said my hair is fine, no hair los or thinning at all, it’s just my scalp I’m noticing. What do I believe?

Thanks.

If you’re using a camera with a bright flash, you’re probably going to see more scalp. The same applies to harsh lighting, which routinely makes your hair appear thinner. I can not tell you what is better. A camera gives you other people’s view, but make sure that the lighting does not distort what you are seeing.

Dear Dr Rassman,

I thought your readers may be interested in this article. The Daily Mail, here in the UK, reviewed some common hair loss “cures” including your favorite product the laser comb :). Not surprisingly, they were all found to have little or no effect apart from regaine.

Here is the link: From a laser comb to rubbing coffee on your head, the His and Hers guide to hair loss cures

Best regards

Aside from the fact that there is no real hair loss cure, this is a decent round-up of some of the over-the-counter hair loss treatments. It doesn’t surprise me that that highest marks for the products they reviewed went to Rogaine (Regaine as it is known in the UK), and treatments like fish extracts and saw palmetto lotions got low scores.