Matthew McConaughey and Hair Transplants

/by William Rassman, M.D./1 /, ,

Dr. Rassman, I am concerned that your post about Matthew McConaughey is misleading. Do you honestly believe he had transplants? Here are two reasons why I think it is unreasonable to think so. First, he had a full head of hair in movies before and directly after the picture (showing hairloss) was taken. The only way he could have had transplants is if his hairloss was sudden and his regrowth was extremely quick. Second, the results are be too good to be transplants even if used in conjuction with drugs or anything topical. I’m sure transplants can make make a big difference, but not that big of one. If he did have transplants then the pictures of your work appear to pale in comparison to the kind of work that can be done. I don’t think your work is substandard to anyone. I think he uses a hairpiece. Are you worried at all that passing his improvement off as a transplant will give people unrealistic expectations as to what hair transplants can do and perhaps unduly persuade people to get hair transplants. Also, do you think hair transplant doctors may be attributing Matthew’s results to hair tranplants in fear of losing people to the hairpiece business?
Sincerely,
Concerned

Just to be clear for the readers of this blog, your question is in reference to the post I made back in May regarding Regenix and the role it may have played in the hairline restoration of this actor.

I have no first hand knowledge of Matthew McConaughey. From photos I have seen of him, there is obviously a big change in his hairline between the older pictures and his current presentation. If the change reflected a hair system, then it is a good one. In the movies, this is done quite often for balding actors, and there are people primping and grooming the hair piece just before they are on film to achieve the best possible look. If the change reflected a hair transplant, then he had a good hair transplant surgeon. Photographs show us what the photographer wants us to see. A hair piece (a wig) would be instantaneous, while a hair transplant would take 8 months to grow out.

As far as expectations, look at the change a hair transplant made in broadcaster Steve Hartman, as featured on the NHI website. The results were at least as good as a great wig, but since it is his real hair growing from his head, he doesn’t have to worry about the costly maintenance or smell issues associated with hair pieces.

I’ve posted links to these photos before, but they are worth reposting to show the dramatic change in Mr. McConaughey’s hairline.

Overdying Hair

/by William Rassman, M.D./1 /,

Can overdying my hair make it fall out?

You can damage the hair itself, making it more fragile and getting it to break off easily with simple brushing. It is possible that damage to the hair below the skin may occur if continued abuse occurs over time.

White or Gray Hair at 23

/by William Rassman, M.D./0 /,

I have male pattern baldness and choose not to take medicines for it because im comfortable with my balding. But, my beard hair and some hair on my head is turning white /gray. i’m 23. what to do?

Dye your hair, as that is the only possible solution to color change and it is an art that has been around for years. Get a hand on how to do it for yourself, once you get it done by a professional if you are cost conscious. I have seen young men with black hair and white beards, so they keep their beards closely shaven, successfully hiding it from everyone.

Tidbits: DHT and DHT Blocking

/by William Rassman, M.D./0 /,

A few times each month, I will post some random hair-related information, which I’m calling “tidbits”. I spend hours each day writing responses to questions I receive on this blog, so it is a nice change of pace. For example…

DHT

I am often asked about what happens to testosterone when one takes Propecia. Testosterone levels do climb by 10% on average when men take DHT blockers like Propecia. Some men work out heavily, adding steroids, growth hormones, and DHEA, while others take even more testosterone. I am often asked about the effects of these medications on hair loss. Each contribute to hair loss caused through genetic causes when men have the gene for hair loss, but some of these medications may have a direct effect on the actual hair loss, independent of genetic factors.

Dr. William Reed, made the following comments: “If one had to guess, I would say that the gym rats are correct. I gather that about 8% of testosterone is metabolized via 5 alpha reductase. The 10% rise in testosterone does not offset the increased androgenic power of this loss of DHT (62% of serum levels … I don’t know the intracellular change in the muscle cell, i.e. if there is any type 2 5 alpha reductase in the muscle cell. If there is, then the intracellular impact within the muscle is even more marked). I don’t think Big Pharma will address this issue or bone density loss (that could also be unfavorably impacted) unless other investigators come up with the data and there seems no profit in that appening. Having said that, I think gym rats are striving for a supraphysiologic state that brings out these limitations of finasteride. Ignored are the benefits to the prostate… and to hair. It’s annoying how Life is seldom black and white.”

The question is also frequently asked about the impact of DHT blockers on those people who build muscle mass and use steroids. There are theoritical issues with regard to this area, where blocking any male hormone may reduce muscle mass, but the official information out there indicates that there are no such side effects. Frankly, I do not have an opinion regarding this, so I am passing this to my readership to make their own assessment.

Using Rogaine Once a Day

/by William Rassman, M.D./1 /

Hi Doc. I have been using Rogaine for maybe 5 years now and it has sort if stabilised the hair loss. But when I went to see a hair transplant specialist she told me that full-strength Rogaine only needs to be applied once a day rather than the recommended twice a day. Is this true? I have been using it once a day since then and that was 3 months ago. I’m concerned that my hair may resume falling out if I continue. Thanks

I am under the impression that the best benefit comes from a twice per day application. Once a day seems to have little effect on most people.

I Can’t Grow Body Hair — Will I Go Bald?

/by William Rassman, M.D./0 /

Are men who don’t grow beard or body hair less likely to bald?

It is possible that this is just delayed growth of beard or body hair in a person in their late teens or very early 20s, and the beard and body hair may eventually grow in. If there are no autoimmune causes for the absence of this hair, then I would suspect that your genetic cards will play out normally. In other words, the lack of body/beard hard is unrelated to eventual scalp balding. There is a possibility of a reduced DHT level, which can be tested by your doctor. This test can measure if you make DHT or not, but I suspect you will find that you do.

Shaving the Head Before Transplantation

/by William Rassman, M.D./0 /,

I had 1600 grafts transplanted at the hairline area about 4 months ago. When the procedure was done the doctor shaved that part of my head. My hair loss up until that point was somewhat concealable when the hair that I had was grown out and some of the hair further back was combed forward. After the procedure I had to cut the rest of my hair to make it look even with the area that had been shaved. This made my hair loss much more noticeable. I was not aware until seconds before the shaving that this would be happening and I was told that this was necessary to gauge the proper growth direction of the follicle. Was this necessary? Had I known it would take about 3 months of growth just to get my hair back to a place where I wasn’t obviously balding I may have reconsidered. At 4 months my hair looks very similar to my pre-operation density and I do not notice any significant new growth. Should I be concerned?

Sounds like some failure of communication occurred. You should have been told that your head would be shaved. I know that many doctors do this, but I do not recommend it. I tend to just work around the problem of long hair. I take the view that everything should be as natural as it was prior to the surgery. At 4 months, I would expect that the hair should be starting to grow out. Look for 80% of the benefits by the 7th month. Good luck.

Treatment Options for Thinning Crown

/by William Rassman, M.D./0 /,

hello–
i’m a 22 year old male–been thinning on the crown/upper back of the head for about 3 years now. i’ve tried everything…used propecia in conjunction with minox 5 % 2x a day for about 18 months with no noticable results. my front hairline is very thick–as is the hair on the sides and lower back of my head. my most recent regimen (for the past 9 months) has been 0.5 mg of Avodart and miniox 5% + tretinoin 2x a day–including nizoral shampoo every 3 days with a arbonne shampoo and conditioner daily. also i’ve been using arbonne’s thermal fusion scalp therapy in the shower every day religiously. still no results–no thicker on the top. do you have any suggestions for what to do? should i continue this regimen and add something else in order to avoid a shed? i’m lost and could use some detailed advice from someone who knows what they’re talking about. you certainly seem to be the right guy. thanks for your help.

Sounds like you have tried it all. Considering that you have tried both Propecia and Avodart, it seems, if you have male pattern balding, the pattern will take over and the balding will not be controlled by the various medications. Not everyone’s hair loss is controlled by these medications. Have you already had your scalp mapped out for miniaturization? If you have, then the measurements would point to the value of the medications you have taken. I always get a mapped out baseline before I start treatment, because I would want to tell you the value of these medications on the course of your hair loss. The mapping process will let you know what progression you are having so that you and your doctor can better plan for your future hair loss.

Smelly Hair

/by William Rassman, M.D./0 /

i have hair but it smells awful i wash it daily but the smell goes away for only a few minutes, anyway it keeps me from doin stuff like datin hangin out, simple things.

You might want to get a doctor to examine you to understand the problem. I can imagine many conditions that may contribute to this, but a good examination is the best approach if you wash it thoroughly. I might wash it in my office, and then observe what good washing can do versus what you are doing; maybe there is a difference just on that level. Our office has good washing facilities for our patient hair washes which we do after all surgeries.

Redness, Hair Growth, and Differences Between Doctors

/by William Rassman, M.D./0 /,

My boy friend is considering hair transplant surgery. How long will the redness last? How long does it take for hair to re-grow? Are there different procedures use by different doctors?

If there is redness at all, it will be gone in 19 out of 20 patients within a week. It generally starts to regrow (like seeds of grass that get placed and take time to grow) in 2-5 months. I tell most people that they can see the impact of the hair nicely by the 7th month, where 80% of the hair will grow to styling length. In one out of 20 patients, the growth will be immediate. Most patients experience some early growth, but I generally tell them to wait patiently for the hair to grow.

There are many different procedures that doctors do. To get a complete scoop, you can call 800-NEW-HAIR or fill out the form on the Request Additional Info page and I will send you a free copy of The Patient’s Guide to Hair Restoration, the book I wrote with Dr. Robert Bernstein that defines the differences. As price is also an issue for the cost conscious buyer, please also take a look at the past blog entry, The Truth About Cheap Hair Transplants.

Good Scalp Shampoo?

/by William Rassman, M.D./2 /

hey doctor, what would you suggest as a good shampoo to use with thinning hair, i am currently using rogaine and have been using the loreal hair thickiner shampoo with it, is there something better out there for the scalp, thanks

I do not recommend one shampoo over another. I generally experiment with many before I find something that feels right for me. As I do not believe that shampoos can bring back the hair, the value is in the styling and looks that the shampoo gives you.

Stress Induced Hair Loss

/by William Rassman, M.D./0 /,

I’m 42/F and in the past three months I have lost a good amount of hair and there is no balding in my family. I am on thyroid RX (5 yrs of Levothyroxine). Since then I have had my thyroid checked and it’s is normal. I have noticed my scalp does itch (not intensly) and the hair is falling out from the follicle (white tips are on the ends of each strand) and it comes out worse in the shower. Dr recommend to seek a dermatologist, which is my next step. I also take Estrogen (7 years), Topamax (6 mo), Maxalt (2 mo). I have alot of stress in my life besides.

Scared of going bald.

There many reasons for hair loss, such as hypothyroidism, ezcema, alopecia areata, telogen effluvium, lupus, drugs, stress, crash diet and infections. I recommend that you have extensive blood work done to rule out many of these causes for your hair loss; a good endodrinologist or dermatologist should be able to do this. Alopecia Areata and Telogen Effluvium are causes of hair loss where biopsies may be indicated. You also need an extensive mapping of your head for miniaturization. Female patterned hair loss has very characteristic findings on mapping. You must realize that it is normal to lose up to 100 hairs per day.

Hair Loss at 19 from Vitamin Imbalance?

/by William Rassman, M.D./0 /,

Hi, i first noticed that my hair was thinning when i was 17. Around the same time, i got this weird rash on the back of my head due to poorly cleaned clippers at a barber shop. Now i’m 19 and it’s really noticable that i am going bald. I can now see my scalp and my hair line has receded at least an inch and a half. I am very young. I believe it has to be a vitamin inbalance. Right now i’m taking ULTRA HAIR, which is filled with Biotin. I’m too scared to take rogaine or propecia, becuase i read that propecia can stop a man’s erection. What should i do? Who should i talk to? And do you think the rash has something to do with all this? The rash is still there. Thank you

If you review the Age category of this blog, you will learn that 17 year olds can get male pattern genetic hair loss. Assuming that you are male and receding, that is the most probable diagnosis. You need to get a diagnosis; you should have your head mapped out for miniaturization and attempt to get proper control of the hair loss with a drug like Propecia. If you have lost the first 1 1/2 inches of hair line, then you will go bald if you do not take a real proper action and get control of your hair loss. Playing with vitamins when you are losing your hair like you described, is like looking for fleas when a herd of elephants are chasing you. You should be running for you ‘life’ (and by that, I mean ‘hair’).

Propecia side effects have been covered on this site before: here, here, here, and here.

Would I Hate Myself If I Had a Transplant at Age 26?

/by William Rassman, M.D./0 /,

I’m a 25 yr. old guy. I visited [a well known doctor] and he told me that if I had a hair transplant procedure, I’d “hate myself for the rest of my life.” Pretty harsh. I appreciate his honesty, but am disappointed that this is not an option for me. I’m confused! I would be more than pleased with the results that I have seen on various good physician web-sites. I’ll be 26 shortly, and am wondering what my options really are if the best results are so bad that I’d hate myself for the rest of my life.

You can always get a second opinion. If the doctor is well respected, there are a number of questions I first would want to know about you, so seeing a photo/meeting with you and speaking with you would be invaluable. Things that may make the doctor have hesitatations with transplanting a man of your age would be:

  1. Unrealistic expectations (which is why we don’t do computer imaging)
  2. Body Dysmorphic Disorder (see BBC News: Health)
  3. Poor donor supply (possibly from DUPA)
  4. Too early
  5. Unable to face the consequences of progressive balding
  6. Psychiatric problems
  7. Financial problems

Many times when I want to point a patient to a psychiatrist, they resist. After all, I am a hair transplant doctor and not a ‘shrink’, so it is not often that I give a special speech on this subject, and certainly not like the one the doctor you discussed gave to you. If you do not communicate with your chosen doctor, that would be one way for him to get your attention. Remember, you do have options, and if you are not comfortable with what you were told by one doctor, you are free to see another.

Hair Problems from Bleaching

/by William Rassman, M.D./0 /,

I am a male and I did a bad job of bleaching my hair and it burned my scalp. When I used the bleach I used it only on the top of my head. The hair on the top of my head seems to be growing slower than the back and sides where I applied the bleach. I am only 18 so can the hair loss be due to the bleach?

It would be unusual for any long term damage from a single bleaching episode on your hair. Assuming that you wait a year or so, everything should resolve. Make sure that you do not have male genetic hair loss, by getting your head mapped out for minaturization. If you do have genetic hair loss, thinning could have been precipitated by the bleaching and proper medications may be in order (like Propecia). Get a good doctor to evaluate you.