Snippet from the article:

GREY hair may be unwelcome, but the processes that produce it are now better understood and could be protecting us from cancer.

Cells called melanocytes produce the pigments that colour hair and their numbers are kept topped up by stem cells. Hair goes grey when the number of stem cells in hair follicles declines. Now Emi Nishimura of Tokyo Medical and Dental University in Japan and colleagues have found what causes this decline in mice.

Read the rest at NewScientist - Grey hair may be protecting us from cancer

This is a long stretch from a prominent researcher. I will not celebrate my gray hair because of this article.

Hi,

Thank you for your great blog. I’m a head shaver, and currently I’m using Rogaine foam. I will shave, then shower, then use the foam. I was wondering if it’s ok to put moisturizer on my head before the Rogaine foam? Would that change the effectiveness? Thanks!

Probably not, but more chemicals on the scalp could potentially block the Rogaine Foam absorption. The application instructions for Rogaine say to apply it to a clean and dry scalp.

Dear Dr. Rassman,

recently you wrote on this blog about having advised several of your patients seeing a certain loss in efficacy of finasteride treatment to higher the dosage from the regular 1 mg per day to 2.5 mg (half a proscar). In older entries, however, you are strongly advising against that therapeutic “move”. Could you please explain why you seem to have changed your mind on this and what conditions you´d like to see fufilled before making such an increase in dosage!

Thank you so much!

There have been more and more complaints by some patients that over the long term, Propecia seems not to prevent the advancing balding patterns that they are experiencing. Because of the high interest in Avodart in some individuals who are not getting control of an advancing balding pattern (without its FDA clearance), there seems to be a consensus by some of the prominent doctors in the field that 2mg of Propecia (or 2.5 mg of generic finasteride — which is a half of a Proscar/generic finasteride pill) may be better in some of these individuals and worthy of a try. Please note that I’m not suggesting that people increase their dosage on their own without talking to their prescribing doctor.

As long as there are no negative side effects, I believe it is a better option than Avodart, which I am reluctant at prescribing until I get more comfortable with the FDA clinical trial that just completed. I will try to understand this better at the ISHRS meeting next month in Amsterdam, where the Avodart study will be discussed. Once I know more, I’ll post it here.

I have a question concerning thin hair. I am a 31 year old male. I have always had really fine hair. I dont appear to be going bald but there is a really thin spot on the back middle section of my head. When my hair is cut short it looks pretty thin back there. Someone told me this might be because this is where the occipital bone is. Is it common to have thinner hair around the occipital bone? Do you see this alot? Thank you very much.

No, I do not see this in isolation. You may be noticing thinning around the rim of the crown area on the back of the head (see image at right).

If you are indeed pointing to where the occipital bone is (see highlighted label on image below), that is the area where hair should be the thickest and fullest in most men who have genetic balding. That is why we call it the permanent zone. Right below this area is the neck and this can have a different genetic code, but there is no bone under that part of the scalp in the midline.

Image source: AARP

Doc, I am 19 and experiencing signifigant hair loss in my hairline/temple area. I have heard that the earlier one looses hair, the balder they will go, but no one on either side of my family has ever experienced extreme hair loss or anything past a norwood class A type Va (worst case)

Is it true that the earlier one starts balding the more hair they will lose, or do they just reach their pattern quicker?

The two points are not necessarily connected, but those that lose a lot of hair often start early in their 20s with the process. From a transplant perspective, a Norwood class 5A pattern is a good end stage pattern for most people who want full coverage, where a class 6 or 7 is often difficult to treat for full coverage. In someone with a Norwood class 6 or 7, the supply of donor hair will often not be enough to solve the need for a full replacement hair transplant. I have transplanted a sereis of Class 7 patients with upwards of 7000 grafts (as high as 9900 grafts in one patient) to get the coverage they wanted. These individuals were fortunate enough to have high density donor hair and good scalp laxity. It certainly took more than one session to reach this number of grafts. For the sake of convenience, the Norwood chart is shown here:

Hi Dr. Rassman or whomever receives this message,

I’m a 24 year old South Asian male and I’ve been taking finasteride daily for over a year now to combat my early hair loss. I’ve experienced good results with regrowth around my crown and an apparent freezing of any more thinning on the top of my head.

However, I’ve recently started taking Strattera (Atomoxetine)for my ADHD (I’ve always had it, but now its starting to interfere with my daily life). Is there any possibility that this could interfere with the effectiveness of the finasteride (I take Finpecia)? What about other ADHD drugs like Adderall or methylphenidate or even high amounts of caffeine?

Thanks for your time

There are many reports by individuals on the web that reflect hair loss in association with Strattera and Adderall. I would discuss these issues and concerns with your prescribing doctor.

If the hair loss problem is not related to DHT (which I believe is the case with these drug side effects), I would not expect DHT blockers such as finasteride to help… unless there is some genetic cause.

Dear Dr Rassman
You wrote an answer to someone yesterday saying this:

“The issues of safety and effectiveness have not been fully explored in the youth like you with Avodart. Without that information in a research controlled, FDA approved study, there is no way to tell the answer to your question. Unfortunately, the manufacturer has not elected to sell into the hair market, despite the good blocking effect that Avodart has on the targeted enzyme. The FDA has certified this drug for prostate disease and I suspect based upon this, the drug should have no impact on the egg fertilized by the sperm of a man taking the drug, or when having unprotected sex during pregnancy”

Does that mean that they do not want to put Avodart on the market for hair loss after all? Please Advise!!! Thanks

The answer you’re referencing is something I wrote way, way back in February 2006, before official trials for using Avodart as a hair loss treatment took place. I’ll know much more about Avodart after the International Society of Hair Restoration Surgeons (ISHRS) meeting next month in Amsterdam and will post what I find on the blog.

DR. I have noticed a bald spot on left side of my head, it is size of bottle cap. What can I do. rest of my hair is fine. I’m 28 yrs old and also have noticed gray and white hair by side burn area. The bald spot is just above my left ear. Please help. I talked to my doctor he didn’t tell me anything.

I would see a dermatologist, as there are many types of diseases that can do this. The possible causes are all listed in one of the chapters of my new book, Hair Loss and Replacement for Dummies. ***shameless plug***

This patient received 250 grafts just a few years ago (not from me, obviously). He knew things were going wrong when the doctor put wooden toothpicks (which could leave behind splinters) into the recipient sites which were made on his head. He overheard the staff chuckling at how he looked. He told me that before selecting his original doctor, he researched the field over the internet and had a few doctor consultations. He selected the original doctor because he was promised a great result and he believed that promise. As the hair started to grow, he became very self conscious and progressively depressed. Going out into social situations made him uncomfortable, even just going out of his house (something he rarely did once the grafts started to grow).

Cosmetic surgery of any type reflects people and their innermost feelings about themselves. I wonder if doctors understand how substandard cosmetic surgery like this can impact a person’s life. This nice young man’s life was in ruins and his fear of going to still another doctor who could possibly do even more harm, did not drive him to learn how to correct the problem until very recently when he ran into us on the internet. First, we spoke over the phone and then he set up a surgery with me and flew in. When I saw him this week, he was frightened with flashbacks of his original horrific experience

Just to be sure everyone is clear — the photos that are shown below are of this man’s substandard work and an example of what a doctor could do if he/she does not use state of the art hair transplantation technology. The term “hair plugs” is still incorrectly used for the modern technology we invented, but the lingering images (reinforced by patients such as this) are hard to abandon. Looking at the results that were once commonplace, one can clearly see that referring to this old technique as “plugs” is not out of line. Fortunately, I took steps to correct the appearance of these plugs by coring some of them out and transplanting more hair to fill in the entire frontal area. All of the plugs that were removed were cut into follicular units, and then re-transplanted into the scalp. I expect that he’ll be much, much better off after this first procedure with me of 2600 grafts grows in, which was done this week.

Here are the photos of his pluggy look referenced here (click to enlarge):

Hey there Dr. Rassman. I’ve been reading through your site here for a few months after I noticed some thinning at the front of my hairline. I’ve been on Propecia for over a month now and I feel better about the situation but obviously have not had any results yet. The reason I’m contacting you is because, frankly, my hair is very, very important to me and it’s hard for me to effectively convey that to my primary care doctor. Is it unusual for patients to travel cross country to seek your treatment or would I be better off finding someone here in Memphis? I am not in a current financial situation that would allow me to come see you but some day I might really want intensive care for my hair. I can tell by reading your material that you are wise man who cares about people. I would appreciate any correspondence and advice you have to offer.

Our practice is not a typical hair restoration practice in that a good number of our patients do travel a long way to see us, though more than half of our patients are local to California or surrounding states. For those patients who are not local to one of our offices, you can set up a “virtual consultation” with us to get an initial opinion. Some things can be managed without a face to face meeting, but we often direct those potential patients to at least have a phone call. We encourage the use of photographs to help us understand the problems at hand. Hair is very important to our audience and many of those we do a virtual consultation with over the phone have developed questions from reading this blog. If you’d like to request additional info or setup a consultation, check here.

With just a month on Propecia and without knowing more about your hair loss situation, I couldn’t begin to guess if you’re a candidate for hair transplant surgery. Hypothetically though, you should choose the surgeon that can best fits your needs and that you feel most comfortable with. I wouldn’t suggest basing your decision on convenience. For those coming from out of town for surgery, we do offer a travel program.