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Snippet from the article:

Put that comb back in your handbag — a study by an Israeli dermatologist has found that too much combing of the coiffure leads to hair loss, the daily Haaretz reported on Monday.

During a test 14 women recorded their daily hair loss and combing habits, with those combing more losing more hair, the research found.

Read the full article — Don’t brush with baldness: put down that comb

The Internet is full of useful information, but as I’m sure you all know, some of it can be deceiving. The article states that an Israeli dermatologist studied just over a dozen women and came to the conclusion that women that comb their hair twice a day have far more hair loss. The study went on for just a month, but what is unknown is the type of hair the women have, their ages, health condition, type of brush used, plus various other factors that would be important to note in a study like this. In fact, I found the original article published in Israel, with a quote from the dermatologist that conducted the study. He says, “It’s a very simple experiment, very primitive, you could say, not high-tech.” I’d have to agree with that. It seems to be pretty incomplete… but it sure makes for a good headline in the news.

Bottom line, if you are rough with the comb and your hair is long and you pull on it when you comb it, it may just fall out eventually. Men with genetic balding and miniaturization have a more fragile hair that is easily traumatized, so I always suggest that people are careful when they comb their hair and not be abusive to it. Gentle combing done very frequently will not cause hair loss.

This is regarding your blog entry titled “I Don’t Think I’m Responding to Finpecia”

I had been taking Proscar for a year and my hairloss stopped completely. Because I was trying to save money I decided to switch to Finpecia. After 3 months on Finpecia I started noticing a rapid hairloss. I immediately went and got a refill of Propecia at CVS. I’ve been back on Propecia for about a month and the hairloss is gradually slowing down. I think Finpecia is fake. Please tell that poor student to throw that stuff away.

The above is an opinion of one of our readers. I’m not going to tell someone to throw away their medication that I didn’t prescribe and I’m unsure is even a problem.

I’ve written about Finpecia before here and here. There are a variety of 1mg generic finasteride made in other countries (not legally available in the US), and you can see some of those listed here.

Doctors say follicular units contain 1,2,3, and sometimes even 4 hairs per unit. My questions is, when miniaturization occurs, does the whole follicular unit get affected at the same time or does the individual hairs within the unit miniaturize at a different pace and time frame? Hopefully my question is clear.

Best regards! I know you keep busy with the blog and practice!

When miniaturization occurs, each hair within the follicular unit seems to have its own time clock, but the follicular unit itself will miniaturize in the patterned area at a different pace, area by area. Often in young men, the frontal hairs will miniaturize faster than the hairs on the top of the head, about 4 inches behind the hairline. As the hairs within the follicular unit miniaturize and it progresses, one hair at a time may drop out and die before another one within the follicular units takes its genetic course.

Using HairDX to help understand if continuing Propecia is appropriate

I’m 29 with a full head of hair, but it’s a bit thinner than it used to be. I started Propecia six months ago after having some miniaturization detected on the front and top of my scalp. I have yet to notice any positive impact from the drug, but feel Propecia might be affecting my sexual performance. Whether I’m imagining side effects or not, I have been thinking about decreasing dosage or stopping Propecia altogether — I’d rather not have to be on a ED drug in my 30s, especially if Propecia isn’t helping me.

Would it be worthwhile having the HairDX test done to help me weigh the costs and benefits of continuing Propecia? Furthermore, does HairDX offer any insight into how hair loss might progress over time, the degree of hair loss that might occur, or the minimum Propecia dosage I might respond to?

The CAG repeat test from HairDX (marketed as “Finasteride Response Test“), will tell you if you may respond to drugs like Propecia. Start from there and then discuss the findings with your doctor. To my knowledge, there is not direct quantification of the HairDX test for CAG and the dose required of drugs like finasteride.

The standard HairDX test won’t tell you how much hair loss you’ll see in the future — just whether you have the genetic markers for hair loss.

I have been experiencing heavy diffuse hair loss for about a year now. My nails are very dry, brittle, have long vertical ridges and split very easily. My big toenails are yellow in color and have been falling off their beds with new ones growing under, for the last 5-6 years. My skin is also very dry. My skin is very dry too.

My scalp is itchy, and when I scratch it I have grainy, sand like white stuff in my nails. Could you please tell me how this hair loss can be controlled? Is it fungal in nature? Or is something else going on inside the body?

Thanks.

Generally, it does sound like you have a fungal problem (onychomycosis), but please see a dermatologist so that he/she can make that diagnosis and provide a treatment path. This isn’t something I can do over the Internet. Your hair and nail conditions could be completely unrelated, but I’d need an examination to determine that.

Doctor,

1. Is there anything that can be done to stop the progression from Norwood 2 to 3? Is there any thinning in the temporal area for Norwood 2? When a maturing hairline begins will it eventually get worse leading to MPB? Also, does a maturing hairline and MPB follow a similar pattern since the hairline recedes ,etc.?
2. I read somewhere that avocado may reduce DHT, but is it really true (I doubt it, but I will still ask)?
3. Is there a critical period to start Propecia? Usually in the U.S. how much does Propecia cost? Also, do you prescribe Propecia and Proscar? Is a consultation in your center free, and usually what is done?
4. When it comes to medication for hair loss is “what you pay is what you get”? Therefore, a generic of finasteride will not be as effective as Propecia? Is there anything added to generic finasteride that is not in Propecia (i.e., any filler substances)?

P.S. I know you can’t respond to all emails, but I would appreciate if you respond to my questions.

Thank You

1. The mature hairline progression is not balding. If your hairline goes further back than the mature hairline, then you are balding. Most non-balding Caucasian men have a maturing hairline. Temporal recession is possible in Norwood 2. You can find full Norwood class descriptions here.
2. Everything I can find online about avocado and DHT says it “may” help treat hair loss, but allow me to end the speculation now. Avocado is a delicious fruit, good to make guacamole, but not good to treat hair loss either by application to the head or eating it.
3. The first consultation in my office is free right now, and I set aside a full hour for first timers. We’ll discuss your hair loss, I’ll map your scalp for miniaturization using a video microscope, and we’ll go over treatment options. If you’re likely to be a finasteride candidate (starting it in the earlier stages of hair loss is best), I’ll likely prescribe it. Propecia costs $190 for a 90 day supply in my office. I don’t know how much other doctors or pharmacies charge, but I believe we’re on the lower end of the price scale.
4. Generic finasteride is less expensive than Propecia, but otherwise as long as it really contains finasteride, the generic is just as good. The issue of fillers is not relevant.

Image Courtesy of California Avocado Commission

Dear Doctor,

I’ve just been reading about your info from Amsterdam.
In addition to this, I was wondering if you in the nearest future see any new drugs against baldness?

I’ve read about some new test.

1) Some Japanese researchers blame the Sox21 gene for baldness.
2) Some researchers blame the wnt gene for baldness.
3) Some researchers blame the P2Y5 gene for baldness.

Because of my research for hope of any new treatments, I’ve become confused. All these different tests and scientists blame different genes for baldness. Can there really be so many genes, which cause baldness? And where does this leave Propecia, if all this new research blame something else then just DHT for baldness?

I hope you understand my wondering mind.

Best regards.

There are many, many genes for balding and only some have been recognized. A few on the X chromosome have been highlighted by the company HairDX, but genes are constantly being found on chromosomes beyond the X chromosome. Genetic hair loss is very complex (not like the eye color of the fruit fly) and it is the many genes that make the discovery of an effective new drug. Propecia just blocks the DHT hormone and does not address the various genes and approaches you asked about above.

My mom’s dad was mostly bald by 30, but my dad has absolutely no sign of baldness at 56 and his dad had a fair amount of hair left in his late 70’s.

I know your mother’s father is the best indicator for inheriting MPB, but what if there’s an extra Y chromosome involved (i.e. someone who is XYY)?

Since I inherited my dad’s hair twice (it also become brown and then later curly at the same point in life, 11 and 17 respectively), could I have dodged a bullet?

I’m closing in on 21 with no sign of baldness yet. Would the extra Y outweigh the MPB on the X chromosome?

Thanks

Even if you were an XY, you have about a 50% chance of inheriting your father’s family line. I do know now about XYY like you are, but I would generally tell you to do what I always tell people to do when determining their likelihood of developing genetic balding:

1. Get a genetic test from HairDX
2. Follow your hair looking for both gross and microscopic changes in potential miniaturization. This is the practical side of the process and it is easy to do this type of microscopic evaluation by mapping out your head for miniaturization.

Hey there I realize your very busy, but I was wondering, since hair is made of protein, do things like eating alot of peanut butter or whey protein shakes help prevent hair loss in any fashion???? Or would it even be harmful to the hair follicle???? Im 18 and trying to stop hair loss before it starts or gets too bad, I would APPRECIATE VERY MUCH if you would answer this question, THANK YOU :).

There is no connection with preventing hair loss by increasing peanuts in your diet. It’s not harmful… unless you put the peanut butter in your hair and then rip it out. If you want peanut butter health benefits, check out this page.

Snippet from the article from The Consumerist:

Earlier this week, the FDA sent a warning letter to Americell-Labs, the manufacturer of many popular lines of such supplements, and also warned consumers to stay away from the products. The “supplements” claim to act a little too much like steroids, and should be tested and sold as drugs if they are, y’know, drugs. If they’re anabolic steroids, they shouldn’t be sold at all.

Read the full article at Consumerist.com

The reason I’m posting this is because I get a lot of emails from bodybuilders inquiring about various supplements that I’ve never heard of. The products in question here are TREN-Xtreme, MASS Xtreme, AH-89Xtreme, HMG Xtreme, MMA-3 Xtreme, VNS-9 Xtreme, and TT-40-Xtreme. These supplements promote “no hair loss” in big, bold print on their websites… then followed by a warning that states, “Possible side effects include acne, hair loss, facial hair growth (women), aggressiveness, irritability, and increased levels of estrogen.”

And that’s just one of the things the FDA had trouble with. Read the full FDA warning here.