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It is clearly stated that MPB is genetic. So here’s my question…if it’s genetic shouldn’t it follow the age of your relatives when they had hair loss? The only person in my family that had hair loss is my father but he was 32 when it began and everybody else in my family that includes uncles, my two grandfathers especially these 2 had all their hair. So how in the world I’m having early signs at the age of 21? I been through heavy depression and stress in the past 3+ years, could that have triggered MPB out of me so early?

If we inherit it, it will probably be your own hair loss design with respect to timing of occurrence and the degree of hair loss. There is no one-to-one connection year-by-year with your dad.

I find your responses to be irritating. Specifically, they take on a condescending tone, are pointless as most recommend seeking medical advice. What is the point in this forum if that is the pat answer. Of course they should seek medical advice.

Sometimes people just want encouragement and hope. Not a …”you should do this… you need to do that… Not helpful at all. Sorry, that is just my observation.

I have not been able to find many (if any) articles on the internet that indicate relief of symptoms and offering a solution.

We just want a solution, not a lecture.

Your point is well taken, but please recognize that many people who write to me want a medical opinion on their condition, something that I can not give without examining a patient and without being able to ask questions. Also, many times my hands are tied by legal restrictions (I am a doctor, but not the doctor of those writing in) and therefore the best suggestion I can give is to visit their doctor. 95%+ of patients seen by the doctor can have a diagnosis by taking a careful history with good observation. This is particularly the case in diseases of the skin and hair where x-rays and blood tests are generally not needed, just experience and skills in the art of diagnosis. Telling me in an email that “my scalp itches” does not tell me much that I can use in diagnosis or offering relief. For example, last week I posted a question from a reader that said it felt like something was crawling around his scalp and I suggested that he might have head lice. In a situation where I could do a face-to-face examination, I would have seen the head lice crawling around his scalp had that been the right diagnosis.

You asked for solutions that bring relief. If that was so simple, then the doctor’s role of history taking and examination would have no value. I offer 2-3 hours a day to the blog to help when I can (sometimes more, sometimes weekends), and many, many emails are screened. I wish it was an easy task, and if only life were simple! As you can see, I volunteer my services on this blog and do not make my living from doing it, but what I do get from the effort was a way to stay in touch with people and a reason to research many of the questions that had great value to my learning experience. Even at 66 years old, I am still a student.

How old do you have to be for an accurate miniaturization mapping?

Any age. It is just an examination of hair condition under a microscope. You can be 1 or 100 years old.

Dear Dr,

I am having UVB treatment for chronic eczema on my body. Should i be protecting my scalp from the UV rays? The sessions are short and only 15mins max. Right now i am on 54 seconds.

UV exposure does impact the skin. Dr. Richard Shiell in Australia believes that he gets less hair growth from transplants on the right side of the frontal hairline in his patients due to sun exposure from those who do a lot of driving. In Australia, they drive on the left side of the road and therefore get more sun exposure to the right side. If he is correct in his observation, UV exposure can damage the skin. There are two areas of potential damage:

1. To the skin and the growing parts of the skin
2. To the blood supply of the scalp

At the dose you are taking, it may not be a problem, but I would check with your doctor and find out from the source.

Snippet from the article in the NY Times:

Call it the Great Eyelash Coup. In November 2007, at the request of the Food and Drug Administration, United States marshals seized 12,682 tubes — about $2 million worth — of Age Intervention Eyelash, a lash enhancer then sold by Jan Marini Skin Research. The F.D.A. considered it an “unapproved and misbranded drug” in part because it contained bimatoprost, which is approved for glaucoma treatment but not for cosmetic use.

Since 2001, ophthalmologists have found that hair growth was a side effect. Others included optic-nerve damage and blindness — hardly worth the risk if you didn’t have glaucoma.

Read the full article — Longer Lashes in a Tube? Maybe Not

The price we pay for unapproved drug experimentation may be more that you ever thought possible. There was another article about bimatoprost (which is the active ingredient in Lumagen) back about 8 months ago that I mentioned. And there’s another drug, latanoprost (Xalatan), that seems to have similar effects on eyelashes (see previous post here).

My scalp consistently feels “weird” (i.e. like bugs are crawling around on it). I know this might sound strange, but I am always having to itch my head because it just never feels normal anymore. This has been going on for the past three years and sometimes I can deal with it, but most of the time its annoying me. Do you have an explanation on this?

Any response is greatly appreciated.

Maybe there are bugs crawling on your scalp. For example, head lice or mites can be small enough where you may not notice by just looking in the mirror. I would see a doctor for a good examination.

Dear Dr Rassman

I have read with interest your website and would be keen to ask you the following.

You state that if hairs are not DHT sensitive, medications such as Propecia will not help. Effectively the most probable medication a doctor or dermatologist does prescribe is right Propecia or Minoxidil. But at this point I wonder whether there are some preliminary tests on the scalp or the hair someone might do before even trying with these medications. In fact, if someone wants to know whether his hairs are DHT sensitive and so whether a medication like Propecia would work, what kind of tests would you recommend?

Thank you for your time. With kind regards

There are no tests that I am aware of to test for dihydrotestosterone (DHT) sensitivity or to test for effectiveness in DHT blocking with Propecia (finasteride 1mg). If you are a male and balding with a typical male balding pattern, DHT is likely responsible and Propecia will likely help… but I suspect DHT is not 100% responsible for male pattern baldness, as genetic and biological processes are not so simply constructed. More importantly, try to look at the problem more practically. You may be very sensitive to DHT or not very sensitive to DHT, but even a little finasteride is worth a shot at slowing the balding process when you have nothing but hair to lose.

Hi, I was wondering if it would look natural if a person with a norwood 5, shaves their head and tattoos the balding portion of the head (in an attempt to regain a shaved norwood 2 look.) Also, when you tattoo the balding portion, would it promote hair loss in the non-balding parts?

Most people who have their scalp tattooed just can not replicate the appearance of a crew cut head of hair. I’ve seen this tried before, and to be honest, the majority I have seen look distinctly abnormal, with one exception: a patient that was able to artfully replicate a short hair cut with a temporary tattoo which he reapplies every few days. While tattoos could potentially cause hair loss (if there’s infection, for example), they more than likely won’t.

Snippet from the article:

An Australian company called Fermiscan is in the process of developing a test that could possibly identify a person with breast cancer using about 20 strands of their hair.

The Fermiscan test has shown a 69% accuracy in detecting breast cancer. A study published in the Journal of the American Medical Association showed that mammograms or ultrasounds showed no greater than a 50% chance at detecting breast cancer, and a 78% detection rate when the two were combined.

Read the full article at InventorSpot.com.

Hello Doctor.

I can’t recall I have ever seen a picture of a balding man from the amazon natives. I can recall I have watched a long time ago a documentary film, in which I have seen an amazon native delousing louses or other insects from another amazon native’s head and then eating the insects. Are they balding-proof thanks to this insects diet?

To my knowledge, balding afflicts all men with no discrimination to race, ethnicity, social class, and even insect diets — with the exceptions being the Native American with ancestry from the Alaskan Bridge, and Aboriginal Australians. I’ve written before about the possibility that there is an isolated gene pool in an isolated area that doesn’t have the hair loss gene, although it is just a what-if until someone studies it.

I just found some wonderful images of Amazon natives at this site, Amazon-Indians.org… and this photo (contains nudity) in particular appears to show hair loss in a native to the rainforest. I don’t know what kind of bugs he eats, if any.

With that said, do you know where I can get some of those insects? They might be worth selling on on this site (don’t take me too seriously here, we’re just before a long weekend).