Dad and his family have been diffuse balding since his early 30s. He has super fine, thin hair. I have the same super fine, thin hair, though luckily no signs of balding yet. A cousin on my dad’s side has pretty severe diffuse balding, the other also has diffuse balding but not as severe.

All of the males in my mother’s family have very thick hair, and none of them are balding even though they’re well into their 60s.

Since I have my dad’s fine hair, does it mean that I’m more likely to have his balding gene? Or is the gene completely separate from the hairs’ characteristics?

Hair characteristics are unrelated to the genetic hair loss process. So just because you have fine hair from your father, doesn’t mean you’re guaranteed to have his hairline.

Here’s an awesome hair transplant result I want to share. This patient had one procedure of 2926 grafts, with the photos taken just under a year after his surgery.

He said that almost no one noticed the hair growth, but family members and friends that he hadn’t seen for a while did detect a change in appearance. Some people thought he lost weight, some thought he had a face lift, but a few did notice that he had hair that was not there the last time they saw him. He isn’t shy, so he’s allowed me to post his photos and I am appreciative that he agreed to share this remarkable change.

Click the photos to enlarge.

After (1 procedure of 2926 grafts):

Before:

Dr. Rassman -

On March 13, you wrote:

“Men in the process of losing their hair in a Norwood class 6 pattern may not be thinning uniformly. They may be losing more of the frontal hair faster, yet have the overall pattern of a class 6 that may or may not become complete. Some men who take finasteride will arrest much of the class 6 pattern thinning, especially in the top and crown of the head, but their frontal balding could actually be advanced.”

Could you explain this in more detail? Are you suggesting that finasteride might accelerate frontal balding, beyond what would have occurred without medication? Or are you just saying that finasteride might have relatively minor efficacy in the front?

I’m a 26-year-old caucasian male, and most male relatives on my mom’s side have Norwood 6 or 7 patterns. Like the guy who wrote on March 13, I appear to be in the early stages of thinning towards a Norwood 6 pattern. My own loss is heaviest in in the vertex, with some loss also in the middle and front (although I have a strong forelock). About three months ago, I started taking 1.25mg of finasteride daily. At my checkup a week ago, my dermatologist noted new growth in the vertex (hooray!) and agreed that my corners were a little worse.

I’m interested to hear your thoughts on how finasteride might impact my ultimate balding pattern, both in the front and back. And I’m interested in a clarification and elaboration of those comments from March 13! Thanks for all your work. Your blog is a great read.

Sorry if I wasn’t clear in my prior post.

A simple way to think about this is that Propecia does not stop hair loss completely, and it works best at the top / crown area. So if you are balding in a Norwood 6 or 7 pattern, Propecia will slow down the hair loss on the top / crown area while the front area will have faster hair loss than the top / crown.

Eventually, you may reach the Norwood 6 or 7 pattern, but if Propecia thwarts the hair loss process, you may be able to delay this for 10+ years if the drug works that way for you.

Came across this article about hair loss in the the daily mail. What are your views doctor rassman?

How a £30,000 hair transplant can still leave you going bald

That’s a nice looking transplant result in the first photo set in the article. The article goes over the various treatments that are available, and warns about scarring and shock hair loss following transplant surgery. Nothing new here that we haven’t written about dozens of times before on this site, unless I’m missing something. It appears to just be a general hair loss treatments article for the UK audience with a punchy headline to grab readers.

Doc, I understand Doctor Cooley is still doing plucked hair procedures but found they need to be done with grafts harvested from FUT or FUE.

What’s your comment on this

It is not considered plucked hair when you are using follicular unit grafts. That sounds like a regular hair transplant procedure. The pulled graft/hair will not grow back from its ‘plucked’ place. It is no longer considered hair multiplication.

If one believes that adding ACell to a hair transplant procedure for better growth, it needs to be studied and proven.

I am a 31 year old male who started Propecia 4 1/2 months ago after noticing very slight corner recession. I have very thick hair and have always seemed to shed a fair amount. After starting Propecia the shedding immediately stopped. However, 4 1/2 months later, my hair has definitely thinned at the corners and my frontal hairline is eroding. While my hair loss is not yet noticeable, I feel my time is short.

Should I still hold out hope for Propecia at this point? Could I still retain those minaturized hairs? Or are they now beyond the drugs grasp? This is having a profound affect on my self-esteem. Any insights you could provide would be greatly appreciated. Thank you for your time.

Let’s start from the beginning with education and facts:

1. There is no drug that permanently stops hair loss.
2. Propecia takes about 8-12 months to see its maximum benefit. Sometimes it takes a little time beyond that.
3. Propecia seems to work mainly on the top and crown area. It does not work well for the front and front corner areas. If it does, it is in a minority of people.

I understand you are trying to address the hair loss issue but you need to discuss these issues with a physician who can give you a realistic expectation and long term goals. We often refer to this as the Master Plan, which we are a big advocates of.

Snippet from the article:

A vaccine that targets 90 percent of all cancers shows promise in early clinical trials. It seems to target the vast majority of cancers and it has produced encouraging preliminary results in phase I/II clinical trials, according to an announcement made on April 2 by the vaccine’s maker, Vaxil Biotherapeutics. The ImMucin vaccine consists of a 21 amino acid-long peptide that represents a key signaling region of Mucin 1, cell surface associated (or MUC1)—a glycoprotein expressed by 90 percent of solid and non-solid tumors.

Read the rest — A Universal Cancer Vaccine?

It’s not hair loss related, but it could prove to be more important than any development in the hair loss world. This is a very exciting announcement, even if it is very early in the grand scheme of things. This info is coming from a safety trial of just 10 patients, and there’s much more work to be done.

More info can be found here and in the study abstract here.

Hi Doctor,

When shampooing my hair, I notice that I lose the most hair from the sore parts of my scalp. What do you think could be causing this? I alternate between Head and Shoulders and Nizoral.

Thank you.

There’s no way for me to answer this question or even take a stab at an explanation without knowing your hair loss history. If you seriously want answers, you need to have your scalp examined by a physician.

Sore spots on your scalp could be a variety of things, from dermatitits to psoriasis to acne. The vast majority of hair loss in men is caused by genetic androgenic alopecia, but if you’re concerned you should see a dermatologist about your tender scalp.

[tags]tender scalp, hairloss, hair loss, shampoo[/tags[

Hello Doctor

I’ve read that blood donation could be shocking enough to the body to cause some sort of hair loss.

True or false ?

False. I’ve never heard of a case where donating blood has caused shock hair loss.

Hello –

With all of the recent talk about the sexual side effects of Propecia and the impending class-action lawsuit against Merck I’m a bit concerned about having taken the drug since September 2008…At this point in time I have not noticed any side effects — I don’t have erectile dysfunction, my libido is fine, I havent noticed any increased tenderness in my breast. If I haven’t noticed any side effects from the drug yet — almost 4 years in — is it possible that these side effects may appear later on? Maybe 5-10 yrs later?

Thank you.

You are in the normal club of everyday patients. I would certainly not worry considering you’ve been taking the medication for years with no side effects… and if I were you, I would considering staying on the drug. Ultimately, I’m not your doctor and it isn’t a decision I am a part of, but if you’re truly concerned, talk to your prescribing physician.

It is unfortunate that we live in such a litigious society. Judging by the press releases I get via this site, the lawsuit talk is mostly generated by law firms seeking out people and looking to cash in.

While unrelated to hair, did you hear about the 80-something year old woman who is suing Apple for a million bucks, because she walked into the clear glass door of one of their retail stores?