ANSWER:
Hello,

Well, if your hair loss is definitely in the male pattern baldness distribution, that would seem to rule out scalp diseases like Alopecia areata, Ringworm of the scalp, that sort of thing. It surely must be related, in your case, to your post-puberty and the high levels of testosterone that exist around and after that time.

The high levels of natural skin oils, in your skin/hair/shoulders, are also consistent with your skin being affected by high levels of testosterone.

You must both have seen doctors in order to get the thyroid blood test done, I wonder what they said?

I don’t think you personally, can infer much from your sister’s condition. In a way, you are the “plumb normal” one here, and she is not. At puberty and soon thereafter, even girls can sometimes get significant levels of testosterone, (or androgens, at least, from their adrenal glands), which are likely to be temporary but might activate a male pattern baldness gene a bit. The male pattern baldness gene is not on the Y- chromosome, so females receive it equally often, – they just don’t express it. Apart from that, I am not qualified to advise you on exact genetic matters.

I confess I don’t quite know what to make or your eyebrows and beard. Those are out-with the male pattern baldness areas. Testosterone should stimulate them, rather than the reverse. You don’t describe any skin-disease rash of these areas.

Whilst baldness is only cosmetically troublesome, there was an article in “The Times” (of London) on Wednesday February 16th 2011, which I quote, ” Men who are going bald by the age of 20 are twice as likely to develop prostate cancer in later life, according to research … published today in the journal Annals of Oncology. … Michael Yama, a co-author of the study,… said that a drug called Finasteride could in future be used as a preventive treatment.

“Under the brand names Propecia and Proscar, [finasteride] is already used for hair regrowth and to treat benign prostate tumours respectively, although for hair loss [finasteride] is not available on the NHS.

“Kate Holmes, research manager the the Prostate Cancer Charity, said thaty future research was required. “We don’t want all 20-year-olds who are going bald to panic, as a result of this study,” she said.”

There is a good bit about this here, (click) http://en.wikipedia.org/wiki/Finasteride

I fear I may have made you more worried rather than less, – this is cutting edge research stuff, which may not be confirmed.

I am not sure what to advise you about the way forward. It depends on how much hair you are losing, imo. I noticed my hair was thinning when I was 19, (second year at university), but in fact I still have reasonable hair now at 63, in spite of portents of doom.

You would have to have a pretty huge amount of testosterone, for it to be considered abnormally high. The diagnosis of this would be a matter for a specialist Endocrinologist. The possibilities include the pituitary gland in the brain, abnormally stimulating your normal testicles to produce excess testosterone; the adrenal glands producing excess testosterone precursor, (“DHEA”); and very rarely, a tumour with active hormone function. They all seem pretty unlikely if you are a basically very healthy guy.

I hope this is of some help.

Best wishes,

Belliger
retired uk gp