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hello.
My question is, if shock loss is one of the side effects with a HT would the doctor insert more graphs in a particular area knowing that shock loss would occur? This way a patient doesn’t feel as if he or she didn’t get a proper procedure done and it looks as if more hair is there then the patient originally began with.

As well, are the hair line and frontal areas more susceptible to shock loss versus the back, top part (Crown) and sides of the head?

The areas most likely to have shock loss are the areas where miniaturization is present. There isn’t one part of the scalp that is more susceptible than another. The more miniaturized the hair is, the greater the risk over time.

Shock loss doesn’t occur for all patients, and taking finasteride prior to surgery usually protects the body from hair transplant induced shock.

Hi Dr. Rassman,

I’m a 22 year old Caucasian male who has experienced some recession due to maturation of the hairline (I hope so anyway). As a teenager I wore my hair long, and I now have long hair again. My question is, is it normal for my bangs to look and feel thinner since there is a higher hairline, and hence, less hair to drape down? And if so, is this a commonly reported phenomenon? Thanks!

This may reflect the miniaturization at the leading edge of the hairline, the first findings for hair loss. If your hairline just got higher due to maturation, I wouldn’t expect your bangs to appear tin. It’s tough to know what you’re seeing without examining you, though.

Yes hi, i’m 20 years old (male). i went to get a hair cut a few months ago and i noticed a bold spot on the side of my head. it has a little bit of thin hairs but you can totally noticed that i have a bald spot. its the size of a quarter. its been a few months now and the hair hasn’t grown back. can you help me with my problem?

thank you

You may wish to see a dermatologist. If it’s just a single spot on the side of your head, there could be a variety of reasons for it to occur — anything from stress to disease. There isn’t much else I can provide without an examination.

Dr. Rassman,

I appreciate all of your feedback on a variety of issues. It really is so helpful for all of us.

I had a HT 3 weeks ago (FUE) with a top notch doctor. Everything went fine. At day 15 post op I was exposed to the Florida sun without a cap or sunscreen, but with hair covering the recipient area, for a total of 10-15 minutes — also during a car ride the sun was shining. I know you have written on this issue, and I have read all of the sun-related posts. However, I would like your thoughts on my situation please.

I noticed some slight pinkness, and the blotchy white and pink spots that I have read about, and some minor sensitivity to the scalp after the sun exposure. I did not have any blistering, and have not yet had any peeling in the area. I am now, since, using sunscreen 70 spf. My question is: is it likely that I affected the grafts, and their growth by this limited exposure (not a severe “red” burn) to the sun?

Please say “No”, but otherwise be objective, and thanks again.

“No”, I do not think you affected the graft.

Most doctors generally recommend protecting the skin from sun exposure (especially after any surgery), because the UV light can cause discoloration of the scar. I would think 15 min in the sun or riding in a car would not be an issue.

can epidural steroid injection lead to hair loss or alopecia in female with discopathy

There is no connection between a single shot of steroid injection in the epidural space to induce hair loss in men or women.

According to clinical studies, finasteride generally works primarily on the vertex, much less well on the midscalp, and not much at all on the front of the head. I’ve seen suggestions that this might be so because the processes that result in frontal hair loss are different than those at work in the crown. (That is, perhaps it’s something other than DHT, or in addition to DHT, that drives hair loss in the frontal and midscalp portions of the head.) Do you think there’s anything to this theory?

From Wikipedia — “in modern science the term ‘theory’, or ’scientific theory’ is generally understood to refer to a proposed explanation of empirical phenomena, made in a way consistent with scientific method.”

Unfortunately, there really isn’t a scientific theory to explain the difference in hair loss in the frontal region and crown of mens’ scalps. Your hypotheses, which are theories that are not considered to have been satisfactorily tested or proven, may have some merit… but I do not know for sure.

In the end, it is genetics that cause male pattern baldness. That much we know. That theory is solid. At this point, I do not know why DHT (for those men who have the genes) affects mostly the crown. For that matter, I do not know why the back of the scalp in men are always spared from balding. Maybe there are other hormones involved.

Snippet from the article:

A postal worker from Londonderry has suffered burns and lost clumps of his hair in what is understood to have been a practical joke gone wrong.

He discovered the hair loss when he took off a motorbike helmet he had taken from the staff locker room at Royal Mail’s delivery office on Great James Street on Wednesday afternoon.

It is believed that an acidic substance had been put in the helmet.

Read the rest — Derry postal worker loses hair in ‘practical joke’

A joke gone too far. I only hope this man wasn’t already losing his hair from genetics. What happened to using a Whoopee cushion?

Hello Dr Rassman,
I have recently been diagnosed with seborrheic derm in my right eyebrow by a dermatologist. I have read in previous Balding Blog posts that you don’t believe seb derm causes hair loss as it is primarily a skin condition, and that loss could result only if there is manipulation of the hair follicles and I agree with you! But, my case is such that I am losing anywhere from 3-6 hairs a day in my right brow (which is the only place I have this issue…white flakes that adhere to the follicle and cause weakening of the hair and then soon loss) so I was wondering if you think this means I might not have seb derm?

Afterall the doc just listened to my symptoms and as I was still speaking wrote out a prescription without even looking at my brow! I am thinking it is a condition which mimics seb derm what do you think? I am planning on eventually getting a transplant when the loss subsides but I can’t seem to control the problem first! He put me on desonide and ketoconazole cream which did nothing for the hair loss of flaking and just exacerbated the condition. Any insight you can give I would greatly appreciate. Thank you Doctor.

If you weren’t happy with your dermatologist’s review of your eyebrow (you said he didn’t even look at it before prescribing medication), you should consider seeing another dermatologist that will examine the hair loss.

As for me, I honestly do not know. It is strange that you are losing eyebrow hair on only one side. Perhaps it is temporary and the hair will grow back? Give it time. Don’t jump on the surgery solution. Follow up with your doctor. If this is of any comfort, I have yet to see someone with one good eyebrow and the other bald, unless, they are pluckers or pickers.

Can acute TE develop into chronic TE because of emotional stress?

Probably! High stress is a known cause of hair loss. In women, this usually reverses with time. In men, you have to distinguish what you see from genetic male pattern hair loss.

Is my beard suffering from traction alopecia?

Hello Dr,

For as long as I could grow a beard - about 10 years now - I’ve been something of a beard scratcher or more appropriately a massager. You know the type, a man in contemplation, rubbing his beard growth - an image you’ve surely seen a thousand times. I keep the beard at various lengths - short and stubble like or a medium length groomed style. To achieve various looks I use a remington beard clipper. Now recently I’ve noticed that a few areas of the beard look less dense, particularly the left chin to bottom lip portion. Don’t get me wrong, there is still hair in those areas it just seems a little thinned out as if somehow it lost some density but kept its overall growth pattern. This left me confused!

I wondered if my beard massaging or perhaps even clipper could have caused this? Almost all the men I know use a clipper on their faces and most can be seen stroking their beards from time to time. I mean the hair follicles are so thick in the beard area I imagine even tweezing them out would be difficult! Any insights would be greatly appreciated.

I doubt that “massaging” your beard would cause traction alopecia. You would have to be constantly pulling on the beard to the point that it sags your face. As people age their body hairs change in general.

I do not know the cause of your beard thinning. As much as we treat scalp hair loss, we rarely treat beard hair loss. I do at times see men with spotty beard hair loss and that often comes from alopecia areata. You may want to see if there are any other areas on your body and scalp where you notice this type of thinning.