Am I Losing my Hair? (photo)

I posted some pictures because I am not sure if I am loosing my hair. I have recently noticed some thining in the front and back but I am not sure if I am really loosing my hair or if it recently has just been looking different. I also notice when I stroke my hand through it a lot of strands are easy to pull out. What can I do? Progaine? Rogaine? I am 22. Thanks!

Doctor Answers 4

Combination Therapies Can Work Well For Treating Male and Female Pattern Hair Loss

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Since not all forms of hair loss are inherited, confirming the diagnosis is  the first order of business for establishing a diagnosis of androgenetic (inherited) male or female alopecia (hair loss). Besides the genetic variety, other common types of hair loss include stress induced alopecia (telogen effluvium), alopecia areata (an immunologic condition), hair loss and scarring arising from infection or inflammation of the scalp, and chemotherapeutic induced shedding.

Regarding male or female pattern alopecia, in most cases  the history and the physical examination are enough to cinch the diagnosis. When there is some doubt, a DNA test, HairDX,a genetic test I have been using for the past four years, may be useful for confirmation.

I am not a big fan of hair transplantation surgery in its current forms; it is after all an invasive procedure and does not grow hair (only shifts hair from one area to another).  I am, however, looking forward in the not too distant future to possibility of cloning hairs, in which one hair follicle will be removed and then prompted to produce countless additional hairs that may then be implanted in the balding areas. This would indeed be a real advance and has so far been found possible in laboratory animals. 

In the meantime, we have two FDA-approved products for hair loss--topical minoxidil (Rogaine) and oral Propecia (finasteride)--the latter approved for men only. I have not been particularly impressed with plain minoxidil in my more than a quarter of a century experience with it. And, while Propecia can be helpful, I have grown increasingly loathe to prescribing it, especially to young men, owing to potential side effects, particularly loss of libido, impotence, etc., which may last for longer periods of time than previously believed.

Fortunately, experienced dermatologists have been able to have other topical formulations compounded that contain higher concentrations of minoxidil, with or without the addition of other hair growth enhancing agents, such as finasteride, azelaic acid, retinoic acid, which may also be combined with the home use and office use of medical microneedling (e.g. Dermaroller) devices or mesotherapy to increase penetration and efficacy.of these medications.

Such combined approaches, which can be tailored to individual needs, have, in my experience over the past quarter of a century, yielded quite gratifying results in helping individuals retard the rate of loss, hold on to the hair they have, and even promote new growth.

New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Prevention of Hair Loss

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Before a person becomes aware that their hair is thinning they have probably already lost a significant amount of hair.  A human head can have as many as 150,000 hairs and that is why it takes considerable hair loss before you know it.  Also, we are all losing 10% of hair in the normal cycle of hair growth whidh then regrows in 3-4 months.  So having some hair coming out is normal.  The best thing you can do as you age is to consider products like rogaine or propecia.

Jack Fisher, MD
Nashville Plastic Surgeon

Propecia for pattern hair loss

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You are definitely showing pattern alopecia where there is thinning of hair on the crown, temple recession of the hairline and soft, unruly curling hair around the ears(these are called barber curls).   It is interesting to note that barbers were the first to notice this change of hair around the ears and came to realize it was a precursor to pattern baldness.  The only medication which works is Propecia(finasteride 1 mg).  It is most beneficial in men your age who are noticing the loss of hair.  You will need to take it daily.  The first thing you will notice is a decrease in the amount of hair loss and over time you will see regrowth of hair in the crown.  Over the years I have noticed that it stops temple recession, but there is little regrowth in the temples.   Good luck!

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Hair loss prevention.

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In over 35 years if hair replacement surgery the only product that I recommend is Propecia. It is the only one that has good before and after pictures and It is the only one I have seen grow cosmetically significant hair. Don't waste your time with the other stuff!!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.