Do you think NHI will ever perform hair cloning procedures?
When cloning is a safe and proven method for restoring hair, we will be on the forefront of it. It will take years and years for the FDA to approve the defined process of cloning and that process has not yet been defined. I don’t hold my breath waiting.
I had 1000 fue 13 months ago — 850 in crown and 150 in front middle of my hairline. I have had reasonable results on the crown, but you can still see a bald patch on my hairline. 150 were placed in a small area in the middle of my hairline, but only approx 50 have survived. A slight wind and it looks like a middle part. Do you think the clinic I went to should rectify this?
Any individual clinic is not required to replace what does not grow, but doing so is a good business practice. As you know, a hair transplant is a surgical procedure. There are two causes for non-growth:
The public tends to think of a transplant as a commodity, offered by various clinics with a marketing program to ‘sell’ and ‘sell hard’ whatever solution to balding and vulnerable patients. I am not against these clinics at all, but realize that a few of them will give you a better quality of work than you may be able to purchase from a doctor who does one or two such surgeries per month. The doctors who dabble in this do not have an organized team, so either they reduce the size of the transplant sessions to match the team, or they develop sub-standard techniques that are not at the state of the art. Some of the larger clinics with many offices, have variable quality of teams (in turn, equals variable qualities of work). I have seen the same national U.S. clinic produce good work from one office and almost malpractice work from another, yet each office publicizes the best sum result of all the offices put together. I have two offices now, one in Southern California (14 years) and one in Northern California (10 years), so quality control has never been the problem for us.
What is your opinion on a lower dose of Propecia. I have heard that some doctors recommend every other (or every 3) days dosing. What is your stance on this?
Propecia has a half life of 4 hours. That means within a day, it is essentially gone from your system. Taking it every 3 days makes no sense, for you are undoing the DHT block that Propecia impacts. If you are going to reduce the dosage, then take a half tablet a day. I am under the impression that 1/2 tablet is 80% as effective as one tablet and 1/4 tablet is basically ineffective. I would want to know why you want to reduce the dosage from the most effective dose? The goal here is to grow hair, not see how little Propecia you can take.
Hello doctor. I am a 27 year old african american male, with only a small degree of hair loss on the sides (by the temple) that basically are about the size of a quarter on each side that messes up my hairline. I have been looking at a couple products to get that look ok, and was wondering what your recommendations would be. I heard that Dermatch was the best and easiest to apply to areas on the hairline. Will this look good in our hair? Would toppik or coueve be better than this? My hair is very short and looks great when it is first cut, but when my the rest of my hair grows out and outpaces the small receding areas it doesn’t look so good. Let me know your recommendations, and thanks.
Best to try these products on your own, as they are not expensive and can be washed off in the shower. The problem may be that these products work well behind hair, but not in frontal bald spots. Nevertheless, I’d try it first. If it does not work for you, then hair transplants may be the only other option. If you are gentically balding, I suggest that you get a working diagnosis and consider Propecia (if indicated) at least to stop the hair loss.
Hello, I am 14 years old and I recently cut my hair very short. I noticed the the area near my temples seem a lot thinner than the rest of my hair. I am asian, chinese to be specific. I was wondering what is causing this, or is this normal?
Considering your age, I would suspect that you are moving toward a normal maturing hairline. Your hairline (including the temples) that are shown in the photo you sent show that your frontal hairline is still your youthful hairline. Changes in both the frontal and temple hairlines occur as boys become men (usually at age 18-20, but it can start as young as 13). You can either wait and see what further changes occur or take the next step to have your hair mapped out with a densitometer or magnifying video-camera for miniaturization which will give you a more thorough evaluation by looking for the patterns of hair loss (unlikely based upon these photos) shown in the Norwood Classification chart. Look to your family’s male members and see if their temples reflect the changes you are experiencing, just further down the road. Also, get your parents involved with this — at only 14 years old, your parents should be able to help you along the way.
Dr. Rassman. Are you familiar with Dr. [name removed]? He seems to do incredible work artistically, but he seems awful aggressive in transplanting and his marketing techniques seem a little shady. What is his reputation in the hair transplantation indusrty? Is he trustworthy? I am considering him because he has a local office.
Thanks!
I make a point not to react to questions like this on a specific basis, but you list many of the elements of a doctor that are critical in the doctor selection process. Aggressive and shady are two negative descriptions. I generally recommend that you stay away from any doctor who you do not trust. Having a local office is the worst way to gamble on your looks for the rest of your life. I use the words confidence, trust, integrity, reputation, artistic, etc.
I do offer a travel reimbursement program if you qualify, so even Los Angeles is not that far away.
Also, please read more about doctor ethics in past blog entries:
I’m 18, and I noticed hairloss at about 17. The hairloss is only in my temples. I know a lot about the options of stopping hairloss and such, and I really want to get on propecia soon. My concern is that I heard that it can effect growth and other issues concerning not being full adult body. I barely have a beard, and I don’t really have any body hair, so I know that I am not done maturing. Will propecia effect any of these things. Is it safe to take when possibly still growing and maturing?
BTW my temples are getting REALLY bad, on one side of my head I’m missing almost a golfball sized front of my temple. I can still see the tiny velus hairs, so i feel like its not too late, but… I just want to make sure I’m not going to mess up my body by taking this drug.
Thank you
This is not a very “doctorly” sentiment, but… I feel for you, man. My husband, Dad, and brother started losing hair at age 17 as well so I know how hair loss as a teenager can affect you. You need to be evaluated in person by the doctor who will prescribe the Propecia, and they will need to go over all the possible side effects in person before you take it. For your information, I have not seen adverse effects personally (and I have put many younger guys on this drug, usually after discussions with their parents), nor have any been reported for your age population on this drug, but Dr. Rassman did report a single case where one of his patients had loss of body hair with Propecia, so your question is not unreasonable and may be a risk factor, although rare. I believe that the younger you are, the drug works better and with fewer sexual side effects noted. However, the biggest decision-making news for you personally is that there are no long term studies on the effects of this drug which have included the youngest people who are affected by hair loss – nor do I suspect there ever will be (no money in it) so there is no data to properly evaluate this in a scientific manner.
So the question you ask is still an open one. I can’t prove it one way or the other, but based on the drug’s mechanism of action it is not likely to affect body growth (just stop the hair loss on top) and there is no data that Propecia interferes with sexual maturation (beard, body hair, nose hair, etc..). Propecia is a DHT blocker and, if anything, it will INCREASE your testosterone (the predominant hormone affecting your age group’s physical changes) when you take it.
Also FYI, body hair development is not the most accurate indicator of maturation – some people never grow beard or body hair and that can be totally normal. I’d again check it over with your doctor if you have concerns.
Hello
About 4 months ago I had some red/copper low lights put in my hair. Within about a week I developed several hives/blisters on my head, the worst of which was towards the back of my head where 3/4 seemed clustered together. About 3-4 weeks after this my hair fell out from that particular area (about 3-4 cms across). I’ve been to my GP who wasn’t very helpful and said it may or may not be an allergic reaction, and she did not know why the hair had fallen out. It’s now 4 months later and I appear to have some regrowth but it’s like baby hair, very fine and short. I can feel it with my finger but it doesn’t cover the bald spot as I have very dark brown hair. Will my hair return in time, and what process does it take? Is it normal that the hair appears like baby hair? It may be an impossible one to answer, but roughly how long before the bald spot is covered and looking like my other hair?I notice that most sites suggests hair grows on average 1/2 inch per month. Is this growth rate the same for hair that has fallen out and is growing back? I’m desperately looking every month for signs of 1/2 inch growth but wondered if the rate was slower/quicker for brand new hair. Thanks
This is a tough hair loss question not only because it is tough for you to go through, but also because it is difficult to diagnose without an exam. You need to see a dermatologist or a hair loss specialist (but definitely an MD) so they can look at the spots with hair loss on your head. The reason is that the hair loss pattern and sequence that you describe could have been caused by many things including 1) a chemical alopecia (reaction to the chemicals used on your head) 2) an allergic reaction, 3) an infection of the skin on the scalp (by anything from a bacterial, fungal, or a viral source), or even 4) Alopecia Areata. Often, only a physical examination by a doctor and testing (sometimes including a scalp biopsy for microscopic analysis) will determine the cause.
The good news is that in most all the cases I have listed, the hair does grow back although it is impossible to predict how long it will take without a definitive diagnosis. In the meantime, see your dermatologist or hair doctor, stay away from the chemicals for hair, and take a photo to document for yourself how the growth is going.
Dr. Rassman here’s my question. I am 40 years old and started to bald when I was about 36. Around then I bagan taking propecia and have encountered good results. Most of my hair has regrown. Anyway, here’s my question. From time to time I think about a hair transplant and I think about this as a means to stop taking Propecia. Am I fooling myself. Will I still be on Propecia after the hair transplant? Thanks.
With the good results you’ve reported, you should not consider stopping the Propecia. Hair transplants should be looked at as a way to augment the results, if you feel that the results now do not meet your objectives. If you stop the Propecia, you will go back to square one and lose all of the benefit you recieved from it in a matter of a few months. You need to sit down with your doctor and work this into a Master Plan for your present and future hair loss.
I just received this email from a patient of mine and thought I’d share it with you, as it brought a smile to my face. Periodically, I want to share the joys of this uniquely wonderful medical practice with my blog audience as I am getting terrific feedback for many of you.
Good afternoon, Dr. Rassman. I thought this might be of help to your new transplant patients and those considering a procedure. I have been a happy client of NHI since 1999. Your organization actually turned me away prior to that until you thought I would receive sufficient benefit.
In September of 2004 you yourself did a whopping 1400 or so in the crown area (your organization did 1200 grafts prior) . Now this is the reason I am writing to you (in addition to just finding this blog business on your website): your prospective patients, especially the younger guys, need to know that balding is a long process. Although they may awake to the process all at once with the “bell in the brain” event, it is likely that the process has been in place for sometime and will likely continue. In my case technology and my finances came together and I was able to get ahead so that I never had a bald spot period in my life and managed to keep the “shine through” months to a minimum. To this day it is a hoot to tell new friends or business aqaintances that I’ve had transplants and would have a spectacular bald spot had I not chosen NHI. None, and I repeat none, believe me. Even when I show them evidence of the donor scar most assume I am pulling their leg. Now, for the second reason for writing after reading a number of your blogs. Last week one and a half years after I started the process, I was lolling in the tub and discovered a veritable thicket of new stumps in the thinest area of my swirl. I made a mental genuflection to LA and hollered to the wife: blog the good doctor and tell him that, as in the previous two sessions, his theory of waves of hair growth continues to be proven.
Sorry about the length of email but continue to reassure your younger patients with confidence that it takes time to grow. My only regret continues to be that in never having gone bald I never got to qualify for your “before and after” photos. However, my dream may yet come true. At the advanced age of 57 my front hairline is going. You may see me back in LA or San Jose for splotch in the front. Please let me know if you are running any “forelock specials” and be prepared to guarantee me a minimum half-page pic in your next updated booklet and I’m there. Remember, there are many other hair docs who would benefit greatly from claiming your good work and artistry for their own were I to rent out to them my forehead and crown as an advert. Perhaps I should hold out for a 3/4 page or maybe an inside back cover. Thank you again for your time and attention to my skull. My wife sends her regards and hints that she needs another free shopping day so she’s hoping the front falls out. I’ll remind you that it was an inappropriate comment you made during my last session that all the other wives who drive their husbands get five free hours at the mall with the husband’s credit card. Through sessions one and two I had had her convinced her it was sufficient reward for her to share my salad at mid-surgery point.
Hi doctor. I tried many oral medicines such as zinc, biotine, vitamins, capsules till the level of acid increased in my stomach. So, my doctor recommended to directly stop any oral capsules for hair loss due to stomach and liver disfunction. I chose Propecia, but the results were catastrophic after 6 months of usage. A decreased sex drive with low ejaculation on a 22 years old male! I did a hormone test that shows the level of sperm and the testosterone had decreased by a massive 1/4. So why? I dont recommend this medicine that plays with a man’s hormone to any one! Recently, I am using tonic + conditioner from a German shampoo named “Kadus Imunal”. Have you heard about it doctor? It sounds very good in Germany due to its good results!
I have little to add to your comments, but I will note that this is not a common experience. I suspect that you are obsessing over your hair loss. Please search for Propecia here to find past blog entries related to this drug.
As for Kadus Imunal, it seems like just a series of shampoo and conditioners. I have no comment on their value.
Dear Dr. Rassman,
From all the information out there, I still can’t seem to find a clear and definite answer as to which products actually work in regrowing hair. I’m in my early 50’s and only have a bit of thinning going on around the crown area on top. Which product would be best for my situation? I would like to see it get thicker again in this area. Also, I’ve heard that using minoxidil may work for some, but ceasing use can actually cause more severe hair loss than before starting to use this product. Is this true?
Minoxidil works great in about 15% of people, but it must be applied twice daily. In about half of men there will be a mild effect. The older you get, the less effective Propecia is at regrowing hair, but when it works, it works well in the crown. Both of these medications must be maintained to hold their benefit and when they are stopped, the body loses all of the benefits in months and brings you back to the base line of hair loss, which is where your hair would be had you never taken the medications. For this reason, if it works, you must stay on it for life. There are dozens of other products sold with promises galore, provided you want to part with your money. Most products that are sold over the counter, if they work at all, have minoxidil in it, so I generally recommend buying minoxidil at the supermarket or Costco for far less money than when it is sold inside some other potion or lotion and not clearly marked.
I have been taking Topamax sprinkle capsules for my migraines for almost a year (onyl 45 mg per day). After the first few months on the drug, I noticed more hair on the floor in my bathroom and that it was falling out when I ran my fingers through it. In November of this year, I switched my birth control pills to Low Ogestrel,a low dosage monophasic pill so as to keep my hormone levels more stable and keep headaches at bay. After doing this, I noticed an increase in my hair loss. Now, in the shower, there is hair everywhere. Hair on my pillow, and hair on my clothes. I’ve noticed that my hair looks thin at my widows peak and on the sides of my head. It’s frightening. I got off the Topamax two weeks ago and the hair loss has continued. I am going off the birth control this month to see if that stops it.
Just wondering if you’ve ever heard of these drugs causing hair loss? Perhaps the combo of the two has wreaked havoc on my body for some reason? My doctors keep saying “It’s possible, but uncommon.” I’ve had all my bloodwork done and every checked out ok.. I just want this to stop. If it is the pills, how long before it will stop?
Thanks for any help!
Hair loss is associated with each and every one of the medications you use. I am sorry to report this to you, but these things have a cost in side effects and finding the balance can be difficult. Some people may be more sensitive than others. It may take months to see any regrowth after stopping or switching the medications. When medications are used in combination, it makes identifying the problem medication(s) more difficult.
I just turned 23, and I have expierenced hair lost for some time now. I would have to say beginning at 8th grade. The kids would make fun of me and tell me I needed rogaine. Well its obviously not stopping and my hair is not coming back. Its curly and long due to not having a hair cut in a while, and everytime I wash/condition my hair, I can see clumps come out everytime. My self esteem is way down and I have tried products before that just dont work. I even joined the Hair Club and spent lots of money for no improvement. U have any ideas/suggestions what I can do or what causes my loss so much. thanks.
This site is replete with answers to questions like yours. I sympathize with you and your problem, but you need to get to a good doctor who can work with you. Please look through this site for other suggestions, even using the search feature to target what you’re looking for. There are even comments and answers on hair loss in the younger man, many of which can be found in the Age category. You must take proper charge of finding the solution or you will continue searching aimlessly.
I want to know everything that you know about the connection between Hyaluronic Acid and hair loss. Why are there no products on the market combining this powerful connective tissue component with Minoxodil? Why can’t they just make a line of products that target hair loss from all ends, like tartar control, whitening toothpaste that fights gingevitis? By combining hyaluronic acid with collagen and minoxidil and DHT blockers wouldn’t hair be at its safest and sturdiest? Also, how come some people will have plenty of DHT and still not go bald? What is the specific chemical quality that constitutes vulnerability of a specific hair folicle to DHT? Instead of inhibiting DHT and affecting muscle mass, secondary sexual characteristics and sex drive, can’t the individual hair folicles be made immune to DHT’s causing hair growth to be inhibited. After all, isn’t DHT what made hair grow out of that folicle in the first place? I know I’m a bit of a hurricane, but I’m in love with a balding man and find myself as invested in his plights as he is, and I can see he is suffering from this.
I found an article on the FDA website which addresses hyaluronic acid. See Science Meets Beauty: Using Medicine to Improve Appearances and do a “find in page” (usually CTRL+F) to search for hyaluronic acid.
DHT is only bad when you are talking about hair loss in genetically prone individuals. Maybe one of our ancestors understood the benefit of balding, but we have not figured it out. There are many solutions for hair loss in men. Propecia is a great drug if the hair loss is caught early enough. Also, hair transplantation works well for many people (see Before and After photos).