I'm a 29 year old male. I first noticed my hair line receding at the temples around 26. The rate at which my hairline is receding has increased dramatically within the last year. I now have a very pronounced, narrow widow's peak which is getting more and more narrow. As far as I can tell, there has been little or no hair loss at the crown yet.

I noticed that when my hairline first started receding, it itched in only the area where the hair was falling out. As the receding moved further back (and up), the itching led the hair fallout in those areas. Now the itching is all along the top of my head where I fear the fallout will happen soon.

My dermatologist did a scalp biopsy because he thought I might have scarring alopecia. The tests came back "inconclusive" and he told me the itching had nothing to do with my hair loss. Since the itching was very localized and matched exactly with the area where the hair was falling out, I have a hard time believing this. He sent me home with a prescription for Propecia and said to try it for a year.

Can you tell me what might be causing the itching (which is now more severe) and occasionally some small bumps? From the pictures I've seen of scarring alopecia, I do not think I have this......

Since the fallout rate has increased dramatically, I hesitate to wait an entire year with this terrible itching to see if Propecia will help, when there might be something else going on.

Dr Proctor's Answer: There is a significant autoimmune component to pattern hair loss . It has been speculated that the itching ( which most docs used to dismiss ) may be a manifestation of this. Another possibility is seborrheic dermatitis, which may also contribute to pattern balding. You might try over-the-counter 1% Nizoral shampoo to see if it clears up the itching. Use as directed.

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