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When I was younger, I always had very thick hair. Never a concern at all. Recently, I ran my fingers through my hair and noticed that I could see my scalp quite easily by pulling the hair vertically or to the side. I usually have a very short haircut, not military style but certainly less than an inch in length. I’ve been paying more attention to my hair lately because I’ve been growing it out, and that’s really the only reason I’ve noticed. It seems like the hair on the side is thinning more…I’m not really noticing a maturation pattern where it’s receding, just thinning.

My uncle on my mother’s side is almost entirely bald, my father has a bald spot on the back of his head and thin hair…so genetic predisposition is possible/probable. I’m wondering what I should do at this point. I may be over-reacting but I’d like to find out. I use gel/comb my hair regularly, but I’ve never seen hair fall out. I can run my hand through my hair several times without seeing any hair fall off.

I’ve also started wearing a hat recently, which is reasonably tight…and may only be coincidence. I’m just not sure what to do/who to see.

Thanks for your help/site…it’s much appreciated.

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To determine if you are balding, you need to have your head mapped out for miniaturization which will show if your have developed or are developing a pattern of thinning that will eventually lead to frank balding. Any topicals you place for combing your hair may make it look fuller, but it will not change the process that is going on. Propecia is the best medication to slow or stop the hair loss and some times it even reverses it, but first you need a diagnosis. The hat will not make a difference in the hair loss, unless is is very tight and causes pulling of the hair.


First, I would like to appreciate your online service, for freely accepting questions and comments and for your valuable answers. Thank You.

I have had my hair transplant about 12weeks ago of approx. 1,650 grafts. My donor area took quite some time to heal, approx. 9-10weeks, before the occasional swelling in a few spots which have now completely subsided. During the first 10 days I had some grafts fall out, which I was told was normal, over the next few weeks I lost more of these transplanted grafts as has been considered normal procedure after a hair transplant. I have had to deal with pimples/puss modules in the transplanted region occasionally and again I read that this is normal. I have used Neospirin ointment to treat these modules and it has helped quite a bit. I am also taking finasteride 1mg for about 17weeks (started 5weeks prior to the procedure as recommended by the Doctor). It is now 12 weeks, and my questions are:

  1. Is it possible that not all the transplanted hair has fallen out? Because when I touch the transplanted region with the palm of my hand, I still feel a few spikes here and there. Just today I noticed a couple of hairs with scab attached at the bottom fall out. Should i be concerned that even after 12 weeks not all of the transplanted hairs have fallen out?
  2. As I do not see much new hair in the transplanted area as yet after 12 weeks, should I be concerned, when I have been reading that by 2-3 months the new hair would start appearing.
  3. I am considered type VI and 35yrs of age. Even with taking Finasteride, I seem to lose at least 50-75 hair everyday after the two daily showers. Do HOT water showers have a negative impact?

Your valuable comments are much appreciated. Thank You

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I am fairly sure that you are not losing hair transplants, but what you are seeing may reflect poor cleansing of the recipient area where the scabs stayed on too long. Without seeing you, I am assuming that what you are seeing is the hair from within the old grafts that is coming out (the hair that should have fallen out earlier). The ‘root’ of the transplanted graft is secure in a couple of days after a transplant until the scabs are all off. Rarely will a transplanted graft come out after the scabs are gone (in our hands in just a few days the wounds lock the hair graft into position because of the small needles we use). We have researched this extensively, and found that they can not be pulled out the earlier of (1) after 10-12 days, even if you try to pull them out, or (2) the disappearance of the scabs (usually a couple of days in our practice). In patients who do not comply with our washing protocol, the scabs may last for weeks.

Hair roots start taking hold and growing hair in 10-20 weeks after the transplant procedure, so I would not worry at this stage in the transplant growth cycle.

Hot showers will not cause hair loss, but if you are losing hair, then there may be a shock effect from the original surgery which should be about over shortly. You need to ask your doctor to map out your remaining hair for miniaturization to determine if your class 6 pattern will progress to a more advanced pattern. That should have been in the discussion when you and your doctor made a Master Plan for what was about to happen to you with a hair transplant.


Dear Doctor,
I have this very close friend who is 15 years old. He is suffering from hair loss and has been since about the age of 11. I’ve talked to him about it many times and he says that the amount of hair he loses after showers is unbelievable. Even when he runs his fingers through his hair strands come out. I really would like to do what I can to help him, he has trouble talking to people so I’m basically the only one who can help. He also gets made fun of at school sometimes and no one likes to be teased. I’ve read up on different causes of hair loss but nothing really is directed to younger teens. Please help me help him.

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Young men as young as 13 can have genetic hair loss. He needs to see a good doctor, get his hair and scalp mapped out for miniaturization and find out if he is genetically balding. Assuming it is genetic hair loss, then the drug that is best to hold on to his hair is Propecia. He must get help and get proper management; the price of premature balding is too grave a consequence for denying the problem.


Is a patient with an oily scalp a good candidate for a hair transplant? My scalp is very oily. I want to enchance my hair density by doing hair transplant. However, I am worry about the oil excreted from the scalp will affect the newly transplanted hair grafts.

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An oily scalp will not effect a hair transplant, as transplanted hairs grow in either a dry or an oily scalp.


I am a 33 year old male and am convinced that I am losing my hair at the front of my head. I have thick hair, but it is certainly thinner, i.e. I seem to have less hairs per square cm. I can also see my scalp at the front, which I could not around 1 year ago. When I comb my hair, or wash it I notice hair in my hands or in the comb. I would say that the number of hairs is around 5 or 6. This is also something pretty new to me. What I would like to know is, am i going bald and how can I determine the rate? Also I take Xanax in small doses and what like to know if this has an effect. Would Rogaine help for frontal hair loss?Finally, how long should I wait before I have a hair transplant. I don’t want to go bald before I do. Thanks.

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Xanax can cause hair loss, but I would think that if you are thinner in the frontal area, then you may be having genetic male patterned hair loss. As I have said many times in this blog, a diagnosis includes an examination for miniaturization, which would be evaluated throughout the head to determine what your genetic pattern might be. At 33 years old, your pattern should be evident when your scalp hair is mapped out. I am ingorning your 6 hairs per day loss as that is low and probably a wrong estimate, but the thinning of the hair in the front is more of a concern for me. If you have male pattern balding, the hair in the front will be heavily miniaturized and will show up nicely on magnification imaging. If that is the correct assessment, then Propecia may help slow or stop the hair loss.


First off I have learned alot from your web site. I’m sure all your readers are very greatful. I know I am!! My question is If someone already suffered from impotence and taking viagra or a simaler product for this would mixing propecia with it for hair loss be a problem. Is it a safe mixture in other words?

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There is no difficulty taking Viagra and Propecia. They do not interact with each other. This way you can enjoy both good sex and great hair. That is a winning combination.


Thank You doctor for the advice on Propecia. I have started taking it now and within days my hair has improved. Yes, i do get proper erections but when i think of my penis….i dont…so i guess psychology is playing a part in not getting erection.

Anyways, can you please suggest some tests which i need to keep doing to check if my testeterone levels are normal (what i mean to say is tests which can check if my sexual organs are normal).

Thank You

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There are doctors that specialize in sexual problems in men. If you are penis-focused, you may be causing your own sexual dysfunction, that is why a doctor who specializes in sexual problems may be a good starting point. They will be able to help differentiate between physical and emotional causes. You can have your doctor measure your testosterone levels to see if they are normal.

I am glad to hear that Propecia is helping, but I would expect that the benefits of it will take months, rather than days.


I have had several transplants over the last 20 years. My donor area is generally depleted and cannot support any large procedures. I have 1-2 very small (quarter size) areas that if some additional transplants were done only in these strategic areas my hair would appear much fuller. Considering the small amount of donor plugs needed could these be provided by smaller more random/scattered donor sites as opposed to the larger harvesting rows that are more concentrated in one area. Thereby minimizing the thinning effect we see in a typical donor area.

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There is an art to making less hair look like more hair. I have many patients like you who have paid the price of the old antiquated procedures of the 1970s and 1980s. I have already written articles on the subject, but what I do for each patient is a one on one determination that takes the years of experience I have spent to develop the Master Plan for such person. Simply put, a good doctor, upon examination, should be able to determine the answer to your question.


Hi Doc:

I am so sorry to bother you again. Can you please tell me if you ever heard of Eqyss Megatek? It is a conditioner & Shampoo for horses that folks claim grows hair stronger & faster. As I have mentioned before, I recently thinned rapidly and I need some help. I am hoping you have heard of this and can comment.

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Interestingly, this is the second question I have received on horse hair products (see also: Mane-Tail-Groom Hair Products). I have no practical experience with horse hair products in humans, but from the inquiries I have made, some Europeans who had association with horses know about these products and swear by them. I would add horse hair grooming to what I offer my patients, but they may think that I am a horse’s ass for doing so.


At age 59 what results can I expect from RK19? Can RK19 be used with Finasteride(propecia) and Minoxidil? Which is a Better program? Is a Dr.’s prescription required?

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RK19 is a product that sells over the counter and can therefore be purchased from their website. Minoxidil can also be purchased without a prescription. Propecia, on the other hand, does require a doctor’s prescription. I have no personal experience with RK19, but after reviewing the photographs, I am more than concerned. The blonde picture was foggy, and the other two pictures seemed to have a scalp coloring agent in them. That makes me suspicious. Let the buyer beware, so use this as your guide in trying to figure out what to do. Please review what I have said in the past on this blog about RK19, as well as what I have said about safe and effective hair loss remedies.


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