Hair Loss/hair loss


QUESTION: Hi there,
I've asked you a question before, and now I have one more. When i wash my hair or run my hands through and kinda shake my hair, I notice the hair that falls down on the sink are REALLY thin. They are thinner than thread.There are also 1 or 2 hair that falls that is thick on one end, and thinning on the other. What can be the reason for that? I had stress hair loss no longer than 2 months ago if that helps.

ANSWER: It is hard to know for sure if these fine hairs are from some of the old hairs which fell out a few months ago and were regrowing but became stressed again when only a month old or if they are hairs which are in the last life cycles and are becoming miniaturized vellus hairs. The thicker ones would be you healthy normal hairs going through normal transition to the next healthy anagen hairs.
In either case the treatment I suggested to you before using Rogaine Foam twice a day for four or more months is the best crutch for these ailing hairs. Taking Propecia is still the best way to stop the progression of thinning due to inherited male pattern baldness.
You should consider both therapies. Propecia to prevent progression ( it stops balding in 85% of me) and Romaine which stimulates hairs to grow longer and thicker in diameter as a crutch ( the hairs still get the message to die from DHT so it is really not a preventative treatment but rather a crutch for an ailing hair)

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QUESTION: Last life cycles? I am only turning 18 next month..
The male in my family like my dad and grandma started losing hair when they are in their early 60's.

Every hair has a predetermined number of life cycles programmed into it from birth. Each life cycle is about 5 years.  If you go to my website and click on the book in the left lower corner "Hair Loss Answers" you can read the book for free online.
Chapter 2 deals with normal hair cycles. Chapter 4 deals with causes of hair loss such as Telogen Effluvium due to stress.  Below is a quote from Chapter 4 in the section on Stress-

Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.

In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.

However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about five years, but each follicle is “genetically programmed” for only a limited number of growth cycles. For example, if a particular hair follicle were “genetically programmed” for only ten growth cycles, after about fifty years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are “genetically programmed” this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.

Each incidence of telogen effluvium uses up one “life” of the affected hair follicles. So instead of having a receding hairline or bald spot at age fifty, the hair loss may occur a few years earlier. This is not a significant issue if telogen effluvium occurs once or twice in a lifetime; however, accelerated hair loss can result from repeated severe stressful events, if each instance triggers a new round of telogen effluvium.

I had a patient who was totally bald when I met him at age seventy, and he had lost all his hair by age twenty-two. He had worked on the Panama Canal fifty years earlier, and for two straight years starting when he was twenty he suffered repeated bouts of severe fever from episodes of malaria. Each time he suffered from malaria induced fever he experienced telogen effluvium, lost what hair he had, and his hair follicles lost another “life.” After ten or fifteen malaria stress cycles, at the age of twenty-two, he had the hair he would have had at age seventy. Which unfortunately for him was no hair at all.

Hair Loss

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


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


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

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