Xiao Pan is 22 years old, is in the prime of life, but the hair above the left sideburns began to fall out, revealing a white piece of scalp, which can affect the face ah! Xiao Pan rushed to buy a treatment for hair loss drugs – minoxidil tincture, the results did not expect, hair loss more serious, the drug how to use the more bald? In the end, what went wrong? There is a drug that makes the hair “fall first and then grow” In an emergency, Pan began to look for answers online. He saw the popular science video I made on *Yin and thought I was reliable, so he came to Chest Hospital to see me. As soon as I saw the drug he was using, I understood that minoxidil is a peripheral vasodilator that can stimulate hair growth in patients with male pattern baldness and alopecia areata when used topically for a long time. However, in the early stages of treatment (the first three months), hair loss increases. Therefore, this drug has a characteristic that makes the hair “fall out first and grow back later”. For patients with monogenic baldness who are eager to grow hair as soon as possible, the treatment plan I gave was not to use “minoxidil tincture” but to inject “tretinoin” locally. In Xiao Pan’s case, since the hair loss area was about 4~5cm in diameter, one treatment was sufficient. A month and a half later, Xiao Pan came to the follow-up, and now he was colored, his hair had grown out more than half, and there was still a small part of the scalp exposed around. In pursuit of a more perfect result, Pan said, “Your method is really good, give me another shot.” I looked carefully at his hair loss area, which was already growing fine hair, and concluded that there was no need to give him the shot. In addition, tretinoin is a hormonal drug, it has a side effect, a large amount of use, will form skin atrophy in the injection site, because the scalp of this area of hair loss Pan is thinner than the surrounding scalp, in order to reduce the adverse effects on the scalp, also did not give him continued treatment. The effect of trimethoprim in the treatment of alopecia areata (the phenomenon of hair loss in one piece of hair) is very good, but the following three points should be noted when using this drug: First, the concentration of the drug should not be too high. This is because the higher the concentration of the drug, the more likely it is to form skin atrophy. This is something that many clinicians tend to overlook in the treatment process. The concentration of trimethoprim after proportioning generally does not exceed 10mg/ml. Second, the injectable dose should not be too large. Generally speaking, like Xiao Pan such a large range, trimethoprim once the injection amount is 5 to 10 mg is enough, because the larger the amount, also will aggravate the side effects brought by hormones. Third, the level of injection should be intradermal in the area with baldness. This means that the injection should not be extended outside the balding area. Also, it must be injected intradermally, not subcutaneously. This is because, if it is injected subcutaneously, the drug will diffuse with the subcutaneous tissue gap and will not have a local therapeutic effect. Therefore, tretinoin should be injected intradermally in the area of baldness, forming a dermal mound, so that it can have a local therapeutic effect. How does baldness, commonly known as “ghost shaving” in rural areas, develop? There are many reasons why it occurs, but the main reason is mental stress and staying up late at night. Generally speaking, people who only lose a piece of hair on their head, so-called “single-hair baldness”, can mostly heal themselves and are easy to treat. However, if there are multiple areas of hair loss on the head, and the hair loss varies in size, this type of “multiple baldness” is more difficult to treat. If you or your friends are facing such a situation, I suggest that you go to the hospital as soon as possible to check whether there are problems with the thyroid gland, adrenal glands, and other organs, or to take blood samples to check the hormone levels, so that you can determine the next step of treatment after the cause is clear. In addition, there are some folk remedies for baldness, such as using onion, ginger, garlic, or plum blossom needle. Some people do get better with these methods, but since some of the baldness itself can heal on its own, it is difficult to say whether it was cured by itself or by these methods.