Doctor for male (pattern?) baldness in L.A. area

March 28, 2015 7:14 PM

Can you recommend a doctor that treats underlying medical causes for hair loss in men in the L.A. area?

Not sure what kind of doctor this would be (dermatologist, endocrinologist, other?), but would like to avoid running around to multiple specialists for various tests. One who could handle all labs/dx in-house would be great.

I also am trying to avoid the sort of doctor that will take all your money for branded salves and poultices and little to zero improvement, just preying on a dude's insecurity. I WOULD like a doctor that will take a small amount of money to either say, "look, time to prepare for shaving or surgery, this is beyond the help of medical science" OR "you have appallingly low levels of [whatever] and a long-running follicular infection, let's treat those for a few months and see what happens." If you know of such a doctor, please let me know, here or by memail.

posted by tyrantkitty to Health & Fitness (3 answers total)

I haven't been to them personally, but the New Hair Institute in LA runs Balding Blog, which is pretty well-respected among people who are nervous enough about their hair loss to join an internet community about it. As one of those people, I appreciate their willingness to tell the following hard truths: 1) Most male baldness is entirely genetic pattern balding; 2) Nothing helps besides the two drugs prescribed for it. Anybody who moves past those two truths to talk about a shampoo or a diet or a laser comb is probably trying to sell you something.

NHI, for their part, are trying to sell you hair transplants—somewhat better than they used to be, but much thinner than they're made to look on shady late-night infomercials, as (to their credit) NHI's before-and-after photos will show—and "scalp micro-pigmentation", which is literally a tattoo of a non-balding head of hair so that you can do the five o'clock shadow thing.

But most reputable hair transplant doctors (NHI included) offer a free consultation, which is valuable even if you have no plans to go under the knife. I saw one, and here's how it worked: He used a microscope to count miniaturized and unminiaturized hairs on different parts of my scalp; he told me, yes, I was losing my hair, but I'd caught it early; he prescribed me finasteride (Propecia), which I have been taking for three years and which has left me basically where I was at the time, hair-wise. I've moved 1000 miles away from his office, but once a year I call them and they authorize some more refills. I never paid him a dime, even though it was immediately obvious (I was anxious as hell, but I had a passable head of hair) I was not going to be a $10,000 transplant client. (His parting words: "For a lot of people finasteride works indefinitely, so just take it every day and hopefully you never have to see me again.")

If you can pull off short hair (or no hair), by all means, go for it. If losing your hair doesn't bother you, by all means, don't let it. But don't listen to the parade of well-meaning people telling you to shave it off if you don't want to—they are trying to be nice, but that doesn't mean they're successfully being nice. It bothers people for perfectly understandable reasons—suddenly one of the physical features most tied to your identity/sense of self in the culture is going to change permanently, and it's not only completely out of your control but something that acquaintances and family members will often feel entitled to give unsolicited advice and make mean jokes about. (It's unpredictable, too—before I realized it was falling out I had never thought much at all about how my hair looked.) [I see on preview that you're not the male in question, but I'm leaving this here by way of explaining why this stupid and natural process can stress people like me {and said male, potentially} out in surprising ways, and how the MeFi chorus of "Shave it! You'll look like Bruce Willis!" can sound from within the anxiety {"Shave it! I think your problem is not very important, and your thinning hair is ugly! I do not understand why people wouldn't want to signal "shaved-head-guy"!}.]

For me, finasteride has cost $3 a month (you cut the 5 mg version into quarters) and had no side-effects at all. Whatever happens from now on, it's taken me the crucial years from 24, when all my friends looked exactly like they did in college and I was too depressed about my dumb hair to go outside for six months, to 28, where all of us are about equally uncardable at bars. Haircuts still make me nervous, but the 20 minutes that hair-transplant guy took to talk straight with me were a genuine blessing; I've needed these years to accept that I am not fully in control of the face I present to other people, and never was.

That got really long! Basically: He's probably losing his hair for the same reason everybody else does. I would recommend seeing NHI or another reputable HT doc for a free consultation, and if they say it's pattern baldness try finasteride; he likely won't grow anything back, but clinical trials suggest most people can expect further loss to stop for a year or 10. (I'm not a great responder, and it's still worked well for me so far.) Minoxidil (Rogaine) provides short-term regrowth but doesn't halt loss, and anyway is much too messy for me to deal with, but for guys with short hair I can see trying it as an adjunct to finasteride.
posted by Polycarp at 2:42 AM on March 29, 2015

Polycarp, your answer was so helpful, thank you for taking the time to write it all out! (And yeah, I forgot the "asking for a friend" bit, whoops. He appreciates that there's someone else out there who doesn't feel like being told "shave your thinning hair, it's ugly" is the most helpful response.)
posted by tyrantkitty at 7:48 AM on March 30, 2015

Just to chime in, I don't get the "shave it!!!" advice either. There is such a thing as Topix hair fibers that you shake into your hair to give the appearance that it's thicker, if you want a low risk low cost way to simulate implants. Otherwise, I agree that accepting that it's normal is best (and sometimes it looks good and gives your look a bit of "personality." As a woman, that's how I think about my new twenty-something body and starter wrinkles as well... )
posted by stoneandstar at 8:47 AM on March 30, 2015