This 28 year old man came to see me, because his family said he was crazy when he mentioned that he thought he was losing his hair. He came in convinced that he is following his father’s pattern and feels that the hair in the front, top, and crown have all lost volume over the years. This is a great challenge and using the HairCheck tool showed that he has lost 40% of his hair in the front, and 47% of his hair in the crown when compared with his permanent zone at the back of his head.
Armed with this information, he was happy that he isn’t going crazy, but I don’t know that any patient has left my office truly “happy” after being told they’re losing hair. I actually thought when I first saw him that he would have no balding present at all. My eyes told me what everyone in his family told him — that he had no hair loss problem. The measurements proved otherwise. His hair is coarse (black with light skin), but because of his hair character he would have to lose over 60-70% of his hair bulk to see the impact of the loss that I measured above.
Finasteride has been proven to help halt hair loss, but it has also been proven to lose efficacy after a certain amount of time. If this medicine only works for a finite period, what is the point of centering ones hair transplants around its short-term benefits? I understand if a person in their 20’s maintains intake of this drug it would keep them with a head of hair through their 30’s, but in their 40’s it will stop working and by that time their donor hair might be all used up. For a truly permanent solution, wouldn’t it be wise to wait until balding reaches a static level, and then go in for a hair transplant?
Nothing is that simple. Hair transplants (while permanent) are not the only answer. Did you know that you can have irreversible acceleration of the genetic hair loss from hair transplants? This is especially true if you are rapidly and actively thinning and if you are in your early 20s.
Another reason is that everybody’s goals and expectations are different. Propecia may not be a permanent solution, but what if it give you an extra 10 years of good looking hair without surgery? This option may not be satisfactory for you, but there are many others who would rather not have surgery and wouldn’t mind taking Propecia.
hello, I am a 25 year old male. At the age of 18 I underwent treatment for acne with the drug accutane. After the six months of treatment I had diffuse hair shedding, literally pouring on to the pillow and sink. Since then I underwent two more treatments with accutane each about two years apart. once again the intense hair shedding began both during and after the treatment. Now a couple years later I still suffer from the shedding.
My hairline has not suffered any recession, my only concern is the crown area where I have a very pronounced cowlick which twists and turns revealing scalp. In this area i lose alot of strong healthy hair bulbed on the bottom like a telogen hair the area becomes red, ithcy, and very suceptable to sun burn even with long hair. In the 8 years I have been suffering this I have not noticed any significant pattern of baldness.
What my question is, is can this be male pattern baldness, a skin disorder, or a following result if the use of the horrible accutane? I have an appointment with a dermatologist for this matter but I would also like your educated opinion. thank you
Accutane (isotretinoin) is known to cause hair loss. Or you could also have male pattern baldness (genetics) unrelated to the Accutane use. Or even a combination of the two — in other words, Accutane may have accelerated your genetic loss. There’s really no way for me to know for sure via the Internet without an exam.
A visit to your dermatologist is the correct next step.
My mom is 82 years old and has always had a full head of hair with no scalp issues. About 1 and a half years ago she experienced burning, itching scalp, loss of hair and weight. This ended in about November, and started again in February till current. What could possibly be cause? She has had all blood work done, however has been under stress for quite sometime. She has stopped getting perms and coloring her hair. She sets own hair with rollers and uses a setting gel. Any suggestions?
You just listed many of the causes of hair loss in women over 80. Stress can cause hair loss as well. She should see a good, caring doctor. I couldn’t tell you why she’s having scalp issues or weight loss.
I’m watching the Cubs game on ESPN tonight and I noticed their manager Mike Quade appears to have no hair on his head at all, including a lack of eyebrows and maybe even eyelashes. Thats gotta be alopecia right? I didn’t realize it could cause complete hair loss like that. I thought it was more spotty.
After looking at some photos, I immediately assumed that this was some form of alopecia areata (probably totalis or universalis), so I looked into it a little to see if he’s spoken about it in the press. Sure enough, an article about Mike Quade in the NY Times from last year says, “Quade was 3 when he was found to have alopecia areata, a condition that caused him to lose his hair. Playing sports, he said, was a path to acceptance, a means of softening the taunts from other children.”
So there you go. Different forms of alopecia areata can cause different types of loss, and you can learn more about them at the National Alopecia Areata Foundation (NAAF) site. It appears that Mike Quade has alopecia universalis.
Another professional sports figure with alopecia areata that comes to mind is NBA player Charlie Villanueva, and he is as a spokesperson for the NAAF.
Hi guys, so I had a dosage question about propecia. I asked my doc if i could take half a proscar instead of a quarter, he said sure. so i started taking half of it and then i read that It’s the same as taking a quarter. can I lower my dose back down to a quarter or is my body now immune to that little propecia? (when you stop taking the medicine u cant start again, so if i started taking a half can I start again at a quarter?)
I dont want to ask my doctor b/c it’s $150 every time i have a question. thanks so much. your blog is invaluable
You should call your doctor to ask about changing doses again (hopefully he wouldn’t charge you for a few minute phone call), and I can’t say what is going to be effective for you. It’s a prescription medication, so always talk to your prescribing doctor.
Cutting the 5mg Proscar pill would bring each dose closer to the recommended hair loss treatment dose (1mg). Generally speaking, I don’t think you’d be “immune” to it because you previously took a higher dose. Some patients have gone off the medication only to restart later, and although it should work once restarted, it might not regrow the hair that is lost during the time you’re not taking it.
I have a simple question - If I will apply half the size of minoxidil 5% will it be as if I have used minoxidil 2.5%?
I ask this because I want to use rogaine foam which is available only in 5%, but I am very sensetive to minoxidil and want to use a smaller portion.
Thanks in advance.
You can try it and see if you are sensitive to a lesser amount. I would start with just a small amount if you are sensitive to it, but you may find that it isn’t effective enough to yield much regrowth. I know the Rogaine Foam is only available in 5%, but have you tried the 2% strength liquid Rogaine?
Hi Doctor(s), I’ve been on Propecia for 3 years now. I caught my hair loss in a fairly early stage while I had a thinning over my entire crown and vertex up to the front (the hairline remains intact) but no fully bald spots. I feel there’s room for improvement and worry about genetics winning out. I’ll continue Propecia but wonder if adding a Rogaine regiment (I realize I must be consistent and keep using it) might subsantially help at this point.
I couldn’t say if it’ll provide substantial benefits in addition to what you already have seen, but I do know that some patients use both Propecia and Rogaine together to try to maximize their results. If you have the patience and money to continue both, you can give it a try.
If one is in the early stages of MPB, is it possible to have a hair transplant straight away, and then keep having “top up” hair transplants as the hair behind the transplanted hair begins to recede? I wanted to take Propecia to begin with, but I am petrified after reading about the possibility of irreversible sexual side effects. I know that some people, including yourself, believe that these may all be in the mind, but the problem is, I am very fragile mentally (I suffer from depression, OCD, and social anxiety), and so I believe that I could be more likely to suffer from them because of this.
Many thanks.
If you are “petrified” about using Propecia, maybe the drug is not right for you. You are already biased against the drug and if you do have an obsessive-compulsive disorder and anxiety issues, it will be a difficult hurdle. I do find that most people who are very apprehensive about the side effects of Propecia almost always end up with the side effects. This has been corroborated by other hair transplant doctors in the past. In that sense I think there is something to be said about the negative placebo effect. I do not mean to shed a negative light onto your issue with medication, but in the end I believe you should speak to a doctor about your options.
With respect to hair transplants in men in their early 20’s with early stages on MPB, I generally do not recommend transplanting at that age, because you may do more harm than good. The process of hair transplantation may accelerate the MPB and you could end up looking even worse after surgery. This is a generalization and you also need to address this one-on-one with a qualified physician.
In the end, there is no easy answer and I do not have all the solutions.
This treatment is for autoimmune disease and there are no studies that show it has value that can be replicated in other patients. Many doctors are offering this treatment for male pattern baldness, but with no proof that it offers better results, I still believe this is just a money-maker for the doc doing it.
After looking at some photos, I immediately assumed that this was some form of alopecia areata (probably totalis or universalis), so I looked into it a little to see if he’s spoken about it in the press. Sure enough, 