Can you lose or damage the hair if using a hairbrush that hasen’t been cleaned for a long time?
Have you heard the old saying that cleanliness is next to godliness? Are you asking if you can damage your hair using a brush that has been in the drawer for a long time and then used on your hair without the brush being cleaned? Well, the answer is probably not. The question I’d wonder might be how old the brush really is and how long it has been since you used it last.
I am Asian. I lost all of the hair in the front. I understand that black hair and white skin (my situation) is more difficult to get good results. True or false?
True. Asian hair, which is often straight and black, is contrasted with a light skin color making the hair transplant less forgiving if it is done improperly. So while it is more difficult to get great results, it is not impossible. We have transplanted hair for many Asian patients over the years.
Here’s an example of one Vietnamese patient that has a Norwood class 6 pattern of hair loss. The photo on the left is before hair transplantation, the photo on the right is after 1 procedure of 1,852 grafts. Please click to enlarge.
Does follicular unit extraction (individual follicles are removed from the back of the head creating a tiny round punctate scar) and FUT (follicular unit Transplant – where by a strip of hair is removed creating a line scar) produce better grafts? In your experience, what procedure out of these two causes the least amount of damage and would better serve the interest of the patient at the end of the procedure?
Both techniques should give you real follicular units, but often the FUE in many doctor’s hands do not give real follicular units because they are transplanted as they are taken out (complete follicular units, more than one follicular unit, or parts of a follicular unit). Strip harvesting is better in most people, simply because the strip is highly efficient and very controlled in most doctors’ hands to prevent damage. FUE grafts are not always of the same quality as strip follicular units. The reason for that depends upon the particular patient and the particular method used for the extraction. In many patients, the grafts are extracted and devoid of fat and supporting infrastructure (very skinny grafts), which makes them more vulnerable to the environment and more easily damaged when transplanted.
Hi Doc, Happy Thanksgiving! I have read recently in some of your blogs that stress is one of the major causes of male pattern baldness (MPB). However, I have also been lead to understand that stress would normally induce a diffuse form of hair loss all over the head; and is reversible once the stressful period has subsided. So does this mean that an individual’s MPB can stop naturally in the same manner, if its primary cause is in fact due to stress? Would taking medications like Propecia or Rogaine help? Thank you so much for this clarification!
When a balding man develops accelerated hair loss from stress, then that hair loss is usually not reversible on its own without some medical intervention. If the hair loss is recent and the man is young (generally under 30), then it may be stopped or reversed with Propecia (possibly Rogaine, although less likely). Reversals is a hit or miss thing, but if the hair loss has been less than 2 years, the reversal is more probable than not.
The diffuse pattern hair loss you referenced and its association with stress is more with women and this may reverse on its own when the stress subsides, often without the use of medications but helped with such medications such as minoxidil. The woman’s reaction to stress hair loss is quite variable and may reflect the cause of the hair loss, the age of the woman, the use of medications that have participated in the hair loss, the existence of a variety of diseases that are known to produce hair loss (e.g. Thyroid), and the existence of any long term female genetic hair loss that may be present.
Hi,
I’ve recently had hair grafts on my temple areas for my male pattern baldness. This was just under 2 months ago. My recovery went as expected, with the graft scabs dropping off after a week. However the skin at these sites is still slightly red (on one side more than the other) and not back to its normal condition. According to all articles I’ve read on recovery, the graft sites should now be back to normal. I’ve spoken to the surgeon about this, and he assures me there’s nothing to worry about. I’m struggling to get an appointment with him to take a look. I’ve also noticed some of that my original hair at the graft sites is thinner than before the operation. I was assured during the pre-op consultation that my existing hair wasn’t at risk from the operation. Any advice for me? Is this something I should be worried about?
Thanks
Occasional redness that lasts beyond 2 months is seen on men who are histamine positive to a scratch test. This person will eventually see the redness fade, but it could take up to 6 months to get there. With regard to shock hair loss (that sounds like what you experienced), in men this hair does not usually come back, but hopefully the new hair will be enough to compensate for the shock loss when it grows in. I am frankly surprised how many people tell me that they can not get help from the doctors who transplanted them. I have never had that complaint and even those of you who are not my patients that write to me via this site get timely, responsive answers.
I recently had a hair transplant ( 25 ) days ago. I had a trichophytic closure in the back and other than itchyness i haven’t had any problems. But today ( 25 days post op ) I woke up and my donor suture are in back bleed a little on my pillow ( dime worth ). I have been obsessively carefull and have not done anything remotely athletic or strenuous since surgery. Why did this happen? The only thing i could think of is i sleeped high on my pillow and slowly slide down. Do i need to do anything different? Should i have it looked at? Ultimately my concern is, is this going to effect the healing / scaring in the end? Is it possible that just by sleeping wrong / sliding down my pillow could stretch apart my donor area and produce a bigger / wider scar this long after surgery.
FYI my sutures were removed 11 days after surgery.
You need to be evaluated by your doctor. I can not guess what is happening to you, but I could write a small book on the things that can cause donor bleeding, including infection, suture reactions to deep sutures, folliculitis, etc.
So please, go back to your doctor. If I was your doctor, I would be responsive and concerned and would want to see you myself.
Hello Doctor,
I’m a 28 y/o male, and I have a question reagarding genetic balding. I understand that MPB can skip generations, but based on your experience from treating many patients, how often have you seen cases of MPB on patients, whom claim to have no family history of balding? Is it very rare, like 1%? Or is it more common, like 20-30%? In my case, my father, and all uncles and both grandfathers has no balding. I appreciate your response.
I would be guessing that something in the order of 20% of men coming to my office report their inability to match the balding pattern they have in their family line. This may or may not be generation skipping. Sometimes, the actual balding pattern that is inherited is less or more than the worst in either side of the family. The other side of that coin is to respond by saying that more than half of balding men will recognize that their pattern existed in some male member of their family (father, grandfathers, uncle or brother).
“There are three general potential threats with Propecia: decreased libido or sex drive, erectile dysfunction and ejaculation disorders. Clinical tests showed that 1.8% of all men treated with Propecia experienced decreased libido, 1.2% – erectile dysfunction and 0.8% – decreased volume of ejaculated sperm.
Interesting to note that after 5 years of Propecia treatment, the above mentioned side effects disappear and only 0.3% of all patients still have them.”
Quote from site.
I am facing a decrease in libido during my first 3 days of propecia. What should i do, should i carry on taking it? it seems that the side effect dissapear, or should i stop it.
Stay the course for a month or so and see if the problem goes away. If not, I generally advise my patients to stop the drug for a week (everything should be back to normal) and then try taking a half a pill a day and see if that makes a difference. I would see the doctor who prescribed the Propecia to you and alert him/her of these problems.
I am a 26 year old male who has been mapped for miniaturization and on Propecia for a little over 3 months. I have noticed that most of the hair I shed does not contain the little white bulb at the end and appears to be thick terminal hair with a slightly tapered tip. Some of the hair shed is real short (about the width and length of an eyelash). Could this be some form of anagen effluvium or loose anagen syndrome? Thanks for your advice.
I am in the dark here, because I do not have you in front of me to see what you’re talking about. Speak with the doctor who mapped your hair for miniaturization and ask him/her how what you’ve observed relates to the mapping results. Do you have genetic hair loss?
I was just wondering when you can get a hair transplant. I’m 20 years old, male. My hair is falling and I’ve already started the propecia. I know that the propecia isn’t going to get me to where I am before so I just want to get a transplant. I don’t want to stick with where I’m at. There are no bald spots….just the scalp is visible all over when my hair is wet. My question is this…..can I get a hair transplant already or do i have to have a bald spot? Thanks a whole bunch.
You should be on Propecia (finasteride 1mg) for at least a year. You need to get your hair mapped out for miniaturization and follow the benefits or lack of benefits of the drug. Either you will:
Based upon the response to the miniaturization mapping, you need to develop a Master Plan with your doctor which will define the various paths open to you, including the timing of things you can do. Some men of your age will slow, stop, or reverse the hair loss on Propecia, while others may continue to bald at their own accelerated rate indicative of strong genetic and hormonal influences. There is no magic about hair transplants and if you are going to get really bald, then great care in how transplants are used is critical to being sure that you will always look normal, never trading short term benefits for your long term appearance. The Master Plan will lay out the transplant option and put it into perspective with projections on your hair loss which might be easy for a doctor with a great deal of experience in doing such predictions. 20 year old men are often less objective and less able to stand back and look at the long term hair loss process when they have short term needs (girls, self confidence), but some doctors see the money in it and may be willing to take your money to allow you to focus on short term agenda issues. That is in no man’s best interest. If you are unfortunate and have a very rapid hair loss process going on that is not benefited from Propecia, hair transplants could be the worst thing you could do right now. Please remember the following philosophy: A Good Decision Today is a Good Decision Tomorrow. Get a caring doctor who works with you on that Master Plan I discussed. I have done a few hair transplants in very young men (early 20s) but I am careful that I know what is happening to them and I learn a great deal about them as fellow human being before embarking on such a path.
For some time now, some studies show a possible link between finasteride and depression. A recent article, titled “Finasteride induced depression: a prospective study”, discussed this connection and was published in BMC Clinical Pharmacology and appeared online in early October.
Some of the relevant points from the article are:
5alpha-reductase is a critical enzyme in the conversion of several steroids such as testosterone, progesterone, aldosterone and corticosterone in the brain. This enzyme converts testosterone to the most natural potent androgen DHT, and also it acts an important role in conversion of progesterone to dihhydroprogesterone (DHP)…..A decline in serum DHT level occurs after finasteride administration. This may contribute to finasteride induced depression. We [the authors] couldn’t find any significant change in the anxiety scores before and after the treatment
The authors conclude: This preliminary study suggests that finasteride might induce depressive symptoms; therefore this medication should be prescribed cautiously for patients with high risk of depression. It seems that further studies would be necessary to determine behavioral effects of this medication in higher doses and in more susceptible patients.
For the complete article, see BioMed Central.
I was wondering if you could answer a question for me. I am a 26 y/o male who is very much into working out (running, weight training, etc). Unfortunately, I am in the beginning stages of MPB as well. I really have changed my whole life around to maintain the hair I have. That being said, I am very cautious about what I put into my body. I came across a supplement at GNC called naNOx9. I was wondering if you knew anything about this supplement, and if so…will it accelerate my hair loss or is it completely healthy? The ingredients are listed below….if you could answer this question for me I would really appreciate it. Dr Rassman, thank you for creating this blog…..I have gained much knowledge about hair loss that I would not ever know otherwise.
Serving Size 3 Caplet(s)
Servings Per Container 60Amount Per Serving % DV
naNOx9 3520.00 mg **
L-arginine*-xanthinol nicotinate **
L-arginine-ketoisocaproic acid-yohimbine HCl **
** Daily Value (DV) not established
Other Ingredients: hydroxpropryl cellulose, Silica, Artificial Flavor, Magnesium Stearate, Microcrystaliline Cellulose, Croscarmellose Sodium, Polyvinylpyrrolidone, vegetable stearine, coating (Polyvinyl Alcohol, Polyethylene Glycol, FD&C Red #40, Talc, Titanium Dioxide, FD&C Blue #2)
Here is the link to the product as well:
https://www.gnc.com/product/index.jsp?productId=2486356&cp=2348700.2325087&parentPage=familyThanks again Dr. Rassman!
Sorry, I do not know of naNOx9. For that matter, I don’t even know how to pR0noUNcE it. The list of ingredients are substantial and I can not attest to how one ingredient impacts another. You have to have faith in the product and the manufacturer and can not just look to a website for such assurance.
I’ll quote myself from a previous blog entry: Millions of dollars are spent on marketing supplements to a health conscious society and it gives a skewed perspective on our health and subliminally gives us the message that we need to take these extra supplements to make us better (lose weight, grow hair, increase our sex drive, build muscle, feel happy, get smarter, reverse aging). As long as things are not done in the extreme and it seems to help, there is nothing wrong with taking supplements. There is no hard medical science supplied which would support the majority of the claims.
yesterday afternoon my mom noticed that i had a patch of hair missing from the back of my head. i dont know if its a disease because my friend had the same problem but he had patches missing everywhere in his head and i dont know if im heading in that same direction. i hope not but it scared me when i found out i had a patch of hair missing. could you tell me what i could do to regain that hair back or what i should do to cure it? thank you for your time. have a nice day
I would like to have more information about your situation. A bald spot in two people who are friends could have environmental or infection causes. What is the age of you and your friend, do you share the same living space (apartment or house), how long have the patches been there? Are they progressive (getting larger) or are they stable and getting better? Are the patches punch like with sharp edges or irregular patches along their rim? Is there any hair inside the patches? I would like to see some photos of these patches. I might be able to give a better indication after seeing the photos, but it might be easier and better to see a good dermatologist in your area and get to the root of the problem. As you can see from my questions, making a diagnosis over the internet can be a problem and a visit ‘one on one’, with a good doctor is the best way to go.
In a recent article in Journal of the American Academy of Dermatology (J Am Acad Dermatol. 2006 Dec;55(6):1014-1023), dutasteride and finasteride were compared over a limited 12 week and 24 week study in 500 men in a study which had also compared placebo effects. The authors of the article are Olsen EA, Hordinsky M, Whiting D, Stough D, Hobbs S, Ellis ML, Wilson T, Rittmaster RS; for the Dutasteride Alopecia Research Team.
Based upon photographs taken, dutasteride was superior to finasteride in this time frame. Dutasteride blocks both Type one and Type two receptors and the suggestion of the authors was that the combined block of these two receptors may be better than a block of one receptor in reversing the process. Clearly, the study needs to be extended well beyond 24 weeks.
The long term safety of Type 1 clocking for DHT production is safe and there is a natural model both genetically and through eating finasteride, but no comparable model exists for the DHT block of both receptors for safety, as the study above just discusses limited views of efficacy. The FDA’s position is still that dutasteride is not an approved drug for treating hair loss.
I was recently diagnosed with excess cortisol (adrenal fatigue) and hypo-thyroidism due to the production of excess cortisol in my body. Can this combo of excess cortisol and hypothyroidism cause color and texture changes to my hair, reduce facial growth and thin/miniaturize my whole scalp hair in a uniformed global fashion?
Adrenal fatigue syndrome is a condition with diverse manifestation. In this condition, hair tends to get thin, wispy and dry. You may also experience some hair loss. In low thyroid function, hair tends to get more coarse and sparse and may become wavy or the hair color may change. You can find a nice table of information here.
For more information, you should see an endocrinologist.