As Seen on


If and when Piloscopy becomes a thing, will you adopt it too?

I’m asking this because you are a very skillful surgeon and it would be a great thing if big surgeons such as you adopt it..

Block Quote

First, what is Piloscopy. A presentation of an endoscopic approach to follicular unit extraction was presented at the ISHRS conference last October by Wesley. The idea was to use an endoscope to enter the scalp from a 2 cm incision and extract follicular units from below the scalp near the skull side with a 1.2 mm punch under suction. At this point in time, it would compete against a well established FUE procedure which is well understood and used by surgeons world-wide. There is no evidence that his technique (which is mostly theoretical) can work efficiently used, if in fact, at all. There are clearly wounds that would be made at different parts of the scalp which would have to be sutured and these wounds would scar. Anyone who claims a ‘wound-less’ surgery is wrong. If the grafts were taken out from an approach below the scalp, there would be a small wound at every folliclar unit where the connection to the epidermis must be cut to get the follicular unit free of the epidermis. This write-up is based upon my memory of his talk before the hair society in October.

See the Consumer Alert in ISHRS website.


Hi Doctor, your blog is extremely useful. I am an 18 year old Indian who has a hairline like Taylor Lautner when he was 18 years old…

You said in that post that he lost immature hairline rounded corners but otherwise had a juvenile hairline. My question doc is that, is losing the corners a sign of a receded hairline that falls under the category of a maturing hairline or is it still a juvenile hairline. Also, I would also like to point out that few of my friends have also lost there rounded corners. Is this normal. By normal I mean, is it not MPB or is it MPB or is it a maturing hairline or is it a juvenile?

I really hope you answer this question and ward off my worries. Thank you so much! Hope you have a great day!

Block Quote


Actor Taylor Lautner does not have balding. His front corner hair line looks slightly higher now than it did when he was younger. Thus I call this maturing hairline or loss of his juvenile hair line. Not balding.

Finally there is no such thing as “abnormal” MPB. Some people have the genes for Male Pattern Balding and some do not. Everyone has a juvenile hair line when they are in their “juvenile” years. Almost everyone will lose their juvenile hair line as they mature (in age). Some will go on to lose more hair (in their 20s and 30s) if they have the gene for Male Pattern Balding.


what’s with all the horror stories being posted on this blog about side effects that are irreversible- or reversible over a long period of time?

I’d very much like to try minoxidil and would really appreciate a professional opinion on the matter.

These anecdotes about wrinkles, dark circles, etc.. are all over the internet. Yet no official info exists.

What gives?

Block Quote

It just shows that Internet can be a great source of information as well as mis-information. Thus I advocate seeing a doctor face to face to ask your medical questions. Please point me to the link on this BaldingBlog if you have found a conflicting information on side effects. You can easily do a search (upper right corner) for this topic on my Baldingblog.

What other readers write about their personal opinion and anecdotes are just that.

Propecia is reported to have sexual side effects in 1 to 2 percent of men. There are reports that it caused permanent side effects but how the study was verified is questionable.
There are reports of Rogain causing wrinkles and dark circles but they are also anecdotes. I have not personally seen this in my 23 years of practice.


I am 27 year old Male. I have diffuse thinning of hairs. There is no bald spot yet and i can hide my thinning with thickening shampoo. But thinning became quite visible when my hairs are wet or oily. I have been using 2% Rogain for past 2 years and it helped in hair loss. But thinning continues.I want to move on to Propecia but recently i read about articles of its effect on semen. I will be getting married in a year and want to have kids in near future. Will it be advisable to start Propecia? Is any of your patients became father even on Propecia ? Any advise will be helpful. Thanks

Block Quote

There have been questions raised on the relationship between low sperm counts or fertility issues and the use of Propecia (finasteride 1mg). While there is no clear evidence that there is a direct relationship, there are reports you may find on the Internet that may justify such concern. The best advice is to speak with your doctor about your concern before starting any medication and consider your risks and benefits.One thought is to have your sperm count and your fertility tested before you start the medication. This is what is often missing in all the case reports. I do not know of any of my patients with this issue and I’ve known many patients (on Propecia) who married and had children.


Hi Dr. Rassman, I’ve been a “lurker” on your blog for yrs, 46 yrs old and if I were to guess, a Norwood 3. I’ve been taking finaesteride for about 1 1/2 years, shampoo with nizoral a couple times / week. I started using Rogaine foam for a few months, but at $62 CAD / mth, it was starting to add up. I’m single, confidence is severely lacking as a result of my receding hairline, so dating isn’t really an option and needless to say I’m always looking for options. l almost considered going for a consultation with Hair Club, but decided against it for now at least. I did come across this article and wondered if you had heard anything about it.

Thanks for having this blog, allowing for people like me a chance to see your advice, keep up with any new developments etc.

Block Quote

There was an article on SCIENTIFIC AMERICAN April 9, 2015 Hair Regrowth Discovery Suggests Skin Cells Communicate Like Bacteria
“When a researcher at the University of Southern California and his colleagues plucked 200 hairs from mice in a specific pattern in a confined area—ensuring that many neighboring hairs were pulled—more than 1,000 hairs grew back in their place, including some beyond the plucked region. “
This finding does not translate into finding a cure for male pattern balding or hair loss in humans. in fact, if you continued to pluck your hairs, they would eventually stop growing. The finding in the study does not mean that if you pluck your own hairs, more will grow. It does however give us a new perspective on cell signaling. More research would be needed to see how it can be applied for practical human applications.

To address your concern for hair loss that relates to a lack of confidence or dating: There are plenty of confident bald or receding men where hair loss is not a factor. Of course everyone is different and if hair loss or hair recession bothers you, see a doctor for possible treatment options. Norwood 3 hair loss pattern can be easily addressed with a good hair transplant surgery.


Creator of Cancer-Cure Diet Faked Her Cancer
Nick Mulcahy April 23, 2015

“The creator of a best-selling mobile phone app and cookbook,The Whole Pantry, has confessed that her story of healing terminal brain cancer through diet and other natural therapies is a fabrication.”…

Dr Saunders continued: “This story shows the difficulty scientists have in getting their stories heard over snake oil salespeople.”

“Hopefully this will make people think twice and do some basic checking of facts,” he added. “We need to be skeptical of the mythical lone genius selling magical cures that ignore basic science and hard evidence.”

Block Quote

I get hundreds of emails a week asking me about my opinion on new hair loss treatment or my thoughts on side effects of Propecia. While the Internet is a great source for information, it is not always accurate. My point has always been there is no substitute for seeing a doctor (in person) when it comes to your personal medical issues which include side effect from Propecia or your hair loss issues. Finally the old adage, if it sounds too good to be true, it probably is.


Your website is a great and informative, objective source of information. Well done.

I’m 48 and been on fin for nearly 15 years under the care of a doctor. I started on 1 mg per day, but reduced to 0.25 mg per day mid last year in response to what I perceived as libido issues. These are now resolved.

I have also noticed a return of morning wood at the lower dose. My question is: do you know of any science to support a negative correlation between finasteride dosage and morning erections, and if so what is the mechanism?

Thank you for your efforts.

Block Quote

I am not aware of any studies and I would be guessing at the mechanism of how morning erections are correlated with finasteride dose. It could just be a perceived effect not related to the dose or it may be the dose change after all. It is not hard to imagine that less drug should cause less side effect. The other issue to consider is that would less drug produce less benefit for what the drug was treating. There is a delicate balance between these two statements.

The observation you pose is real (for yourself) but it is difficult to prove on an absolute basis unless you have hundreds (if not thousands) of patients who are willing to take the a pill that is randomized to different dose or just a placebo (“sugar pill”) and report their erection in the morning. Even the doctor overseeing the patient would not know if the pill was a placebo until the entire study was complete (double blind randomized control test).

My personal thought is that if you and your doctor are in agreement with what works for you, then so be it.


If I have been using Propecia religiously but also been experiencing anxiety to the point of palpitations and twitching, would Propecia blunt any possible stress-related hair loss? If stress is what has lately been causing thick hairs to fall out when I gently comb my hair with a wide-tooth comb, are those hairs gone forever?

Block Quote


Propecia is only for the treatment of androgenic alopecia in almost exclusive men. It has no effect on other types of hair loss and no effect on most women. Hair loss from stress is not androgenic alopecia.


I’ve noticed recently in the shower that short hairs are falling out that are tapered at the end of my hair, not the root. I’ve noticed more of these recently. Some are thinner and some are thick. All my uncles are balding on my mothers side. Are these hairs a sign of future balding? Thanks.

Block Quote

Hair loss in men occurs in a pattern and that is why it is called “Male Pattern Balding”. How a hair looks don’t really mean much unless you are looking at miniaturized hairs will look thinner for people who are balding. We all can lose up to 100 hairs a day normally and if you do the math, 100 hairs per day is 36,500 hairs per year and as the average Caucasian male has 100,000 hairs on his head, that means that his hair cycle is 3 years as he replaces all of the hair on his head every three years.


Can that numbing agent that the dental assistant repeatedly injected into my gums before she cleaned my teeth cause hair loss?

Block Quote

There is no connection between your gum anesthesia and your hair, but if you are stressed, you might induce more hair loss as stress is a factor for hair loss.


Page 1 of 3123

Valid CSS!

HTML 5 Validated