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Hair Loss/Male pattern balding without any family historyg

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Question
Hi Dr Panagotacos, I hope you can answer a couple of questions to help me understand the hair loss problems of my 17 year old son. He is suffering from hair loss which is most similar to a Ludwig pattern( I know this is usually women) and his hairline is not receding.
There are no cases of any hair loss in either side of our family before the age of fifty going back to my son's great grandparents.

1) Can a man carry a gene for male pattern balding without suffering from this condition himself?
2) Can male pattern balding occur spontaneously in such a family?
3) Could this hair loss be Telogen Effluvium even though he has been losing hair for about a year and it is thinner on the top of his head?
4) Could his hair loss be caused by chronic stress(eg.exams etc) even though he has not  suffered any major traumas?
Many Thanks

Answer
1. Yes, if the bald genes he is carrying are off set by hairy genes.
  The son could end up with the bald genes each parent has without getting their hairy genes.
2. A woman can carry the balding genes much more easily than a man and it can easily be carried several generations without showing up. If you can flip a coin four times in a row and get tails each time it is possible for a woman to pass balding genes to her daughter and she to her daughter so that balding in a son may not show up for four generations or more.

3. and 4. This does not seem to be a Telogen Effluvium problem or due to stress from exams.
  
A biopsy would help differentiate the problem and a simple swab of the cheek could be sent for genetic analysis to see if the balding genes are present from the mother.
  I suggest you read about this at http://www.hairdx.com/en-us/
and then go to your dermatologist and ask if you can get a scalp biopsy done as well.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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