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Hello Doctor

I am a semi pro soccer player . Last week i had to play a couple of 90 minute outdoor games , running up and down in below zero temperatures and freezing north wind (no head cover allowed in soccer games ) . Ever since i think i notice more hair falling when showering or combing . Corellation or causation ? Permanent or temporary loss ?

I just returned from a trip from Antarctica. I didn’t notice any more bald people in the freezing weather down there. I do not believe your 90 minutes of soccer play and shower has any correlation with hair loss.

hey.
im a 16 year old boy presently living in auckland. im fighting to cope with my problem…ie hair loss….
i keep losing a lot of hair every time i comb my hair…about 20 of them…..and i lost all my confidence and courage….i just cant go to my high school any more….and there are times that i thought of suiciding also…

pls help me…i tried talking ti my parents but they just tell me that im paranoid…..again pls help me….im really struggling

I am sorry that you are having a hard time with hair loss. Losing 20 hairs a day is very normal, as one can lose 100-200 hairs a day and this can be normal in many men. In its place new hairs are growing without you even noticing it to replenish the hairs that have fallen out.

If you have genetic androgenic hair loss, there are medications that can also help. Empower yourself with education and knowledge about hair loss. If there are other issues, speak with your parents, your counselors at school, your friends, or relatives. Someone will listen, so don’t give up. The problem may not be as large as it seems. Get a medical assessment to find out if you are really losing your hair.

How do you distinguish between Syphillytic Alopecia and DUPA Androgenic alopecia? I’m probably experiencing Andro Alopecia diffusely around my entire head but I just want to make sure. Is Syphillytic alopecia treatable? How do you test for it?

Thanks

In a very basic sense, physicians diagnose patients by taking a history and examining the patient face to face. In more recent years with the advent of the Internet, many self diagnose and run into conflicting information and/or scare themselves with wild diagnoses.

If you think you have syphilitic alopecia, diffuse unpatterned alopecia (DUPA), androgenic alopecia (AGA), or any other form of alopecia, a good start is a visit to your doctor. And if you do believe you have syphilitic alopecia, I’d think hair loss would be the last among your list of concerns, since other symptoms of syphilis would be hard to ignore. Tests are available to diagnose syphilis.

I just started the Hep B vaccine and am experiencing hair loss at 54. Will it grow back?? I’m very concerned because of my age.

All health care workers receive hepatitis B vaccine, yet health care workers are not at any increased risk for hair loss. What you may be experiencing may be coincidental or very rare.

I did find this quote from the National Foundation for Infectious Diseases: “There have been rare reports of hair loss after hepatitis B vaccination, with the majority of individuals regrowing their hair (Wise, 1997). Studies are in progress to better quantify the possible slight risk of hair loss.”

Dr. Rassman,

Hello and Good day.

I just wanted to say thanks to Dr. Pak. At 25, with only slight recession, Dr. Pak saved me a great deal of time and heartache by getting me on medication first. Believe me, I consulted other clinics and they were all too willing to transplant me. In addition, I saved a great deal of money by getting the generic drug instead of Propecia (NHI was the only clinic to offer this and save me money!)

I also wanted to quickly chime in on the whole Propecia side effects debate. To be clear, I am now 27 and healthy. Since Dr. Pak started me on Proscar a couple of years back I have had no negative side effects from the drug. Everything is normal.

The only side effect I have experienced since starting the drug (other than not losing hair)is a palpable decline in the amount of deodorant I have to use. What was one a daily routine is now limited to heavy exercise. Have you ever heard of something like this from any of your other patients?

Weird, huh? Thanks again!

Thanks for the kind words. Glad to hear the we also saved you money on your deodorant use. What you’re reporting is unusual, but I have heard of a similar side effect only a few times in the many years. It must be rare, along with reports like less body hair growth.

Hello, thanks for being a boat of sanity on a sea of panic driven nonsense. I have a question about risk of balding. I remember before that you said body hair and MPB were genetically distinct processes. Now I have found a new entry on Wikipedia (not always accurate I know) saying there is a correlation between body hair and head hair thinning.

Given I am quite hairy myself (but have made it to 35 with a full head of thick hair) this is a bit of a worry. Do you have any thoughts on the matter.

Wikipedia

(I couldn’t find the source for this - on the androgenic hair page there is a reference to a 1947 article but no link)

As you said, Wikipedia is not always accurate. Anyone can post information there. For that matter, I just noticed that the post of follicular unit extraction (FUE) on Wikipedia is not completely accurate either.

Body hair is not necessarily linked with MPB, but even if it is, what would you do and how would that information help us/you? I wish I could give you answers on the presence of a link between head and body hair loss, but I haven’t seen anything reliable that ties the two together.

Dr. Rassman,
Re: Patient Results - 7846 grafts & scar revision. Very impressive images! Please provide more information regarding the patient and the procedure:-
- Patient’s age and history?
- Norwood class?
- Hair density?
- Hair weight?
- Scalp laxity?
- Donor hair depletion?
- Propecia and/or Regaine user?
- Time span of treatment?
- Further surgery required?
- Did you carry out all three procedures?
- etc.
Thank you.

This is the post you’re referring to — Patient Results - Over 7800 Grafts and a Scar Revision.

His hair weight was medium-fine, his scalp laxity was good, his hair density was slightly above average, and he was placed on Propecia. I don’t remember if he continued with the drug. He was a Norwood class 6 evolving pattern balding patient when he started the transplant process. The treatment spanned 6 years and I personally performed the surgery on him.

Dear Dr. Rassman,

I will try to keep this simple: Once a man with hairloss can make out his “horseshoe” pattern, is it possible or common for any of the “horseshoe” hair to bald at a later point?

I am 26 and, while I don’t have any bald spots, the hair on top of my head is thinner and more limp than the hair on the sides and back of my head. My “horseshoe” hair goes all the way up the sides of my head, and does not dip down low at the back of my head. Given that this hair has remained unaffected for the past 8 years since I’ve been thinning, is this indicative of hair that will remain unaffected for the remainder of my life?

The thinning in a young man at 26 years old which can produce an apparent horseshoe pattern, may be stable for years in the horseshoe itself. I have seen men that have a horseshoe pattern which is much more narrow than most Class 7 pattern patients. I often classify them as a Class 8 pattern to reflect the narrow band.

The normal height of the posterior part of the horseshoe is somewhere between 2 1/2 and 3 inches high (not counting neck hair). If this Class 8 patient was to have a hair transplant to cover his entire head (assuming the Class 7 pattern) he will likely have moved some of his non-permanent hair in the procedures. With the strip method of harvesting, the scars can be vary bad for cases this large. I have unfortunately seen this type of pattern with the scars produced by overly aggressive surgeons, and each one is a real challenge.

I couldn’t tell if it’ll dip down further as the years progress, but measuring the bulk of the remaining hair should be able to tell you if that area is continuing to thin.

Hello Dr. Rassman,

Is it possible to start balding in the vertex area and scalp area while still maintaining a juvenile hairline? I noticed that I still have hair under my furrowed brow, but the overall thickness of my scalp hair has dramatically decreased. I am 22 years of age.
Thank you.

Yes! You can start balding from the vertex (crown) area while maintaining a juvenile hairline. Those patients are a subset of the normal Norwood hair loss patterns with a persistent frontal hairline.

In rare instances, someone with this type of hair loss may even continue to have his juvenile hairline for the rest of his life, even though his crown has become bald.

Just wanted to send you a link to this silly article. One of the claims is that petroleum-based waxes can block hair follicles.

Link: Worried you’re going bald? Eat nuts and have a fried breakfast

Thanks for the find. Yes, it is a silly article. Journalism isn’t what it used to be. Even the title of that article suggests eating a fried breakfast will somehow stop your hair loss. That’s ridiculous.