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I’m currently a 3 on the Norwood scale and I see some miniaturization in my crown. Someday I’ll probably reach a 6 on the Norwood scale like my father did, but lets say for some reason I were to progress as far as a 7, when would that miniaturization be present? Would a doctor be able to find it now even though I’m only a 3?

I am not a psychic and I cannot predict the future. If I could, I’d be 100% correct with my Oscar picks. Alas, I was not.

Not everyone loses hair at the same rate from a Norwood 3 to a 6. More importantly, you may never progress to Norwood class 6 or 7. Maybe you will just be a Norwood class 3 or 3V. The Norwood Classification is not meant to be seen as a progression of balding. It just describes the many variations of how bald men look. You can, however, influence what type of balding pattern you will get by treating it with medication (finasteride) which may halt your hair loss. It almost certainly will slow down the rate of progression if you will follow in your father’s footsteps.

I just read this article about hair loss on MSN — The Naked Truth About Baldness

They basically say that you shouldn’t bother medicating for MPB because the results aren’t worth it. They don’t even mention surgery as an alternative to medication. I was wondering if you believe this had any merit or if it is just lazy irresponsible writing.

The author of that article concludes the piece by saying, “From a medical point of view, there is no need to treat male pattern baldness. At best, the treatments are expensive and only partially effective.”

The medication treatments aren’t necessarily that expensive and effectiveness depends on the person. Surgical hair transplantation cost can vary depending on how much is required, but there have been some beautiful results. From a medical point of view, he is right — you do not need to treat male pattern baldness. It isn’t a life or death issue. But from a social point of view, I think millions of men would disagree as hair plays a very real and important role, defining our youth, virility, and sex appeal. Celebrities like Michael Jordan, Bruce Willis (pictured), and Jason Statham may be the exception, but hair is very important to most of us! That should be fairly evident by the thousands of emails I’ve answered on this site.

Male pattern hair loss is not a disease and there is no cure for it, though medication such as Propecia and Rogaine can slow the process down dramatically in some people, possibly even reversing it in younger men. Hair transplantation may not be worth it for some people (such as the writer of the quoted article), but the solutions are absolutely natural and undetectable when done in the hands of an artistic and competent hair surgeon.

My hair seems to fall out every year and then it grows back. I can comb my hair and the comb is full of hair. Right know my hair is falling out and I noticed a bald spot on the left side of my head. I read so of the other people’s concerns and you stated that your hair don’t fall out year to year. In my case it does I wrote it down and it always happen in Feb-April each year. Please tell me what I can do about this.

I would want to know if you are using a tight hat or if you have done anything different during this time period that might cause the hair loss you see. Normally, humans have asynchronous hair cycling, which means that we lose on average 100 hairs per day and regrow the same numbers of hairs. In a 3 1/2 year hair cycle, the entire 100,000 hairs will replace themselves.

Some doctors think that humans may have more hair loss in the spring and less during the winter when it is colder, but frankly, I don’t believe anyone really knows. I can not explain your problem, but if the hair did not come back on schedule, I would be more than concerned.

Hi Dr. Rassman, how goes it? Thanks for taking the time to update this blog, much appreciated.

I was wondering if scoliosis would have any effect on triggering MPB or hairloss in general. My sternum is under chronic pressure and stress which causes constant discomfort. I’m 24 years old and have had scoliosis for about 11 years. Both sides of my family have moderate to no balding and my father does have slight thinning in the crown. The unlucky family members who did encounter hairloss didn’t experience it til well past 40, even 50. I’m experiencing some diffuse thinning (still have juvenile hairline) and minor thinning in the crown that has been noticeable since I was 16-17. Luckily balding in the crown hasn’t progressed rapidly, but is certainly present.

Oh, one more thing. Stress is a cause for hairloss, but how so physiologically? For example, does stress cause insufficient nutrition to the follicles or an increase in DHT?

Hi! It goes well. Thanks for asking.

Scoliosis (spine curvature) has no direct relationship to hair loss, but stress can play a role. Clearly, you sound stressed. The mechanism for the stress-induced hair loss is unknown. You are the type of patient I would love to see, build a Master Plan for and help. The one-on-one relationship with a good doctor is the best way to start your search for a cause of your hair loss. Assuming genetic hair loss is the cause, Propecia (finasteride) is the best thing to initially do for a 24 year old. The hair loss gene can skip generations, so I don’t know how far back in your family tree you were looking…

Hi, about two months ago I got gum in my hair and my girlfriend ripped it out and with it came a chunk of hair. I didn’t worry about it all that much because you couldn’t really see the bald spot because my other hair covered it pretty well. Well it’s been two months and I got a buzz cut and now I still have a quarter sized bald spot a little bit above my left ear. How long will it take for this hair to grow back? Will it even grow back at all? I’m starting to get worried about permanent damage seeing as how it’s been two months and it’s still as smooth as a babies butt. Thanks.

The hair should grow back within the next few months. I have seen many cases of a one-time hair pull before (from a fight, mugging , gum situation, prank gone wrong)… and the hair has always regrown. You’ll just need to be patient.

About 6-8 months ago I noticed that my eyebrows appeared sparse compared to my youth, particularly on the outer third to half. No outright baldness just sparsity as they moved toward the outer edge. This alarmed me considerably and I went to see a doctor who had my thyroid tested. The results came back negative for any disorder. The doctor also explained that eyebrows can lose density with age and at 33 that should be something to consider. Well feeling self conscious about something tends to lend itself to fixation as it has in this case. Since my unsatisfying diagnosis I’ve taken to touching or gently rubbing my eyebrows - both in an attempt to stimulate growth and a tactile way of assessing further loss. As well I routinely add a tiny amount of hair sculpting paste to the brows which seems to add to their shape and give them the illusion of increased density.

Through my attempts at alleviating my anxiety over thin brows I’ve actually added a new fear - the fear of further loss resulting from brow manipulation. I’ve noticed that when I stoke the brow or apply the hair product brow hairs will appear on my fingertips. Not every single time I touch them but frequently and at least a few hairs daily, sometimes 8-10 hairs. Unlike hair loss on the head there isn’t much information on what is considered “normal” loss when it comes to brow shedding. I don’t pluck the hair nor aggressive rub the brow, these hairs fall out with little encouragement. Should I assume that these hairs will grow back unlike those of chronic pluckers? How long does it take for these hairs to replenish themselves? Are my actions causing this shedding or is this the natural cycling of brow hair? How many brow hairs are considered “normal” to lose daily? I really can’t find much information out there and would be greatly appreciative of your insight. Thank-you.

Eyebrow hair goes through a normal life cycle just like the hair anywhere else on your body, but this doesn’t sound like natural cycling based on what you describe. If you have been rubbing the eyebrows (more about the repetition as opposed to the aggressiveness), this can cause traction alopecia to the hair on the brow. This can result in permanent hair loss.

If you do not get the return of your eyebrows in another 4 months or so, then a hair transplant can work well. While you wait it out, you might try Rogaine (minoxidil) on the eyebrow to see if it might regrow hair there, but just be careful not to get it in your eyes.

I hate to keep bothering you, but I’m full of questions! With fine hair, how much hair can be lost before it is considered noticeable? 25%? 50%? I am 4 months into using Propecia, and have new hair sprouting all over. I am surprised, as I have been losing hair for 20+ years. I am going to see where Propecia takes me, then finish it off with transplants.

In general, you need to lose about half (50%) of your original hair density (in even distribution) to notice social thinning but that also reflects your hair and skin color. In those with platinum blonde hair, you might be able to lose 80% before it is socially detectable. On the other hand, if you had black hair against white skin, a loss of 20% might be socially detectable. In other words, you need to lose between 20-80% of your original hair density to have others notice that you are thinning and this is based upon hair and skin color and the character of your hair. Of course, you (yourself) would notice that you are losing hair much sooner. This is generally if you lose hair evenly everywhere (and not in a pattern).

For those who respond well to Propecia, it takes about 8-12 months to see early differences… but it will not regrow all the hair you lost. Propecia mainly works to sustain what you ALREADY have and make those finer (miniaturized) hairs thicker and healthier. This will make it look like you have more hair as your hair diameters are thickening. You see, it’s not only about the numbers. Also be careful and note that Propecia should not be considered a cure to balding, but rather it slows that process down (dramatically) in some patients.

i wanna know that can armpit hairs be the donor for scalp hair transplantation???? plz reply me soon

I suppose anything is possible, but I doubt you’d really want to do this if you knew what the end result would look like. I have seen everything from transplanting armpit hair, pubic hair, and even beard hair to the scalp (I’ve not done these procedures, but have seen patients with them done).

Not only is the hair quality and texture just not the same as scalp hair, but more importantly, the growth rate and success of body hair transplantation is not as high as scalp hair transplantation (despite what the doctor may tell you). Plus, underarm hair will carry its glands with it so you may have to use deodorant on that hair. In my humble opinion, it is an experimental surgery with a potential for problem results.

Hi there,

To get a tan I started using the drug melanotan II for a few weeks(i know im stupid). When I stopped a month later hair loss started. It’s getting worse every day. Before I used it I never encountered hair loss.

I know you maybe not know anything about melanotan but was wondering if there could be a connection between my hair loss and using melanotan or is it just coincidence it happened?

I’m really looking forward to your reply.

I’ve posted before what I know about Melanotan — and I still know nothing. I’m not any more familiar than I was a few years ago when someone asked about it. I did try to find some kind of connection for you by searching with Google, but I came up empty.

It could just be coincidental or perhaps you had an allergic reaction of some sort. I don’t know enough about you (age, for starters) to really provide a path for you to go. At this point, you may just wish to wait it out or see your doctor for an exam.

In response to “Propecia Benefits Won’t Last Forever?”

I understand this is a difficult question to answer but say two identical twins under same environmental conditions etc were losing their hair, one took propecia the other didn’t and continued indefinitely, would some time down the track (say 40 years) would they reach the same point of hair loss as each other or would their be lasting effects of propecia maintaining a substantial difference between the two?

I would guess that the twin taking Propecia will not lose the same amount of hair as the untreated twin, but that would depend upon the final pattern of the non-treated twin. The lower the Norwood balding pattern (see patterns here), I’d expect there to be less of a difference after 40 years, but the treated twin would have the benefits of maintaining his hair longer than his brother if he treated it in the early stages of the balding process. Good question!