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Hair Loss/Care for dry thinning hair

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Question
Hi, I've currently been experiencing dry, thinning hair and a receding hairline for the last couple of years, and the past week I've noticed the thinning of my hair becoming a lot worse. At first it started at the crown of my head, but now I have bald spots spreading all over the place, and I'm still in my twenties. I am completely overwhelmed by this and I don't know what to do. My questions are as follows:

1) Is it worse to keep hair growing long when it is dry and thinning? Could that make it worse? Should I consider keeping my hair somewhat short in this condition?

2) I use Pantene Pro-V shampoo and it has citric acid in it. Is this good or bad? Is there a particular shampoo that you could recommend that can easily be obtained at any store? What should I avoid? also should I use a conditioner, or shampoo/conditioner combos?

3) I don't wear hats, but when I go for a walk I wear a jacket with the hood up. This isn't detrimental to my hair, is it?

4) I wear a respirator at work. Could this have a negative influence on my hair?

5) I play a lot of wind instruments, and this may sound like a really stupid question, but is the vibration bad for my hair?

6) I've heard that vitamins are good for restoring hair. Are there any particular vitamins that can be bought at any grocery store that I should look for? Any particular foods that I should avoid? Also I take 25 mg of Quetiapine Fumarate medication once daily. Is this medication bad for the hair, and can I still take the vitamins with this kind of medication?

7) What about when I go to the barber? I currently get  a Number 2 ceasar hair cut...is there a particular style that is good for dry thinning hair? Should I avoid the barber putting gel in my hair? Also how should I go about him cutting my hair in the condition it's in? Should I bring my soft brush and have him use it on my hair rather than a conventional comb? I've heard that conventional combs are bad for thinning hair, and that I should only use really soft brushes on hair such as mine.

8) When I go into the shower, my hair always looks horrible when I finish. Normally I stay there for twenty to thirty minutes and use hot water for my body, but I always cool the water when it's time for me to shampoo and then rinse my hair. what step-by-step instructions can you give me? I'm always afraid to go into the shower now because of how my hair looks afterwards.

9) I've heard that massages are good for the hair, but I want to see exactly how it's done so I know that I am doing it right and effectively. Is there a video that you can recommend?

10) Last but not least, what if hair loss is hereditary? I have some uncles and a cousin who are bald or balding, but my dad had a full head of hair. If it is hereditary and in the genes, could hair loss still be avoidable?

I know that these are a lot of questions, but I am absolutely desperate, and there is so much ambiguity on the internet. I would really appreciate the answers to these questions...it would help me out a lot.

Thanks for your time.

Answer
Male pattern baldness is related to your genes and male sex hormones. It usually follows a pattern of receding hairline and hair thinning on the crown, and is caused by hormones and genetic predisposition.

Each strand of hair you have sits in a tiny hole (cavity) in the skin called a follicle. Baldness in general occurs when the hair follicle shrinks over time, resulting in shorter and finer hair. Eventually, the follicle does not grow a new hair. However, the follicles remain alive, which suggest that it's possible to grow new hair.

Symptoms
The typical pattern of male baldness begins at the hairline. The hairline gradually moves backward (recedes) and forms an "M" shape. Eventually the hair becomes finer, shorter, and thinner, and creates a U-shaped (or horseshoe) pattern of hair around the sides of the head.

Exams and Tests
Classic male pattern baldness is usually diagnosed based on the appearance and pattern of the hair loss.

It is important to note that hair loss may be due to other conditions. This may be true if your hair loss occurs in patches, you shed a lot of hair, your hair breaks, or you have hair loss along with redness, scaling, or pain.

A skin biopsy or other procedures may be needed to diagnose other disorders that cause hair loss.

Hair analysis is not accurate for diagnosing hair loss due to nutritional or similar disorders. However, it may reveal substances such as arsenic or lead.

Treatment
Treatment is not necessary if you are comfortable with your appearance. Hair weaving, hairpieces, or change of hairstyle may disguise the hair loss. This is usually the least expensive and safest approach for male baldness.

Two medications are approved to treat male pattern baldness:

Minoxidil (Rogaine) is a solution that you apply directly to the scalp to stimulate the hair follicles. It slows hair loss for many men, and some men grow new hair. Hair loss returns when you stop using this medicine.
Finasteride (Propecia, Proscar) is a pill that interferes with the production of a certain male hormone linked to baldness. It slows hair loss. It works a bit better than minoxidil. Hair loss returns when you stop using this medicine.
Hair transplants consist of removing tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring and possibly, infection. The procedure usually requires multiple sessions and may be expensive. Results, however, are often excellent and permanent.

Suturing hair pieces to the scalp is not recommended. It can result in scars, infections, and abscess of the scalp. The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.

Outlook (Prognosis)
Male pattern baldness does not indicate a medical disorder, but it may affect self-esteem or cause anxiety. The hair loss is usually permanent.

Possible Complications
Psychological stress
Loss of self-esteem due to change in appearance

All of your questions you ask are not important to the type of hair loss you have.  The underlying cause is genetics.

Hair Loss

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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